9th Annual Penn Urban Doctoral Symposium (2012) Perceptions of Neighborhood Built Environment and Health on Walking in Minority Urban Older Adults

1. 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

2. 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

3. 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

4. Built Environment Definition
Design: aesthetic, physical
functional qualities
Land use patterns: spatial
distribution of human activities
Transportation system physical
infrastructure and services for
connectivity

5. Sample and Setting
Sample 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%

6. Self-reported walking
minutes 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

7. 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
Score
p value significant at <.05 level: ↑ increase s walking; ↓ decreases walking

8. 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 .1192
Note. * p value < .05; ** p value < .01; *** p value < .001

9. 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

10. 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

11. 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

12. Implications
 Policy:
– Modification of neighborhood built environment in
response to self-reported health status
– Proximity, access, benches, public transit
systems