Built Environment and Mobility of Older Adults: Important Policy and Practice Efforts

As people age, they prefer to “age in place.” The concept of aging in place refers to the ability to live in one's own home, wherever that might be, for as long as one can feel confident and comfortable. Where people live and whether these environments can support them are critical questions for public health and public policy, especially since the baby boomers began to turn 65 on January 1, 2011. Equally important for public policy, those aged 85 and older are the fastest growing population group in the United States. The Health and Aging Policy Fellows Program, with the Centers for Disease Control and Prevention Healthy Aging Program, has supported a project to determine how design features of the built environment can support the mobility of older adults. Mobility refers to physical activity, usually walking, but also encompasses the ability to stay connected to nearby community resources and services. The project's purpose is to investigate features that support mobility in built environments. This policy brief introduces the realist synthesis method used in the project and selected national initiatives and activities to place this work in a broader context. Given the importance of mobility concerns to older adults, it must be determined without delay which design features support mobility and how local areas can better prepare to support the health of their aging populations.

[1]  G. Kaplan,et al.  Neighborhood social environment and risk of death: multilevel evidence from the Alameda County Study. , 1999, American journal of epidemiology.

[2]  S. Kane,et al.  Realist review and synthesis of retention studies for health workers in rural and remote areas , 2011 .

[3]  Leading Health Indicators for Healthy People 2010: Final Report , 1999 .

[4]  Jana Lynott,et al.  Getting Out and About: The Relationship Between Urban Form and Senior Travel Patterns , 2009 .

[5]  Barbara McCann,et al.  Planning complete streets for an ageing America , 2009 .

[6]  J. Stoker,et al.  The Department of Health and Human Services. , 1999, Home healthcare nurse.

[7]  Brian N. Fildes,et al.  Safety of older pedestrians , 2004 .

[8]  Denis A. Evans,et al.  Neighborhood Social Cohesion and Disorder in Relation to Walking in Community-Dwelling Older Adults , 2009, Journal of aging and health.

[9]  J. Connelly,et al.  A systematic review of controlled trials of interventions to prevent childhood obesity and overweight: a realistic synthesis of the evidence. , 2007, Public health.

[10]  K. Powell,et al.  The Effectiveness of Urban Design and Land Use and Transport Policies and Practices to Increase Physical Activity: A Systematic Review. , 2006, Journal of physical activity & health.

[11]  Dongseok Choi,et al.  Measuring the influence of built neighborhood environments on walking in older adults. , 2006, Journal of aging and physical activity.

[12]  Sara Wilcox,et al.  The Prevention Research Centers Healthy Aging Research Network , 2005, Preventing chronic disease.

[13]  Alan E Hubbard,et al.  Lower-body function, neighborhoods, and walking in an older population. , 2010, American journal of preventive medicine.

[14]  Kimberly A. Eccles,et al.  Pedestrian Signal Safety for Older Persons , 2007 .

[15]  A. Pisarski Commuting in America II: The Second National Report on Commuting Patterns and Trends , 1996 .

[16]  Leslie A Perdue,et al.  Neighborhood environment in studies of health of older adults: a systematic review. , 2009, American journal of preventive medicine.

[17]  M. Pratt,et al.  Policy as intervention: environmental and policy approaches to the prevention of cardiovascular disease. , 1995, American journal of public health.

[18]  E. Barrett-Connor,et al.  Exercise patterns in a population of older adults. , 1989, American journal of preventive medicine.

[19]  Fuzhong Li,et al.  Neighborhood-level influences on physical activity among older adults: a multilevel analysis. , 2004, Journal of aging and physical activity.

[20]  Ray Pawson,et al.  Evidence-based Policy: The Promise of `Realist Synthesis' , 2002 .

[21]  Laura Kettel Khan,et al.  Recommended community strategies and measurements to prevent obesity in the United States. , 2009, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[22]  A. Rosso,et al.  The Urban Built Environment and Mobility in Older Adults: A Comprehensive Review , 2011, Journal of aging research.

[23]  E. Yelin,et al.  Impact of perceived neighborhood problems on change in asthma-related health outcomes between baseline and follow-up. , 2008, Health & place.

[24]  I. Yen,et al.  Older People and Social Connectedness: How Place and Activities Keep People Engaged , 2012, Journal of aging research.

[25]  K. Glanz,et al.  An Ecological Perspective on Health Promotion Programs , 1988, Health education quarterly.

[26]  J. Hughes,et al.  Does moving from a high-poverty to lower-poverty neighborhood improve mental health? A realist review of 'Moving to Opportunity'. , 2009, Health & place.

[27]  B. Belza,et al.  Older Adult Perspectives on Physical Activity and Exercise: Voices From Multiple Cultures , 2004, Preventing chronic disease.

[28]  A. Stand.,et al.  Exercise and physical activity for older adults , 1998 .

[29]  Patricia O’Campo,et al.  Community-Based Services for Homeless Adults Experiencing Concurrent Mental Health and Substance Use Disorders: A Realist Approach to Synthesizing Evidence , 2009, Journal of Urban Health.

[30]  L. Dijkstra,et al.  Promoting safe walking and cycling to improve public health: lessons from The Netherlands and Germany. , 2003, American journal of public health.

[31]  C. Hogue Falls and Mobility in Late Life , 1984, Journal of the American Geriatrics Society.

[32]  Laura Keyes,et al.  Creating Communities: Atlanta's Lifelong Community Initiative , 2011 .

[33]  M. Northridge,et al.  Sorting out the connections between the built environment and health: A conceptual framework for navigating pathways and planning healthy cities , 2003, Journal of Urban Health.