anne bradley mitchell
DESCRIPTION
9th Annual Penn Urban Doctoral Symposium (2012) Perceptions of Neighborhood Built Environment and Health on Walking in Minority Urban Older AdultsTRANSCRIPT
Perceptions of Neighborhood Built Environment and Health on Walking in
Minority Urban Older Adults
Anne Bradley Mitchell PhD(c), CRNP
University of Pennsylvania School of Nursing
Ann L. O’Sullivan PhD, FAAN, CRNP, (Chair),
Pamela Z. Cacchione PhD, APRN, GNP-BC
Jerry C. Johnson MD
Yvonne L. Michael ScD, SM
Background
Older adults are 14% of the population in PA
Philadelphia has the greatest percentage of older adults among the top 10 cities
Walking is the most common form of physical activity for older adults
Older adults: recommended walk > 150 minutes/week
Only 22% of older adults achieve recommended level
Purpose and Aims
Purpose: Describe the relationship of older adults’ self-reported health status and their perceived neighborhood built environment with the amount of self-reported walking
Aim: Examine whether the self-reported health status mediates the relationship between the perceived neighborhood built environment and the amount of self-reported walking
Built Environment Definition
Design: aesthetic, physical functional qualities
Land use patterns: spatial distribution of human activities
Transportation system physical infrastructure and services for connectivity
Variable Sample West Philadelphia
Median age 74.5 years 74 years
Age >75 years (percent) 50% 53%
Female 69% 66%
Minority race 98% 94%
Rates health as fair or poor 25% 52%
Sample Characteristics (n=140)
Sample and Setting
Range Mean MedianStandard Deviation
Total walking
0 to 910 201.18 150 184.24
Transport walking
0 to 700 123.53 90 123.16
Non-transport walking
0 to 420 66.07 20 107.77
Self-reported walking minutes per week
Variables Total walkingp values
Transport walking p values
Non-transport walking p values
Demographic ↓ Female ↓ Older age ↓ BMI > 30
↓ Female ↓ Older age ↓ Car Access
↓ Health problems
↓ Female ↓ BMI > 30
Perceived Neighborhood
Built Environment
↑ Proximity to services↑ Density
↑Proximity to services↑ Access to services
↑ Density
↑ Aesthetics
Self-reported health SF-12
↑Physical Component
Score
↑ Physical Component Score
↑Mental Component score
p value significant at <.05 level: ↑ increase s walking; ↓ decreases walking
Results
Summary of Significant Covariates
Walk Total Walk Transport Walk Non-Transport
Gender .012* .045* .226
Age .003** .006** .018*
BMI .002** .017* .001***
Self Reported Health .021* .045* .057
Perceived Neighborhood .277 .093 .026*
Access to Car .106 .050* Not entered
R2adj .2209 .1896 .1192
Note. * p value < .05; ** p value < .01; *** p value < .001
Conclusions
Gender, age, BMI were significant for less walking similar to previous findings with non-minority samples
Older adults performed more transport walking than non-transport walking
Proximity to retail and neighborhood density significant for transport walking
Conclusions
Aesthetics significant for non-transport walking 53% achieved recommended amount of walking Health perceptions and demographic statistics had
greater significance than built environment features Traffic and crime were not significant variables
Implications
Research: – Findings of minority sample
similar to nonminority sample, non urban sample,
– Testing the theory – Dimension of time interacting with the environmental press
Clinical: – Use of Health Problem indicators– Counseling for BMI and activity– Adequate treatment of joint pain
Implications
Policy: – Modification of neighborhood built environment in
response to self-reported health status– Proximity, access, benches, public transit systems