Mobility Disability and the Urban Built Environment

Clarke, Philippa; Ailshire, Jennifer; Bader, Michael; Morenoff, Jeffrey D.; House, James S.

doi:10.1093/aje/kwn185

Cited by 230 publications

(209 citation statements)

References 30 publications

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“…Several studies have documented associations between different health outcomes and neighborhood characteristics, after accounting for differences in individual-level characteristics across neighborhoods. Such associations have been reported for a diversity of health outcomes including cardiovascular diseases [7][8][9] , mortality 10,11 , mental health outcomes [12][13][14][15][16] , physical activity 17,18 , and perceived health 19 , among others [20][21][22] . Many studies have used census-based indicators, constructed by aggregating the socioeconomic characteristics of residents as proxies for the more specific neighborhood features hypothesized to be relevant to health.…”

Section: Introductionmentioning

confidence: 97%

Assessing the Psychometric and Ecometric Properties of Neighborhood Scales in Developing Countries: Saúde em Beagá Study, Belo Horizonte, Brazil, 2008–2009

et al. 2012

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Although specific measurement instruments are necessary to better understand the relationship between features of neighborhoods and health, very few studies have developed instruments to measure neighborhood features in developing countries. The objective of the study was to develop valid and reliable measures of neighborhood context useful in a Latin American urban context, assess their psychometric and ecometric properties, and examine individual and neighborhood-level predictors of these measures. We analyzed data from a multistage household survey (2008)(2009) conducted in Belo Horizonte City by the Observatory for Urban Health. One adult in each household was selected to answer a questionnaire that included scales to measure neighborhood domains. Census tracts were used to proxy neighborhoods. Internal consistency was evaluated by Cronbach's alpha, and multilevel models were used to estimate ecometric properties and to estimate associations of neighborhood measures with socioeconomic indicators. The final sample comprised 4048 survey respondents representing 149 census tracts. We assessed ten neighborhood environment dimensions: public services, aesthetic quality, walking environment, safety, violence, social cohesion, neighborhood participation, neighborhood physical disorder, neighborhood social disorder, and neighborhood problems. Cronbach's alpha coefficients ranged from 0.53 to 0.83; intraneighborhood correlations ranged from 0.02 to 0.53, and neighborhood reliability varied from 0.76 to 0.99. Most scales were associated with individual and neighborhood socioeconomic predictors. Questionnaires can be used to reliably measure neighborhood contexts in developing countries.

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Section: Introductionmentioning

confidence: 97%

Assessing the Psychometric and Ecometric Properties of Neighborhood Scales in Developing Countries: Saúde em Beagá Study, Belo Horizonte, Brazil, 2008–2009

et al. 2012

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“…26,27 One study in the city of Chicago found that older adults with movement-related impairments had a fourfold higher odds of reporting severe difficulty walking when living in neighborhoods with streets in poor condition (e.g., cracks, broken curbs, potholes) compared to those living in neighborhoods with streets in good condition. 28 Another study of older adults living in the Houston area found that curb cuts and bus shelters were non-existent in the vast majority (75 %) of respondent neighborhoods and fewer than 10 % of respondents used public transportation even though close to half of these adults lived within two blocks of a bus stop. 16 Curb cuts, smooth pavement, and barrier-free sidewalks are just some of the many environmental factors that can enhance independence and social participation in older adults at greatest risk, such as those who are socially isolated, prone to falling, or those with underlying weakness in movement-related functions and balance.…”

Section: Introductionmentioning

confidence: 99%

Optimizing Mobility in Later Life: The Role of the Urban Built Environment for Older Adults Aging in Place

Clarke

Gallagher

2013

J Urban Health

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Hazards in the urban built environment can create barriers to mobility among older adults aging in place. We investigated the relationship between urban built environment characteristics and 15-month trajectories of mobility disability in a sample of 1,188 older adults living in Detroit, MI, a city that has undergone rapid economic and structural decline. Data come from the Michigan Minimum Data Set for Home Care (2001Care ( -2008, an enumerative database of older adults in Michigan who qualify for federal or state-funded home and community-based long-term care through a Medicaid waiver program. Standardized assessments are made at intake and every 90 days by case managers. Built environments were assessed with a virtual audit using the "Street View" feature of Google Earth. A summary accessibility score was created for each block based on a count of the number of accessible features (e.g., continuous barrier-free sidewalks and proximity of public transportation). Using growth mixture models, two latent trajectories of outdoor mobility were identified: one capturing occasional outdoor mobility (representing 83 % of the sample) and one capturing almost no mobility outside the home. Controlling for sociodemographic and health risk factors, individuals living in more accessible environments had a 18 % higher odds of being in the more mobile group (OR01.18, 95 % CI01.01, 1.41). These findings emphasize the importance of the built environment for mobility among urban-dwelling older adults.

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“…Several of them also expressed their fear of falling when getting around, specifi cally because of a loss of balance, which occurs frequently in individuals with a TBI, regardless of age [19,37,38]. Insecurity and fear of suffering a fall are cause for concern for seniors with or without a TBI and are described as determining factors when choosing a neighborhood or a place to visit [5,7,[42][43][44][45][46][47]. Being able to move, getting out, and planning outings are essential to seniors since they promote improved cognitive and functional abilities, better quality of life, and physical health [7,8,48].…”

Section: Discussionmentioning

confidence: 99%

Towards a better understanding of the impact of the sequelae of TBI on the social participation of seniors

Levert¹

2017

Arch Nursing Pract Care

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CC By 068Citation: Levert AbstractBackground: The multiple sequelae caused by traumatic brain injuries (TBIs) can considerably reduce the ability of seniors to resume their activities of daily living and their leisure activities, and to return to meaningful relationships so they can participate in the life of their community. Purpose of the study:This article aims to put forward the perceptions of older participants about the sequelae they themselves identify as consecutive, short or medium long term, with their TBI and consequently, the limitations they experienced in terms of their social participation. Results:The fi ndings reveal a correspondence between the multiple sequelae of the TBI identifi ed by the participants and those documented in the scientifi c writings. These sequelae could be grouped according to the limitations found in the operational framework's three spheres of activities related to social participation: those that promotes self-realization through an autonomous and independent everyday life; through pastimes and leisure activities; and through relationships with others. Main fi ndings:The fi ndings are innovative compared with what is generally described in the scientifi c literature, since existing studies offer few concrete examples of the limitations encountered in terms of social participation due to sequelae following a TBI. Four sequelae namely memory loss, loss of balance, lack of motivation or apathy and fatigue, appear to have many impacts on a variety of activities which could explain their signifi cance for participants. Conclusion:The fi ndings pave the way for new research avenues that focus on analyzing social participation opportunities of older adults by reinforcing their capacities. Potential implications:Results provide benchmark for health care and social services professionals for the mobilization of most effective resources and services to help seniors to engage in rewarding, meaningful social participation activities.

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Mobility Disability and the Urban Built Environment

Cited by 230 publications

References 30 publications

Assessing the Psychometric and Ecometric Properties of Neighborhood Scales in Developing Countries: Saúde em Beagá Study, Belo Horizonte, Brazil, 2008–2009

Assessing the Psychometric and Ecometric Properties of Neighborhood Scales in Developing Countries: Saúde em Beagá Study, Belo Horizonte, Brazil, 2008–2009

Optimizing Mobility in Later Life: The Role of the Urban Built Environment for Older Adults Aging in Place

Towards a better understanding of the impact of the sequelae of TBI on the social participation of seniors

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