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APHA Scientific Session and Event Listing

Arleen Brown, MD, PhD, Sage Teton, Juan Barron, and Alfonso Ang, PhD. General Internal Medicine and Health Services Research, UCLA, 911 Broxton Plaza, Box 173617, Los Angeles, CA 90024, 310-794-6047, abrown@mednet.ucla.edu

BACKGROUND: Persons with chronic conditions must often engage in complex medication, dietary, and exercise regimens. Chronic disease management among community-dwelling older persons may be influenced by neighborhood physical, social, and economic characteristics. Our aims were to identify and understand perceptions of the local environment and the role neighborhoods play in the management of chronic conditions among older adults.

METHODS: We recruited 66 participants age³60 years from senior centers, community clinics, and social service organizations for 11 focus groups with residents from neighborhoods of high (N=4) and low (N=7) socioeconomic status (SES) in Los Angeles County. Using systematic qualitative methods, we clarified complex interactions between values, neighborhood perceptions, experiences, and disease management.

RESULTS: We identified several themes: 1) Participants from low SES neighborhoods reported difficulty obtaining medications and poor selection in local markets. 2) Persons from low SES areas cited examples of factors that deterred walking, including neighborhood violence (“I used to go walking before ... they killed 2 guys here”), physical decay, unleashed dogs on the streets, and speeding cars. 3) Neighborhood cohesiveness was cited as an important factor in maintaining or improving conditions in groups from low and high SES areas. Persons in low SES areas associated low cohesiveness with isolation, stress, and difficulty identifying neighborhood resources.

CONCLUSIONS: Our findings suggest that neighborhood characteristics influence chronic disease management among older adults and that some factors disproportionately affect low SES neighborhoods. Regardless of SES, neighborhood cohesiveness may be an important construct that can facilitate chronic disease management among older persons.

Learning Objectives:

• To identify neighborhood characteristics that influence disease management for older adults with chronic conditions and assess whether they vary by neighborhood socioeconomic status.

Keywords: Environment, Aging

Presenting author's disclosure statement:

Any relevant financial relationships? No