BACKGROUND

Urbanization and aging are global phenomena that offer unique challenges in different countries. A supportive environment plays an important role in addressing the issues of health behavioral change and health promotion (e.g., prevent chronic illnesses, promote mental health) among older adults. With the development of the socio-ecological theoretical model, studies on the impact of supportive environments on physical activity have become popular in the public health field in the EU and US. Meanwhile, very few Chinese studies have examined the relationship between built environment features and older adults' physical activity at the ecological level. The purpose of the study is to investigate how the factors part of the built environment of Nanjing's communities also influence leisure time physical activity among the elderly.

METHODS

Using a socio-ecological model as a theoretical framework, we conducted a cross-sectional study of 399 elderly people from 19 communities in Nanjing, China, using a one-on-one questionnaire to collect data, including participants' perceived built environment and self-reported physical activity. A multivariate linear regression method was used to analyze the factors influencing their recreational physical activity.

RESULTS

This study found that compared to older people with low average monthly income, the recreational physical activity of the elderly with average monthly incomes between 1001 and 2000 ¥ (β = 23.31, p < 0.001) and 2001 ¥ or more (β = 21.15, p < 0.001) are significantly higher. After controlling for individual covariates, street connectivity (β = 7.34, p = 0.030) and street pavement slope (β = - 7.72, p = 0.020), we found that two out of ten built environment factors indicators influence their physical activity. The importance of each influencing factor ranked from highest to lowest are monthly average income, street pavement slope, and street connectivity. Other factors were not significantly related to recreational physical activity by the elderly.

CONCLUSIONS

Older adults with a high income were more likely to participate in recreational physical activity than those with a low income. In order to positively impact physical activity in older adults and ultimately improve health, policymakers and urban planners need to ensure that street connectivity and street pavement slope are factored into the design and development of the urban environment.