Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China.
Sau Po Center on Ageing, The University of Hong Kong, Hong Kong, China.
Front Public Health. 2022 Mar 14;10:861836. doi: 10.3389/fpubh.2022.861836. eCollection 2022.
Health deterioration among frail older adults is a public health concern. Among the multi-dimensional factors, the neighborhood built environment is crucial for one's health. Although the relationship between the built environment and health in the general population has been thoroughly investigated, it has been ignored in the case of frail older adults, who may have difficulties in their daily basic living skills. A path analysis is constructed to model the proposed theoretical framework involving the neighborhood built environment and health among frail older adults. This study thus aims to investigate the environmental influences on health, and to validate the theoretical framework proposed for health and social services.
This study used secondary data collected in Hong Kong. A sample of 969 older community dwellers aged 60 or above were frail with at least one activity of daily living. Demographic information, neighborhood built environment data, service utilization, and health conditions were collected from these participants and their caregivers. A path analysis was performed to examine the proposed theoretical framework.
The health condition was of general concern, including frailty and incapacities in daily activities in frail older adults. Besides psychosocial factors, service use, and caregivers' care quality, the built environment had a significant impact on the health of older adults as well. Specifically, more facilities offering services and groceries, a shorter distance to the nearest metro station, and more greenery exposure are associated with a better-expected health condition among frail older adults.
The proposed theoretical framework successfully supplements past negligence on the relationship between the built environment and the health of frail older adults. The findings further imply that policymakers should promote the usability of transit and greenery in neighborhoods and communities. In addition, service utilization should be improved to meet the basic needs of frail older adults in the communities.
虚弱老年人的健康恶化是一个公共卫生关注点。在多维因素中，邻里建成环境对人的健康至关重要。尽管一般人群的建成环境与健康之间的关系已经得到了彻底的研究，但在虚弱的老年人中却被忽视了，他们可能在日常生活的基本生活技能方面存在困难。本研究构建了路径分析模型，以模拟涉及虚弱老年人的邻里建成环境与健康的理论框架。因此，本研究旨在调查环境对健康的影响，并验证健康和社会服务的理论框架。
本研究使用在香港收集的二手数据。研究样本包括 969 名年龄在 60 岁或以上且至少有一项日常生活活动能力虚弱的社区居住老年人。从这些参与者及其照顾者那里收集了人口统计信息、邻里建成环境数据、服务利用情况和健康状况。进行路径分析以检验所提出的理论框架。
健康状况普遍受到关注，包括虚弱和虚弱老年人日常生活活动能力的丧失。除了心理社会因素、服务利用和照顾者的照顾质量外，建成环境对老年人的健康也有重大影响。具体而言，提供更多服务和杂货店设施、到最近地铁站的距离较短以及更多的绿色植物暴露与虚弱老年人预期健康状况的改善相关。
所提出的理论框架成功地补充了过去对虚弱老年人的建成环境与健康之间关系的忽视。研究结果进一步表明，政策制定者应促进社区邻里交通和绿色植物的可用性。此外，应改善服务利用情况，以满足社区中虚弱老年人的基本需求。
