(Withdrawn) The Effects of Community Environment on Self-Rated Health Among Older Koreans

Background and Purpose: In recent years, Korea has begun to observe an interest in “age-friendly communities” with its rapidly aging population, combined with an increased emphasis on independence in later life. Ecological theories suggest that a supportive environment may help older adults successfully age in place and enhance their health and well-being. The interest in age-friendly environments is still relatively new in Korea, and few empirical studies have examined whether and to what extent environmental characteristics affect older adults’ health. More importantly, most prior studies in Korea used environmental indicators measured by subjective reports of survey participants. Although the perception of the community residents is important for their health, subjective and objective measures of community characteristics are known to be differentially related to older adults’ health. Thus, this study examines the associations between community environment, perceived and objective, and self-rated health of older Koreans. Guided by person-environment fit perspectives, the study also investigates whether the associations between community environment and self-rated health vary by individuals’ socioeconomic status (SES).

Method: Individual-level data are drawn from the 2019 Community Health Survey, a population-based national study on community residents’ physical and mental health. The analytic sample included 66,949 adults aged 65 or older living in 250 administrative districts (si-gun-gu). Community-level data are drawn from the Land Survey and multiple administrative indicators collected at the si-gun-gu district level. Objective environmental indicators measured at the district level include access to community resources (i.e., average walking distances to parks, health centers, senior centers, and public fitness centers), community safety levels, and percentages of old-age basic pension recipients within a district (as a proxy of community SES). Subjective indicators measured at the individual level include satisfaction with neighborhood transportation, safety, healthcare centers, and the natural environment. Multilevel regression models are estimated to examine the association between community-level environment indicators (level-2) and individual-level self-rated health (level-1) by considering the interdependence between individuals within each district.

Results: A greater proportion of basic pension recipients in a community (lower community economic status) predicts lower levels of self-rated health after controlling for individuals’ social, economic, and health-related characteristics (b=-.004, p<.001). Satisfaction with the community environment is also positively associated with better self-rated health. Although the overall effects of the access to community resources (i.e., walking distance to parks, health centers, senior centers, and fitness centers) on self-rated health are not statistically significant, the positive effects of the better access to community resources are more evident among older adults in 70s and those with lower levels of SES compared to their younger, upper-SES counterparts.

Conclusion and Implications: The community environment plays an important role in the health of community-residing older adults, and thus, it is critical to make the communities more aging- and health-friendly. Given the greater effects of the community resources among those with lower levels of SES, special attention from community social workers and policymakers are needed for such vulnerable older adults.