Nonlinear Associations of the Built Environment with Cycling Frequency among Older Adults in Zhongshan, China

The health and welfare of older adults have raised increasing attention due to global aging. Cycling is a physical activity and mode of transportation to enhance the mobility and quality of life among older adults. Nevertheless, the planning strategies to promote cycling among older adults are underutilized. Therefore, this paper describes the nonlinear associations of the built environment with cycling frequency among older adults. The data were collected from the Zhongshan Household Travel Survey (ZHTS) in 2012. The modeling approach was the eXtreme Gradient Boosting (XGBoost) model. The findings demonstrated that nonlinear relationships exist among all the selected built environment attributes. Within specific intervals, the population density, the land-use mixture, the distance from home to the nearest bus stop, and the distance from home to CBD are positively correlated to the cycling among older adults. Additionally, an inverse “U”-shaped relationship appears in the percentage of green space land use among all land uses. Moreover, the intersection density is inversely related to the cycling frequency among older adults. These findings provide nuanced and appropriate guidance for establishing age-friendly neighborhoods.

Download Full-text

Nonlinear Associations between Medical Expenditure, Perceived Medical Attitude, and Sociodemographics, and Older Adults’ Self-Rated Health in China: Applying the Extreme Gradient Boosting Model

Healthcare ◽

10.3390/healthcare10010039 ◽

2021 ◽

Vol 10 (1) ◽

pp. 39

Author(s):

Yuqing Liang ◽

Wanwan Zheng ◽

Woon-Seek Lee

Keyword(s):

Older Adults ◽

Health Expenditure ◽

Health Benefits ◽

Medical Expenditure ◽

Gradient Boosting ◽

Threshold Effects ◽

Self Rated Health ◽

Extreme Gradient Boosting ◽

Nonlinear Associations ◽

Partial Dependence

Background: although China’s total health expenditure has been dramatically increased so that the country can cope with its aging population, inequalities among individuals in terms of their medical expenditures (relative to their income level) have exacerbated health problems among older adults. This study aims to examine the nonlinear associations between each of medical expenditure, perceived medical attitude, and sociodemographics, and older adults’ self-rated health (SRH); it does so by using data from the 2018 China Family Panel Studies survey. Method: we used the extreme gradient boosting model to explore the nonlinear association between various factors and older adults’ SRH outcomes. We then conducted partial dependence plots to examine the threshold effects of each factor on older adults’ SRH. Results: older adults’ medical expenditure exceeded their overall income. Body mass index (BMI) and personal health expenditure play an essential role in predicting older adults’ SRH outcomes. We found older adult age, physical exercise status, and residential location to be robust predictors of SRH outcomes in older adults. Partial dependence plots of the results visualized the nonlinear association between variables and the threshold effects of factors on older adults’ SRH outcomes. Conclusions: findings from this study underscore the importance of medical expenditure, perceived medical attitudes, and BMI as important predictors of health benefits in older adults. The potential threshold effects of medical expenditure on older adults’ SRH outcomes provide a better understanding of the formation of appropriate medical policy interventions by balancing the government and personal medical expenditure to promote health benefits among older adults.

Download Full-text

Non-Linear Effects of the Built Environment and Social Environment on Bus Use among Older Adults in China: An Application of the XGBoost Model

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18189592 ◽

2021 ◽

Vol 18 (18) ◽

pp. 9592

Author(s):

Lanjing Wang ◽

Chunli Zhao ◽

Xiaofei Liu ◽

Xumei Chen ◽

Chaoyang Li ◽

...

