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Urban built environments and trajectories of mobility disability: Findings from a national sample of community-dwelling American adults (1986-2001)

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  • Clarke, Philippa
  • Ailshire, Jennifer A.
  • Lantz, Paula
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    Abstract

    As people age, they become more dependent on their local communities, especially when they are no longer able to drive. Uneven or discontinuous sidewalks, heavy traffic, and inaccessible public transportation, are just some of the built environment characteristics that can create barriers for outdoor mobility in later adulthood. A small body of literature has been investigating the role of the built environment on disability, but has been limited to cross-sectional analyses. The purpose of this paper is to further advance this area of research by examining the role of the built environment on long-term trajectories of mobility disability in a national sample of American adults (age 45+) followed over a 15-year period. Using multilevel logistic growth curve models with nationally representative data from the Americans' Changing Lives Study (1986-2001), we find that trajectories of mobility disability are steeper in older age groups. Women and those with lower education had a higher odds of mobility disability over time. The presence of just one chronic health condition doubled the odds of mobility disability at each of the four study waves. Among older adults (age 75+), living in neighborhoods characterized by more motorized travel was associated with an odds ratio for mobility disability that was 1.5 times higher in any given year than for older adults living in environments that were more pedestrian friendly. These results suggest that the built environment can exacerbate mobility difficulties for older adults. When considering ways to minimize disability as the population ages, simple changes in the built environment may be easier to implement than efforts to change risk factors at the individual level.

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    File URL: http://www.sciencedirect.com/science/article/B6VBF-4WW4018-1/2/e1d2f0621f8bcdee42459ae997510e35
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    Bibliographic Info

    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 69 (2009)
    Issue (Month): 6 (September)
    Pages: 964-970

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    Handle: RePEc:eee:socmed:v:69:y:2009:i:6:p:964-970

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    Related research

    Keywords: USA Disability Built environment Aging Trajectories Mobility;

    References

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    1. Vicki Freedman & Eileen Crimmins & Robert Schoeni & Brenda Spillman & Hakan Aykan & Ellen Kramarow & Kenneth Land & James Lubitz & Kenneth Manton & Linda Martin & Diane Shinberg & Timothy Waidmann, 2004. "Resolving inconsistencies in trends in old-age disability: Report from a technical working group," Demography, Springer, vol. 41(3), pages 417-441, August.
    2. Susan L. Ettner, 1996. "The Opportunity Costs of Elder Care," Journal of Human Resources, University of Wisconsin Press, vol. 31(1), pages 189-205.
    3. Cervero, Robert, 1996. "Mixed land-uses and commuting: Evidence from the American Housing Survey," Transportation Research Part A: Policy and Practice, Elsevier, vol. 30(5), pages 361-377, September.
    4. Stuck, Andreas E. & Walthert, Jutta M. & Nikolaus, Thorsten & Büla, Christophe J. & Hohmann, Christoph & Beck, John C., 1999. "Risk factors for functional status decline in community-living elderly people: a systematic literature review," Social Science & Medicine, Elsevier, vol. 48(4), pages 445-469, February.
    5. John R. Beard & Shannon Blaney & Magda Cerda & Victoria Frye & Gina S. Lovasi & Danielle Ompad & Andrew Rundle & David Vlahov, 2009. "Neighborhood Characteristics and Disability in Older Adults," Journals of Gerontology: Series B, Gerontological Society of America, vol. 64(2), pages 252-257.
    6. Freedman, Vicki A. & Grafova, Irina B. & Schoeni, Robert F. & Rogowski, Jeannette, 2008. "Neighborhoods and disability in later life," Social Science & Medicine, Elsevier, vol. 66(11), pages 2253-2267, June.
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