Built Environment Correlates of Physical Activity and Health in Older Adults
Date of Award
Brown School of Social Work
Doctor of Philosophy (PhD)
Background and purpose. Physical inactivity in the fast-growing populations of middle-aged and older adults will increase chronic disease burden, functional limitations, and health care costs. Individually oriented interventions are costly and difficult to sustain. Environmental approaches may provide a greater yield because they can be applied to entire communities. The specific aims were to: 1) conduct a review of built environment measures used in older adult studies; 2) determine built environment correlates of physical activity among middle-aged and older adults with and without arthritis; and 3) test for associations of built environment characteristics with metabolic risk in middle-aged and older adults.
Methods. A literature search of multiple electronic databases identified 125 studies published January 2000 through December 2011 that tested relationships of built environment characteristics with physical activity or health among older adults. Secondary analyses of archival health and spatial cross-sectional data were conducted among middle-aged volunteers living in a 12-county area encompassing Dallas, Fort Worth, and Austin, Texas. Generalized estimating equations were modeled to test relationships of built environment characteristics with physical activity and metabolic risk while adjusting for individual characteristics.
Results. In Aim 1, built environments measures were typically developed for any-aged adults with a variety of methods and spatial scales. Walkability and presence of recreational, retail, and service destinations were well assessed at a community-scale for urban design and land use policies but few street-scale measures addressed older adults' varying gait speeds and functional abilities. Meeting total physical activity recommendations was positively associated with presence of a park and a composite index for recreational activity conduciveness among those with self-reported arthritis. Meeting criteria for metabolic syndrome was negatively associated with numbers of private exercise facilities near home and a composite recreational activity conduciveness index.
Implications. More emphasis on street-scale pedestrian infrastructure features of the built environment is needed to address potential environmental sensitivity to the built environment by subgroups of older adults. The field is still identifying which characteristics of the built environment best facilitate physical activity and healthy aging in middle-aged and older adults.
Chair and Committee
Ross C Brownson
Ellen F Binder, Jenine K Harris, J. Aaron Hipp, Christine M Hoehner, Nancy Morrow-Howell
Allen, Margaret, "Built Environment Correlates of Physical Activity and Health in Older Adults" (2012). Arts & Sciences Electronic Theses and Dissertations. 271.