Keyword(s):

Older Adults ◽

Land Use ◽

Built Environment ◽

Social Environment ◽

Public Transport ◽

Dwelling Unit ◽

Bus Stop ◽

Environment Variable ◽

Non Linear ◽

Unit Density

Global aging has raised increasing concerns on the health and well-being of older adults. Public transport is a viable option to improve the mobility and quality of life among older adults. However, policies that promote the public transport use among older adults are rare. This study utilizes the eXtreme Gradient Boosting (XGBoost) decision tree to explore the non-linear associations of the built and social environment with bus use among older adults in China. The bus use of older adults was obtained from the Zhongshan Household Travel Survey (ZHTS) in 2012. Results show that non-linear relationships exist among all built environment and social environment characteristics. Within certain thresholds, the percentage of green space land use, land use mixture, bus-stop density, and dwelling unit density are positively related to bus use among older adults. Likewise, one social environment variable, the proportion of older adults in a neighborhood, is the key social environment variable. Furthermore, the dwelling unit density and proportion of older adults appear to have an inverse U-shaped relationship. Additionally, age, ownership of motorcycles, and distance from home to the nearest bus stop also show non-linearity. The findings presented in this paper facilitate effective planning interventions to promote bus use among older adults.

Download Full-text

Non-linear Relationships Between the Built Environment and Walking Frequency Among Older Adults in Zhongshan, China

Frontiers in Public Health ◽

10.3389/fpubh.2021.686144 ◽

2021 ◽

Vol 9 ◽

Author(s):

Jiani Wu ◽

Chunli Zhao ◽

Chaoyang Li ◽

Tao Wang ◽

Lanjing Wang ◽

...

Keyword(s):

Older Adults ◽

Land Use ◽

Built Environment ◽

Green Space ◽

Additive Model ◽

Walking Behavior ◽

Old Adults ◽

Linear Relationships ◽

Walking Activity ◽

Non Linear

Aim: Promoting walking activity is an effective way to improve the health of older adults. Walking frequency is a critical component of walking behavior and an essential determinant of daily walking levels. To decipher the association between the built environment and walking frequency among older adults, this study's aims are as follows: (1) to empirically test whether non-linear relationships between the two exist, and (2) to identify the thresholds of the built environment characteristics that promote walking.Methods: The walking frequency of old adults was derived from the Zhongshan Household Travel Survey (ZHTS) in 2012. The sample size of old adults aged 60 or over was 4784 from 274 urban and rural neighborhoods. A semi-parametric generalized additive model (GAMM) is used to analyze the non-linear or non-monotonic relationships between the built environment and the walking frequency among older adults.Results: We found that non-linear relationships exist among five out of the six built environment characteristics. Within certain thresholds, the population density, sidewalk density, bus stop density, land use mixture, and the percentage of green space are positively related to older adults' walking trips. Furthermore, the land use mixture and the percentage of green space show an inverse “V”-shaped relationship.Conclusions: Built environment features can either support or hinder the walking frequency among older adults. The findings in the current study contribute to effective land use and transport policies for promoting active travel among older adults.

Download Full-text

Eye-Level Street Greenery and Walking Behaviors of Older Adults

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17176130 ◽

2020 ◽

Vol 17 (17) ◽

pp. 6130

Author(s):

Peng Zang ◽

Xuhong Liu ◽

Yabo Zhao ◽

Hongxu Guo ◽

Yi Lu ◽

...

Keyword(s):

Older Adults ◽

Land Use ◽

Population Density ◽

Built Environment ◽

Street Connectivity ◽

Design Consideration ◽

Methodological Limitation ◽

Urban Greenery ◽

The Relationship ◽

Walking Time

Evidence suggests that built environment characteristics affect older adults’ travel activity behaviors, e.g., walking and cycling, which have well-established health benefits. However, the relationship between urban greenery and walking behaviors remains unclear, partly due to methodological limitation. Previous studies often measured urban greenery from a bird’s eye perspective, which may mismatch with the pedestrian’s perception from the street. In this study, we measured greenery view index from eye-level streetscape photos retrieved from Baidu Street View, an online mapping service provider. Walking behaviors of 180 older adults in six neighborhoods were collected from questionnaires. We also measured land use diversity, pedestrian-oriented design (street connectivity), and population density—the three Ds of the built environment. Results show that street greenery view index contributes to walking time of older adults, suggesting street greenery should be taken into design consideration to promote walking behaviors of older adults.

