Anne Bradley Mitchell
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9th Annual Penn Urban Doctoral Symposium (2012)

9th Annual Penn Urban Doctoral Symposium (2012)

Perceptions of Neighborhood Built Environment and Health on Walking in Minority Urban Older Adults

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Anne Bradley Mitchell Anne Bradley Mitchell Presentation Transcript

  • Perceptions of Neighborhood BuiltEnvironment 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 AimsPurpose: Describe the relationshipof older adults’ self-reported healthstatus and their perceivedneighborhood built environment withthe amount of self-reported walkingAim: Examine whether the self-reported health status mediates therelationship between the perceivedneighborhood built environment andthe amount of self-reported walking
  • Built Environment DefinitionDesign: aesthetic, physicalfunctional qualitiesLand use patterns: spatialdistribution of human activitiesTransportation system physicalinfrastructure and services forconnectivity
  • Sample and SettingSample Characteristics (n=140) 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%
  • Self-reported walkingminutes per week Standard Range Mean Median Deviation Total 0 to 910 201.18 150 184.24 walking Transport 0 to 700 123.53 90 123.16 walking Non- transport 0 to 420 66.07 20 107.77 walking
  • Results Variables Total walking Transport walking Non-transport p values p values walking p values Demographic ↓ Female ↓ Female ↓ Female ↓ Older age ↓ Older age ↓ BMI > 30 ↓ BMI > 30 ↓ Car Access ↓ Health problems Perceived ↑ Proximity to ↑Proximity to services ↑ Aesthetics Neighborhood services ↑ Access to services Built ↑ Density ↑ Density Environment Self-reported ↑Physical ↑ Physical ↑Mental health SF-12 Component Component Score Component score Scorep value significant at <.05 level: ↑ increase s walking; ↓ decreases walking
  • Summary of Significant Covariates Walk Non- Walk Total Walk Transport Transport Gender .012* .045* .226 Age .003** .006** .018* BMI .002** .017* .001*** Self Reported Health .021* .045* .057 Perceived .277 .093 .026* Neighborhood Access to Car .106 .050* Not entered R2adj .2209 .1896 .1192Note. * 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