Is a positive perception of the neighborhood environment associated with community engagement for non-working older adults with chronic conditions?

Objective: Living with a chronic condition can negatively affect quality of life and potentially lead to withdrawal from community engagement, particularly for non-working older adults. This study examined whether a positive perception of the neighborhood was associated with community participation controlling for person-level demographic and health status factors.

Methods: Data from the 2006 Southeastern Pennsylvania Household Health Survey were analyzed for relationships between four indicators of neighborhood environment (feeling a part of the neighborhood, having trust in neighbors, willingness of neighbors to help others and also to work together to improve the neighborhood), and participation in local activity programs, groups, or organizations by 2,285 adults aged 60+ (mean 73.2 years) who reported at least one chronic condition or condition requiring medical treatment on a regular basis. A composite neighborhood score was also created (additive of the individual items, ranging from 0-5) to assess a less versus more positive perception.

Results: Person-level factors (sex, race, and health status including instrumental activities of daily living) were strongly associated with community participation, as were each of the four indicators of the neighborhood environment. Regression modeling showed that after controlling for person-level factors, a more positive perception of the neighborhood was significantly associated with community participation (OR=1.47, 95%CI:1.33-1.62). Trust was no longer significant when the individual neighborhood items were modeled.

Conclusions: These results extend previous findings on the advantages of a positive perception of neighborhood to also have an association with engagement in community activities and organizations for non-working older adults with chronic conditions.