Optimizing mobility in later life: the role of the urban built environment for older adults aging in place

J Urban Health. 2013 Dec;90(6):997-1009. doi: 10.1007/s11524-013-9800-4.

Abstract

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 (2001-2008), 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 (OR = 1.18, 95 % CI = 1.01, 1.41). These findings emphasize the importance of the built environment for mobility among urban-dwelling older adults.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Accidental Falls
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Disabled Persons*
  • Environment Design
  • Environment*
  • Female
  • Health Status
  • Home Care Services / statistics & numerical data
  • Humans
  • Independent Living*
  • Long-Term Care / statistics & numerical data
  • Male
  • Medicaid
  • Michigan
  • Middle Aged
  • Mobility Limitation
  • Sex Factors
  • Socioeconomic Factors
  • United States
  • Urban Health*