How the Urban Neighborhood Environment Influences the Quality of Life of Chinese Community-Dwelling Older Adults: An Influence Model of “NE-QoL”

Abstract

Due to functional impairment and low mobility, the sphere of activities of older adults often shrinks and they rely on their living environment more. Especially for urban community-dwelling older adults who are aging in place, the urban neighborhood environment affects their quality of life (QoL) heavily. This study aims to explore how the urban neighborhood environment affects QoL of community-dwelling older adults and develop a mediation model called "Neighborhood Environment-Quality of Life (NE-QoL)" for community-dwelling older adults. The reliability test is applied to test and modify the questionnaire based on cross-sectional data collected from the survey, the multiple regression analysis is used to identify significant influence relations between variables of neighborhood environment and dimensions of the QoL, mediation effects are assumed and tested by the mediation analysis in SPSS, and then the "NE-QoL" is developed to reveal the detailed influence path between the urban neighborhood environment and QoL of community-dwelling older adults. The "NE-QoL" model reveals seven variables of the urban neighborhood environment, which influences the QoL of community-dwelling older adults significantly, and three mediation effects exist in the influence path, making clear the understanding about the relationship between neighborhood environment and the QoL of community-dwelling older adults. It provides valuable retrofit guidelines of the neighborhood environment for improving QoL of community-dwelling older adults.

Neighborhood Attributes and Well-Being Among Older Adults in Urban Areas: A Mixed-Methods Systematic Review

“…The most salient feature in the studies was the presence of and access to natural areas, such as green and blue spaces ( Table 2 —a more detailed table is provided in Supplemental Appendix 4). Natural areas were associated with well-being in three out of four quantitative studies ( Sugiyama & Thompson, 2006 ; Yu et al, 2019 ; Zhang & Li, 2019a , 2019b ). These spaces were also strongly associated with enjoyment and reflection in qualitative studies, as they provide pleasurable passive interactions, including observing people, engaging in small talk, or sometimes offering small snacks (e.g., fruit) to others ( Coleman & Kearns, 2015 ; Ottoni et al, 2016 ).…”

“…Yan et al, 2015;Yan et al, 2014). In the remaining four, no significant effect was identified (Au et al, 2020;Smith & Gauthier, 1995;Zhang et al, 2019;Zhang & Li, 2019a, 2019b. The importance of good transit services and low floor vehicles was also highlighted in two qualitative studies (Coleman & Kearns, 2015;Finlay et al, 2018;Keene & Ruel, 2013).…”

Multiple Linear Regression-Structural Equation Modeling Based Development of the Integrated Model of Perceived Neighborhood Environment and Quality of Life of Community-Dwelling Older Adults: A Cross-Sectional Study in Nanjing, China

“…As mentioned above, descriptive items of factors of perceived neighborhood environment have been validated by "NE-QoL" model [33], and descriptive items of domains of QoL have been validated by WHO [12]. Thus, it was not necessary to conduct a validation test, but the reliability test was still essential to check the reliability of the questionnaire.…”

“…Since these factors are professional concepts which may be hard to understand by many older adults, their perception of factors of the neighborhood environment cannot be measured directly. Thus, several descriptive items were designed to describe the perception with neighborhood environment in detail, which have already been validated [33]. Neighborhood environmental factors and descriptive items are shown in Figure 1.…”

Quality of Life (QoL) Effects of Sustainable Transport Policy Framework in Developing Economies

“…Zhang and Li [64] Neighborhood environment Accessibility to facilities, sidewalk condition, neighbor support, safety, etc Wann-Ming [58] Space, humanity, functionality, social connectivity Architectural planning space, space organization and accessibility, and green space; the relationship between people and society Han et al [23] Social environment, natural environment, transport accessibility Population density, the convenience of essential facilities, green space, distance to nearest public transit stations Nakamura [36] Access, amenity, safety, and cost Access to work, shop, school, and hospital; house size, streetscape, and green space; accident, crime, flood, and pollution; rent Putra and Sitanggang [42] Insurance, empathy, reliability, responsive, tangible, comfort Drivers' knowledge, security, drivers' help for passengers, waiting time, traveling time, information system, convenient service, cleanliness, first-aid facilities, appearances, seating availability, public transport using Air Condition Gunaruwan and Jayasekera [22] Social sustainability, health, education, and accessibility Maternal mortality, infant mortality, literacy, and life expectancy; bus kilometers millions per 10,000 population Jaskiewicz and Besta [24] Mobility (public transportation usage) Lack of care, level of availability, comfort, independence, reliability, meeting people, pride, safety Kim and Ulfarsson [29] ** Socio-demographics, health, neighborhood environment, transit stations, health Saxena et al [44] Physical health, psychological health, social relationship, and environmental Daily activities, energy, fatigue, dependence, discomfort; leisure activities, transport, physical environment, etc Schneider et al [46] Access, design, environmental issues, maintenance, mobility, safety, and transparency Traffic flow, commute time, construction, congestion, travel time within and between communities, etc de Groot and Steg [9] ** Comfort, status, security, health, social justice, freedom, privacy, safety, work (22 indicators) Mollenkopf et al [34] Socio-structural, health-related, psychological factors, environmental conditions, and features of the person-environment interaction 97 parameters are defined (availability, security, social network)…”