331162
Environmental influences on the racial/ethnic and gender patterning of mobility and physical capacity in older adults
Introduction: Researchers have documented racial/ethnic and gender patterning in mobility and physical capacity in older adults. The neighborhood physical, social, and economic environment can shape older adults’ ability to function independently outside of their home, and may explain the racial/ethnic and gender patterning of mobility.
Methods: Using 2012 data from the National Health and Aging Trends Study (NHATS) (N=6,572 age 65+), mobility and physical capacity were assessed using a physical performance battery, self-reported physical impairment, and difficulty going outside. Neighborhood context was assessed by census tract-level economic and social indicators, observer ratings of neighborhood physical disorder and conditions outside participants’ homes (e.g., broken stairs).
Results: Non-white participants lived in neighborhoods characterized by more physical disorder, and had higher odds of living in structures with broken stairs, entry ramps and continuous sidewalks. Black/African Americans and Hispanics had approximately twice the odds of physical impairment compared to Whites [OR=1.93 95% CI (1.60,2.31); OR=2.07, 95% CI (1.52,2.80)], and men had 20% lower odds of impairment (p=0.01) than women after accounting for demographic factors. Women, Black/African Americans and Hispanics reported the highest odds of difficulty going outside (p<0.01). Higher neighborhood disorder, entry ramps and broken steps were associated with worse physical capacity [β=-0.50, SE=0.18, p<0.01; β=-1.30, SE=0.17, p<0.01; β=-0.27, SE=0.14, p<0.05], and having an entry ramp and broken steps were associated with higher odds of reporting more difficulty going outside [OR=1.61, 95% CI (1.21,2.13); OR=1.40, 95% CI (1.08,1.82)]. Disparities in mobility and physical capacity were not explained by the neighborhood environment.
Discussion: Differences in mobility and physical capacity by race/ethnicity and gender contribute to later life health disparities. Although neighborhood physical conditions did not explain these disparities, they were associated with mobility and physical capacity and are risk factors that could be modified to reduce future disability in older adults.
Learning Areas:
Assessment of individual and community needs for health educationPlanning of health education strategies, interventions, and programs
Social and behavioral sciences
Learning Objectives:
Identify racial/ethnic and gender patterning of environmental context and barriers for older residents.
Evaluate racial/ethnic and gender patterning in mobility and physical capacity of older adults.
Analyze relationships between the built environment, race/ethnicity and gender, and mobility outcomes for older adults.
Keyword(s): Minority Health, Built Environment
Qualified on the content I am responsible for because: My research agenda focuses on health disparities and ways in which the social, economic and built environment are associated with racial/ethnic, socioeconomic and sexual orientation-based health disparities.
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.