Age-Friendly Neighborhoods and Economic Vulnerability
Methods: We examined the association between the social and physical environment and elder health through secondary analysis of interview data from 1,372 adults (n=814 low income and n=571 higher income) age 60 and older living in Detroit and geographic data on their surrounding environmental characteristics. Using exploratory factor analysis, we identified six factors that capture the social and physical environment: 1) access to business and leisure, 2) access to health care, 3) neighborhood problems, 4) social interaction, 5) social support, and 6) community engagement. We then conducted separate linear regression models for low income and higher income elders to test the association between these factors and self-rated health, which previous research demonstrates is predictive of mortality, physical disability, chronic disease status, health behaviors, and health care utilization.
Results: For both low-income and higher income respondents, access to health care predicted higher self-rated health (B = .067, SE = .033, p<.05 and B = .213, SE = .077, p<.01, respectively). Social support was associated with increased self-rated health for low-income elders (B = .128, SE = .040, p<.01), while community engagement predicted higher self-rated health for higher-income elders (B = .114, SE = .050, p<.05). Additionally, the neighborhood problems factor was associated with lower self-rated health (B = -.095, SE = .048, p<.05) only for higher-income respondents.
Conclusions and Implications: Existing models to create more age-friendly neighborhoods often neglect the potentially unique needs of economically vulnerable older adults. Findings suggest, however, that financial resources should be an important component of research and interventions on social and physical environmental influences on the health and well-being of older adults. This paper will discuss implications not only for environmental interventions designed to improve health, but also interventions aimed to promote aging in place, a programmatic and policy goal that may not be preferred, optimal or practical for those living in or near poverty.