142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Neighborhood safety factors associated with older adults' health outcomes: A systematic literature review

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Jaewoong Won, MS , Landscape Architecture and Urban Planning, Texas A&M University, College Station, TX
Chanam Lee, PhD, MLA , Department of Landscape Architecture and Urban Planning, Texas A&M University, College Station, TX
Marcia Ory, PhD, MPH , Health Promotion and Community Health Sciences, Texas A&M HSC School of Rural Public Health, College Station, TX
Samuel N. Forjuoh, DrPH, MD , Family & Community Medicine, Texas A&M Health Science Center, Temple, TX
Background: Neighborhood safety is important for older adults’ health and wellbeing, but has not been sufficiently addressed in previous studies.

Objectives: This systematic literature review, following the PRISMA guidelines, focuses on identifying neighborhood safety factors associated with older adults’ health behaviors/outcomes. 

Methods: The search was conducted in 2013-2014 via PubMed, EBSCO, ProQuest, Ovid, and Web of Science. Combinations of various search terms related to safety, health, neighborhood environment, and older adults were used. The inclusion criteria were: English-language peer reviewed journal articles; empirical studies; quantitative studies; safety-related independent/control variables; health-related outcome variables; and a senior population (50+ years).

Results: Of the 52 articles identified from the search, most studies were cross-sectional (87%) or did not clearly employ a theoretical framework (81%). Self-reported methods were commonly utilized (e.g. 91% for health behaviors/outcomes and 85% for safety). Thirty-three studies focused on health behaviors, such as walking (n=17, 33% of the 52 studies) and physical activity (n=16, 31%); eighteen studies used direct health outcomes, such as health status (n=4, 8%), mental health (n=6, 12%), morbidity/mortality (n=2, 4%), obesity (n=1, 2%), physical function (n=6, 12%), and health-related quality of life (n=2, 4%); and one study included both health behaviors/outcomes.

Six categories of safety variables were identified, including overall/general neighborhood safety (n=30, 58%), crime-related safety (n=29, 56%), traffic-related safety (n=25, 48%), and proxies (e.g. vandalism, graffiti, etc.) for safety (n=16, 31%). Although falls are the leading cause of injuries among older adults, only 5 studies addressed fall or injury related risk factors at the neighborhood level. Overall/general neighborhood safety appeared most relevant to behavioral outcomes, while crime-related safety was correlated more frequently with specific health conditions such as depression and functional disability.

Conclusion: This review identified several important gaps in the existing studies dealing with neighborhood safety-health relations among older adults that require further attention in future studies.

Learning Areas:

Environmental health sciences
Other professions or practice related to public health
Planning of health education strategies, interventions, and programs
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the procedure of the systematic literature review following the PRISMA guideline. Identify specific dimensions of neighborhood safety related to promoting or improving health behaviors and outcomes among older adults. Discuss the research gaps in the literature.

Keyword(s): Built Environment, Aging

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As a doctoral student at the Center for Health Systems and Design, I have carried out numerous research duties, ranging from the environmental assessments on perceived/objective barriers and motivators of health behaviors and outcomes to statistical data analyses. My valuable training and experiences from the research projects will allow me to foster academic acumen and contribute to the development of the multidisciplinary research focusing on the neighborhood environments and health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.