Objectives-To examine the role of neighborhood social conditions and walking in communitydwelling older adults. Methods-A multi-level analysis of data from 4,317 older adults (mean age = 74.5; 73% black) from a geographically-defined urban community. Participants completed structured interviews including 14 questions on neighborhood conditions and self-reported walking. The neighborhood questions were summarized into individual-level measures of perceived neighborhood social cohesion and disorder. These measures were aggregated by neighborhood to construct neighborhoodlevel measures of social cohesion and disorder.Results-Neighborhood-level disorder, but not social cohesion, was significantly associated with walking, independent individual-level neighborhood perceptions and other correlates of walking. Further adjustment for race weakened this association to a marginally significant level.Discussion-Neighborhood conditions may shape walking behavior in older adults, especially conditions that reflect physical neglect or social threat. Promotion of walking behavior in older adults may require improvement of the safety and upkeep of the neighborhood environment. Keywordsaging; neighborhood conditions; walking; physical activity; multi-level modelsThe benefits of regular physical activity are well established, and have been documented for health outcomes at all stages of life (Bouchard, Blair, & Haskell, 2007; U.S.Department of Human Services, 1996). Among older adults, regular physical activity is associated with a reduced risk in mortality and aging-related decline in physical and cognitive function (Boyle, Buchman, Wilson, Bienias, & Bennett, 2007;Kramer et al., 1999;Kushi et al., 1997; U.S.Department of Human Services, 1996). Walking is by far the most predominant mode of physical activity among older adults (McPhillips, Pellettera, Barrett-Connor, Wingard, & Criqui, 1989; U.S. Department of Human Services, 1996), and associated with beneficial health Simonsick, Guralnik, Volpato, Balfour, & Fried, 2005;Weuve et al., 2004). In addition, impairments in walking and overall mobility are thought to be a critical early stage of the disablement process in this population (Ferrucci et al., 2000;Lawrence & Jette, 1996;Simonsick et al., 2005).There is a growing recognition that various aspects of the neighborhood environment may account for individual differences in physical activity (Brownson, Baker, Housemann, Brennan, & Bacak, 2001;Humpel, Owen, Iverson, Leslie, & Bauman, 2004. People's perceptions of the neighborhood, such as walkability, safety, and friendliness, have been found to be correlated with overall physical activity and walking (Ball, Bauman, Leslie, & Owen, 2001;Cerin, Saelens, Sallis, & Frank, 2006;Humpel et al., 2004;King et al., 2000;King et al., 2003;Owen, Humpel, Leslie, Bauman, & Sallis, 2004). Features of the built environment related to the design of the urban landscape and land use mix may also be associated with physical activity levels (Atkinson, Sallis, Saelens, Cain, & Black, 2005...
552Research on the contribution of neighborhood characteristics to individual health has progressed rapidly over the last decade. Mounting empirical evidence of neighborhood socioeconomic structure (SES) effects on a range of adult outcomes including mortality (Haan, Kaplan, and Camacho 1987), heart disease (LeClere, Rogers, and Peters 1998), number of chronic conditions (Robert 1998), and self-rated health (Malmstrom, Sundquist, and Johansson 1999) has fueled calls for continued research on the health effects of multiple dimensions of community SES and the mechanisms that may account for the community structure-health link (Robert 1999). Despite these efforts, neighborhood effects research on health has typically focused on only one dimension of neighborhood structure-the prevalence of economic deprivation-and has yet to explore competing hypotheses regarding the community level mediators of structural effects on health.We draw on social disorganization and collective efficacy theory (Shaw & McKay 1969;Sampson, Raudenbush, and Earls 1997), Wilson's theory of neighborhood decline (Wilson 1987;, and research exploring the health effects of neighborhood context to elaborate and test two sets of hypotheses. First, we extend the typical focus on the health consequences of neighborhood poverty to include a range of other structural characteristics of neighborhoods including the concentration of affluence, residential stability, and ethnic heterogeneity. Our focus on the role of affluence, in particular, builds on recent theory and research highlighting the potentially important role of middle and upper-middle class residents in anchoring community institutions and providing organizational and economic resources with which to promote a healthy environment (Cagney, Browning, and Wen 2002; Robert 1998). Wilson's theory of social
Population-based studies of health often use education as the sole indicator of socioeconomic status (SES); the independent contributions of education and other SES covariates are rarely delineated. Using Wave 1 of the Asset and Health Dynamics Among the Oldest Old study, the authors examined the extent to which educational attainment influences performance on three separate domains of cognitive status by race and Latino ethnicity and introduced controls for wealth and household income. Results indicate that the education effect is minimally weakened after adjusting for wealth; the wealth effect, however, is greatly attenuated after adjusting for education. Blacks and Whites exhibited a similar education--cognition relationship; Latino elderly did not experience commensurate gains in cognitive function with increasing education. Results suggest that although the education--cognition relationship may in part reflect an SES gradient, the association is more likely due to the process and consequences of education itself.
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