Aging in neighborhoods differing in walkability and income: Associations with physical activity and obesity in older adults

Abstract

While there is a growing literature on the relations between neighborhood design and health factors such as physical activity and obesity, less focus has been placed on older adults, who may be particularly vulnerable to environmental influences. This study evaluates the relations among objectively measured neighborhood design, mobility impairment, and physical activity and body weight in two U.S. regional samples of community dwelling older adults living in neighborhoods differing in walkability and income levels. An observational design involving two time points six months apart was employed between 2005–2008. U.S. Census block groups in Seattle-King County, Washington and Baltimore. Maryland-Washington DC regions were selected via geographic information systems to maximize variability in walkability and income. Participants were 719 adults ages 66 years and older who were able to complete surveys in English and walk at least 10 feet continuously. Measurements included reported walking or bicycling for errands (i.e., transport activity) and other outdoor aerobic activities measured via the CHAMPS questionnaire: accelerometry-based moderate-to-vigorous physical activity; reported body mass index; and reported lower-extremity mobility impairment measured via the Late-Life Function and Disability Instrument. Across regions, time, and neighborhood income, older adults living in more walkable neighborhoods had more transport activity and moderate-to- vigorous physical activity and lower body mass index relative to those living in less walkable neighborhoods. The most mobility-impaired adults living in more walkable neighborhoods reported transport activity levels that were similar to less mobility-impaired adults living in less walkable neighborhoods. The results add to the small literature aimed at understanding how neighborhood design may influence physical activity and related aspects of health linked with day-to-day function and independence as people age.

An Area-based Median Household (or Family) Income as a Measure of Neighborhood Affluence-Deprivation Continuum within US Cities

“…As discussed above, the same analogy may be used to infer a potential conflict of interest in the use of composite measure (e.g., Diez Roux et al 2001;Krieger et al 2003;Singh 2003;Winkleby and Cubbin 2003;Messer et al 2006) versus single measure (e.g., Galea et al 2007;Stockdale et al 2007;Tonorezos et al 2008;Sallis et al 2009;Black and Macinko 2010;King et al 2011) of neighborhood socioeconomic characteristics in previous studies. Figures 1 through 4 suggest that an area-based median household (or family) income in a regression analysis would convey the same information as that of selected composite measures considered in this study, despite the conceptual and theoretical differences.…”

“…For instance, area-based indexes of socioeconomic advantage (SEA) (Diez Roux et al 2001), socioeconomic status (SES) (Winkleby and Cubbin 2003), socioeconomic position (SEP) (Krieger et al 2003), socioeconomic deprivation (SED) (Singh 2003), and deprivation (DEP) (Messer et al 2006), among others, have been developed by different authors in the US (Table 1). Of equal importance, a single measure of neighborhood socioeconomic characteristics (i.e., an area-based median household or median family income) has also been used in some studies (e.g., Galea et al 2007;Stockdale et al 2007;Tonorezos et al 2008;Sallis et al 2009;Black and Macinko 2010;King et al 2011) instead of a composite measure. Therefore, a natural question arises: do single and composite measures of neighborhood socioeconomic characteristics capture the same dimension of neighborhood context?…”

What can local authorities do to improve the social care-related quality of life of older adults living at home? Evidence from the Adult Social Care Survey

“…Adapted toilets, showers, and lifting equipment have been suggested as home modifications which improve the independence and quality of life of older adults (McCullagh, 2006). Finally, it has been found that 'going outdoors' by older adults is supported by neighbourhood and public transportation attributes such as bus stop locations, transport fares and scheduling, adequate handicap parking, pedestrian infrastructure, proximity to shops and services and feelings of familiarity and safety (McCluskey, Thurtell, Clemson, & Kendig, 2011;Shigematsu et al, 2009;Van Cauwenberg et al, 2012;King et al, 2011). Characteristics of places are not only physical, they have social and emotional meaning (Wiles, 2005), and for older people it seems important to have choices about where and how they age in place .…”

Associations between time spent in green areas and physical activity among late middle-aged adults

“…For older adults, being confident to be physically active and having social support is positively correlated with PA, while feeling too old has an adverse effect (Bauman and Bull, 2007;Carlson et al, 2012). Next to individual characteristics, the relation of neighbourhood built environment factors and PA has been widely studied in the past, mainly showing that people living in highly walkable neighbourhoods tend to be more physically active (Berke et al, 2007;Frank et al, 2010;King et al, 2011;Marshall et al, 2014;Van Holle et al, 2014;Marquet and Miralles-Guasch, 2015). However, a study based on a national survey on Canadian adults reports that there is a positive association between neighbourhood greenness in a 500 m buffer around the home location and leisure-time PA (McMorris et al, 2015).…”