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Philippa J. Clarke photo

Urban Built Environments and Trajectories of Disability Among Older Adults

a PSC Research Project [ARCHIVE DISPLAY]

Investigator:   Philippa J. Clarke

Older adults are particularly dependent on their local communities, and due to declining health and functional status, financial strain and social isolation, are vulnerable to health risks generated by the urban built environment, including substandard housing, inaccessible transportation, heavy traffic, and unsafe or poorly designed urban streetscapes. Yet the effect of the built environment on independence in older adults is under-studied. The purpose of this research project is to understand the role of the built environment in disability progression in later life.

Specifically, the aims of the project are threefold: 1) to characterize in detail the surrounding built environment for a high risk population of community dwelling older adults; 2) to examine the relationship between the built environment and disability progression; and 3) to identify whether older adults living in less accessible neighborhoods are more likely to be admitted to a nursing home over time.

The research objectives will be investigated through a program of secondary data analysis with existing population-based data (Michigan Minimum Data Set for Home Care) using a combination of quantitative multilevel methods and geographic information systems (GIS) software. Latent trajectory class analysis will be used to examine the effect of urban accessibility and urban design on trajectories of mobility disability and subsequent nursing home admission over a 15 month period. The skills needed to appropriately use GIS and spatial analysis techniques for this research will be obtained as a key component of this career development award.

Current research on later life health and independence places almost exclusive emphasis on factors at the individual level. Yet, the role of the surrounding environment may play a key role in shaping patterns of independence and dependence among older adults. This project addresses one of CDC’s Health Protection Goals, “Healthy People in Health Places”, by focusing on the design of built environments that define healthy communities for older adults at risk for disability.

Funding Period: 09/01/2007 to 09/29/2010

Country of Focus: USA

This PSC Archive record is displayed for historical reference.

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