Age-friendly communities and self-rated health: An exploration of Detroit elders

Within the past decade, many organizations have proposed “age-friendly” models to help communities adapt the social and physical environment to promote elder health and well-being. To date, however, there is little evidence regarding the relationship between these models and outcomes in older adults. Using measures based on the U.S. Environmental Protection Agency's Model for Age-Friendly Cities, we examined the association between the social and physical environment and self-rated health through secondary analysis of interview data from 1,376 adults age 60 and older living in Detroit and geographic data on their community characteristics. Using exploratory factor analysis, we identified six factors that capture the EPA Model: 1) access to business and leisure, 2) access to health care, 3) neighborhood problems, 4) social interaction, 5) social support, and 6) community engagement. We measured self-rated health as a dichotomous variable (0=poor/fair, 1=good/very good/excellent). In the final logistic regression model, having sources of social support and being engaged in the community was significantly positively associated with higher self-rated health, while living in neighborhoods characterized by multiple problems was significantly negatively associated with higher self-rated health. Access to business and leisure, access to health services, and social interaction were not significant. These findings suggest that certain aspects of the EPA Model may be more relevant for the health and well-being of an urban elderly population that is overwhelmingly African American and majority low income. Future research should examine the outcomes associated with this age-friendly model in other populations of older adults.