Download Full-text

The Role of Destination’s Built Environment on Nonmotorized Travel Behavior: A Case of Long Beach, California

Journal of Planning Education and Research ◽

10.1177/0739456x16688765 ◽

2017 ◽

Vol 38 (2) ◽

pp. 152-166 ◽

Cited By ~ 4

Author(s):

Dohyung Kim ◽

Jiyoung Park ◽

Andy Hong

Keyword(s):

Built Environment ◽

Travel Behavior ◽

Mode Choice ◽

Long Beach ◽

Environment Factors ◽

Household Travel Survey ◽

Future Policy ◽

Household Travel ◽

National Household Travel Survey

This study examines how built environment factors at trip destinations influence nonmotorized travel behavior in the City of Long Beach, California. Using 2008–2009 National Household Travel Survey with California Add-Ons, we found that nonmotorized users tend to choose more clustered destinations than motorized users, and that density, diversity, and design at destinations significantly affect mode choice decisions. Transportation networks and nonmotorized facilities at trip destinations are especially important factors for nonmotorized mode choice. Future policy and research need to consider built environment factors at trip destinations to effectively accommodate nonmotorized travel within a city.

Download Full-text

How the Daily Smartphone is Associated With Daily Travel, Physical Activity, and Self-Perceived Health: Evidence From 2017 National Household Travel Survey

Journal of Aging and Physical Activity ◽

10.1123/japa.2019-0222 ◽

2020 ◽

Vol 28 (5) ◽

pp. 740-748

Author(s):

Yong Yang ◽

Sheng Li ◽

Kai Zhang ◽

Xiaoling Xiang ◽

Zhigang Li ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Vigorous Physical Activity ◽

Middle Aged ◽

Travel Survey ◽

Household Travel Survey ◽

Smartphone Use ◽

Mean Differences ◽

Household Travel ◽

National Household Travel Survey

Knowledge of how smartphone use in daily life, rather than in the context of intervention, may influence people’s behaviors and health is limited and mixed. The 2017 National Household Travel Survey (NHTS) data were used to examine the associations between daily smartphone use and several outcomes, including engaging in vigorous physical activity, self-perceived being healthy, and the adjusted mean differences for total trips and active travels among older adults (≥65 years) as well as among young and middle-aged groups (18–64 years), respectively. The prevalence of daily smartphone use declined with increasing age. Daily smartphone use was associated with increased total trips and active travel, a higher likelihood of engaging in vigorous physical activity, and in self-perceived being healthy status. The associations were stronger among older adults than young and middle-aged adults. More studies are needed to address the complex pathways among daily smartphone use and other outcomes. Daily smartphone use has the potential to address the unmet daily needs of older adults and bridge health disparities for this disadvantaged group.

Download Full-text

A Machine Learning Approach to Identify Predictors of Potentially Inappropriate Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) Use in Older Adults with Osteoarthritis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18010155 ◽

2020 ◽

Vol 18 (1) ◽

pp. 155

Author(s):

Jayeshkumar Patel ◽

Amit Ladani ◽

Nethra Sambamoorthi ◽

Traci LeMasters ◽

Nilanjana Dwibedi ◽

...

Keyword(s):

