Physical Activity, Socioeconomic Status, and Perceptions of Neighborhood Safety in Older Adults

Author(s): Kealey, Melissa | Advisor(s): Satariano, William A | Abstract: BackgroundMobility, "the ability to move oneself [e.g., by walking, by using assistive devices, or by using transportation) within community environments that expand from one's home, to the neighborhood, and to regions beyond" (Webber, Porter et al. 2010) ], is important to healthy aging. Walking, both for recreation and for transportation, has been suggested to be a particularly accessible, affordable, and safe way to be physically active. It is important to understand the barriers to and supports for walking in one's neighborhood for older adults. Neighborhood socioeconomic status and other neighborhood characteristics, such as perceived safety from crime, are associated with walking and physical activity. Health symptoms may also be important determinants of walking and physical activity for older adults. Objectives1. Determine to what extent objective and perceived neighborhood characteristics of older adults vary by the socioeconomic status of the neighborhood. Determine what objective neighborhood and personal characteristics are associated with perceived neighborhood safety in older adults. 2. Determine the leading health symptoms reported by older people as causing difficulty when walking outdoors.3. Determine the different physical activities engaged in by older men and women. Determine the association between both neighborhood socioeconomic status and perceived safety from crime and physical activity.MethodsThe study titled "Environmental Correlates of Physical Activity among Older Adults: A Healthy Aging Research Network (HAN) Collaboration" (referred to in this dissertation as the "HAN Walking Study") was designed to examine how the neighborhood environment may influence physical activity and walking behavior in older adults, and how this relationship may be modified by the functional capacity of older adults. Data were collected from 884 older adults at four sites across the country, from a diversity of physical environments. Data collection included in person interviews, lower-body functional capacity testing, accelerometers, walking diaries, and secondary GIS data. Results1. Participants living in neighborhoods of low socioeconomic status (low SES) have objectively shorter block lengths, higher housing density, and more businesses. Participants living in low SES neighborhoods perceive that they are less safe from crime and traffic. They also perceive that their neighborhood is more densely populated with greater percentages of apartments and condominiums. Perceived crime safety is associated with both neighborhood characteristics as well as the characteristics of the people who live there. 2. Most participants report multiple barriers to walking outside. Overall, 95.5% report at least one health symptom or other barrier to walking, with a range of 0-37 and a mean of 7.9 barriers.3. The most frequent types of activity reported by both women and men are light housework (93.0%) and shopping or running errands (93.0%), followed by walking at a normal or leisurely pace (77.7%). In a combined model, crime safety, but not neighborhood poverty or primary type of neighborhood housing, is associated with physical activity. ConclusionsWalking is engaged in by the majority of both older men and women in this study. However, they perceive multiple barriers to walking. Neighborhood determinants of walking may be one pathway through which neighborhood socioeconomic status influences health outcomes. Perceived safety from crime is possibly an important neighborhood determinant of walking and physical activity. Further research is needed to determine how changes in neighborhoods as well as other interventions may reduce barriers and lead to increased walking behavior in older adults.