Review and special articleNeighborhood Environment in Studies of Health of Older Adults: A Systematic Review
Section snippets
Background
A growing literature has reported associations between neighborhood and health behaviors and health status in the general population. As the literature expands, it is worthwhile to consider specific populations such as older adults. The world population is aging; the proportion of people aged ≥65 years is growing.1 In the U.S., the number of people aged ≥65 years will more than double from 2000 to 2030 (from 35 to 71 million).2
The neighborhood-health literature highlights associations for four
Methods
Articles for possible inclusion were identified through a search of databases (Figure 1), incorporating articles published from January 1, 1997, to December 31, 2007. The articles were identified using the search term residence characteristics in MeSH and the term neighborhood in PubMed in the title or abstract field. Prior to reviewing abstracts, the research team established inclusion and exclusion criteria. English-language empirical studies of physical and mental health outcomes (including
Identified Studies
The majority of the 33 studies (n=25) were cross-sectional; eight were longitudinal. The majority of the studies (n=26) were conducted in the U.S.; seven were conducted in Europe or Australia. Neighborhood exposures were evaluated with respect to a wide variety of health outcomes, including mortality and morbidity, self-reported health or quality of life, mental health, cognition, disability, and physical activity/BMI. The size and scale of the studies varied. For example, 24 studies
Discussion
There is modest evidence that neighborhood significantly influences the health of older adults. However, the analytic approach of many of the studies limited their ability to identify specific neighborhood factors associated with health for older adults. While the study subjects of all of the studies discussed here were aged ≥55 years, the research questions and methods did not necessarily assess or take into consideration characteristics specific to the older population, such as their physical
Conclusion
This literature review provides limited evidence that neighborhood environment is a primary influence on older adults' health and functioning. These results highlight the need for additional hypothesis-driven research based on models linking specific neighborhood exposure to health outcomes in older adults. New methods are needed to define “activity spaces”104 that are relevant to older adults and integrate direct measurement of these spaces into research. Further, relevant neighborhood
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