Machine Learning ◽

Older Adults ◽

The United States ◽

Gradient Boosting ◽

Study Cohort ◽

Real World Data ◽

Extreme Gradient Boosting ◽

Inflammatory Drugs ◽

Anti Inflammatory ◽

Using Data

Evidence from some studies suggest that osteoarthritis (OA) patients are often prescribed non-steroidal anti-inflammatory drugs (NSAIDs) that are not in accordance with their cardiovascular (CV) or gastrointestinal (GI) risk profiles. However, no such study has been carried out in the United States. Therefore, we sought to examine the prevalence and predictors of potentially inappropriate NSAIDs use in older adults (age > 65) with OA using machine learning with real-world data from Optum De-identified Clinformatics® Data Mart. We identified a retrospective cohort of eligible individuals using data from 2015 (baseline) and 2016 (follow-up). Potentially inappropriate NSAIDs use was identified using the type (COX-2 selective vs. non-selective) and length of NSAIDs use and an individual’s CV and GI risk. Predictors of potentially inappropriate NSAIDs use were identified using eXtreme Gradient Boosting. Our study cohort comprised of 44,990 individuals (mean age 75.9 years). We found that 12.8% individuals had potentially inappropriate NSAIDs use, but the rate was disproportionately higher (44.5%) in individuals at low CV/high GI risk. Longer duration of NSAIDs use during baseline (AOR 1.02; 95% CI:1.02–1.02 for both non-selective and selective NSAIDs) was associated with a higher risk of potentially inappropriate NSAIDs use. Additionally, individuals with low CV/high GI (AOR 1.34; 95% CI:1.20–1.50) and high CV/low GI risk (AOR 1.61; 95% CI:1.34–1.93) were also more likely to have potentially inappropriate NSAIDs use. Heightened surveillance of older adults with OA requiring NSAIDs is warranted.

Download Full-text

Non-linear associations between built environment and active travel for working and shopping: An extreme gradient boosting approach

Journal of Transport Geography ◽

10.1016/j.jtrangeo.2021.103034 ◽

2021 ◽

Vol 92 ◽

pp. 103034

Author(s):

Jixiang Liu ◽

Bo Wang ◽

Longzhu Xiao

Keyword(s):

Built Environment ◽

Active Travel ◽

Gradient Boosting ◽

Extreme Gradient Boosting ◽

Non Linear

Download Full-text

Research on the Difference Between Recreational Walking and Transport Walking Among the Elderly in Mega Cities With Different Density Zones: The Case of Guangzhou City

Frontiers in Public Health ◽

10.3389/fpubh.2021.775103 ◽

2021 ◽

Vol 9 ◽

Author(s):

Peng Zang ◽

Hualong Qiu ◽

Fei Xian ◽

Xiang Zhou ◽

Shifa Ma ◽

...

Keyword(s):

Physical Activity ◽

Land Use ◽

Built Environment ◽

Older People ◽

Street Connectivity ◽

Guangzhou City ◽

Normalised Difference Vegetation Index ◽

Land Use Mix ◽

Recreational Walking ◽

Intersection Density

Walking is the easiest method of physical activity for older people, and current research has demonstrated that the built environment is differently associated with recreational and transport walking. This study modelled the environmental characteristics of three different building density zones in Guangzhou city at low, medium, and high densities, and examined the differences in walking among older people in the three zones. The International Physical Activity Questionnaire (IPAQ) was used to investigate the recreational and transport walking time of older people aged 65 years and above for the past week, for a total of three density zones (N = 597) and was analysed as a dependent variable. Geographic Information Systems (GIS) was used to identify 300, 500, 800, and 1,000 m buffers and to assess differences between recreational and transport walking in terms of the built environment [e.g., land-use mix, street connectivity, Normalised Difference Vegetation Index (NDVI) data]. The data were processed and validated using the SPSS software to calculate Pearson's correlation models and stepwise regression models between recreation and transit walking and the built environment. The results found that land use mix and NDVI were positively correlated with transport walking in low-density areas and that transport walking was negatively correlated with roadway mediated centrality (BtE) and Point-of-Interest (PoI) density. Moreover, recreational walking in medium density areas was negatively correlated with self-rated health, road intersection density, and PoI density while positively correlated with educational attainment, population density, land use mix, street connectivity, PoIs density, and NDVI. Transport walking was negatively correlated with land-use mix, number of road crossings while positively correlated with commercial PoI density. Street connectivity, road intersection density, DNVI, and recreational walking in high-density areas showed negative correlations. Moreover, the built environment of older people in Guangzhou differed between recreational and transport walking at different densities. The richness of PoIs has different effects on different types of walking.

Download Full-text