BACKGROUND
Understanding the relationship between structural and social features of the neighborhood environment and activity engagement is important to the goal of creating healthy communities that enable older adults to retain their health and independence. Recent studies of environmental influences on physical activity in older adults have shown the importance of objective neighborhood characteristics (i.e., the “built” environment), as well as individual perceptions of their neighborhood such as access to resources, safety from crime and social cohesion. Neighborhoods and Senior Health (NASH) was a cross-sectional, multi-level study designed to understand the relationships among objective neighborhood features and individual perceptions associated with individual activity engagement.
OBJECTIVE
We examined whether neighborhood features and resident perceptions of neighborhood walkability, safety and social cohesion were associated with self-reported walking for errands, total physical activity and general community-based activity (including sedentary activities).
METHODS
We mailed invitations to adult Kaiser Permenante members, aged 65 years or older, who resided in 8 Denver neighborhoods that were selected to vary on walkability, crime, average household income, and proportion of elderly residents. Consented participants received mailed surveys that included subscales from the Neighborhood Environment Walkability Scale (NEWS), to assess perceptions of neighborhood walkability. Social cohesion was measured using a 5-item scale that assessed trust, reciprocity and shared values among neighbors. Activity engagement outcomes were measured using the Community Health Activities Model Program for Seniors (CHAMPS). Walking audits were conducted in each neighborhood using pedestrian items from the Systematic Pedestrian and Cycling Environment Scan (SPACES) instrument and social capital items from the Neighborhood Brief Observation Tool (NBOT). Additional items deemed relevant to an elderly population (e.g., curb-cuts; driver behavior) were added, for a total of sixty items.
RESULTS
Surveys were completed by 190 older adults (mean age 74). Two-level hierarchical analyses, controlling for age, sex, income and health, and clustering of participants within neighborhood, indicated that variables promoting walkability were associated with greater frequency of walking for errands (p<.05), however, calories expended in total physical activity were insufficient to meet health objectives. Contrary to expectations, total physical activity and community-based activity were highest in less walkable neighborhoods and were associated with more recreational facilities (p<.01) and fewer incivilities (p<.05) (e.g., graffiti and abandoned buildings). These relationships appeared to operate through perceived social cohesion and perceived safety from crime (p<.01).
CONCLUSIONS
For older adults, the importance of characteristics of the built environment in promoting physical activity and general activity-engagement may be secondary to attributes of the social environment that promote perceptions of safety and social cohesion. Thus, interventions that build trust and a sense of community among neighbors may be key to increasing physical activity and other forms of activity engagement that are important to maintaining health and independence throughout the lifespan.
