Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Princetonlaan 8a, 3584CB, Utrecht, The Netherlands.
BMC Public Health. 2024 Mar 18;24(1):843. doi: 10.1186/s12889-024-18262-x.
Studies have shown how environmental factors influence older people's health and functional limitations, which are crucial for achieving healthy aging. However, such a healthy aging model has been criticized for defining health as an absence of disease, because chronic conditions cannot be reversed through medical treatments. In response to such critiques, this study refers to Huber's positive health definition, arguing that health should not be defined as the absence of disease but as the ability to adapt and self-manage in the face of social, physical, and emotional challenges. There is a need to develop a community-based approach to healthy aging that considers how the residential environment enables older people to adapt and self-manage. Drawing on Sen's capability approach, this study proposes that such a community-based approach should provide a supportive environment to enable older people's capabilities to live independently.
Using hierarchical multiple regression analysis of data from 650 older people (60 years and older) surveyed in Beijing, we unravel which features of the residential environment support older people' s capabilities to live independently and how these impacts differ depending on older people's frailty levels.
The results show that four environmental factors, namely perceived accessibility (B = 0.238, p < 0.001 for physical capability, B = 0.126, p < 0.001 for social capability, B = 0.195, p < 0.001 for psychological capability), pleasant surroundings (B = 0.079, p < 0.05 for physical capability, B = 0.065, p < 0.05 for social capability), meeting opportunities (B = 0.256, p < 0.001 for social capability, B = 0.188, p < 0,001 for psychological capability, and life convenience B = 0.089, p < 0.05 for physical capability, B = 0.153, p < 0.001 for psychological capability) positively affect older people's capabilities to live independently. These four environmental factors cause differences in older people's capabilities between different neighborhood types. Moderation analysis shows that meeting opportunities are more relevant for frail older people (B = 0.090, p < 0.001 for social capability, B = 0.086, p < 0.01 for psychological capability).
This study contributes to the literature by emphasizing the role of supportive residential environments in enabling older people to live independently. Furthermore, we identify four environmental factors that support older people's capabilities. Results can be used to develop effective community-based environmental support to enable older people to live independently.
研究表明，环境因素如何影响老年人的健康和功能限制，这对于实现健康老龄化至关重要。然而，这种健康老龄化模式因将健康定义为没有疾病而受到批评，因为慢性疾病无法通过医疗手段逆转。针对这些批评，本研究参考了 Huber 的积极健康定义，认为健康不应定义为没有疾病，而是指在面对社会、身体和情感挑战时适应和自我管理的能力。需要制定一种以社区为基础的健康老龄化方法，考虑居住环境如何使老年人能够适应和自我管理。本研究借鉴 Sen 的能力方法，提出这种以社区为基础的方法应该提供一个支持性的环境，使老年人能够独立生活。
我们使用分层多元回归分析，对北京 650 名 60 岁及以上老年人进行调查，分析了居住环境的哪些特征支持老年人独立生活的能力，以及这些影响如何因老年人的脆弱程度而异。
结果表明，四个环境因素，即感知可达性（身体能力的 B=0.238，p<0.001，社会能力的 B=0.126，p<0.001，心理能力的 B=0.195，p<0.001）、宜人的环境（身体能力的 B=0.079，p<0.05，社会能力的 B=0.065，p<0.05，心理能力的 B=0.065，p<0.05）、满足机会（社会能力的 B=0.256，p<0.001，心理能力的 B=0.188，p<0.001，生活便利的 B=0.089，p<0.05，身体能力的 B=0.153，p<0.001，心理能力的 B=0.153，p<0.001）积极影响老年人独立生活的能力。这四个环境因素导致了不同邻里类型老年人能力的差异。调节分析表明，满足机会对体弱老年人更为重要（社会能力的 B=0.090，p<0.001，心理能力的 B=0.086，p<0.01）。
本研究通过强调支持性居住环境在使老年人能够独立生活方面的作用，为文献做出了贡献。此外，我们确定了支持老年人能力的四个环境因素。研究结果可用于开发有效的社区环境支持，使老年人能够独立生活。
