Adverse Neighborhood Environments and Health Behaviors among Older Americans

Maintaining healthy lifestyle, including healthy diet and physical activity, in adverse neighborhood environments may be more difficult for older adults because of changes linked to aging, which make them more vulnerable to their environments. This study aims to investigate the association of neighborhood disorder with diet quality and physical activity in a national sample of older Americans. For this study, we used data from the Health and Retirement Study. Neighborhood disorders include vandalism, boarded houses, abandoned cars, demolished houses, trash, litter, or junk, poorly kept communal areas, homeless people, prostitution, winos or junkies, and drug use or drug dealing near residents’ housing unit (range: 0-11). Diet quality and physical activity were assessed using the Healthy Eating Index 2015 (HEI-2015; range:0-100) and the metabolic (MET) equivalent activity points (range: 0-31 in this sample). Ordinary least squares regression models were estimated to examine an association between neighborhood disorder, diet quality, and physical activity. Neighborhood disorder was associated with poor diet and physical inactivity. For one additional negative neighborhood feature, HEI-2015 scores and MET-equivalent activity points decreased by 0.55 (95% CI: -1.09. -0.01) and 0.69 (95% CI: -1.05, -0.33). Findings of this study suggest that older adults living in adverse neighborhoods are at a greater risk of poor diet and physical inactivity, which are important risk factors for poor health and chronic diseases. Promoting neighborhood environments and perceived neighborhood safety would increase access to health food, encourage healthy diet and physical activity, and support healthy aging.

Neighborhood Environments and Cognitive Decline in Middle and Old Age in China: Gender and Age Variations

Older adults are more vulnerable to neighborhood physical and social conditions due to longer exposure, increased vulnerability, changing spatial use, and a greater reliance on access to community sources of integration. Previous research has demonstrated an association between neighborhood environments and cognitive function in older adults. However, most studies were cross-sectional, focused on western countries, and did not examine potential moderating factors. This study examined gender and age variations in the relationship between neighborhood environments and cognitive decline in middle and old age in a developing country that is experiencing rapid population aging and rising prevalence of Alzheimer’s disease and related dementias. Using data from a nationally representative sample of adults aged 45 years and older from the three waves of China Health and Retirement Longitudinal Study (CHARLS 2011-2015), this study estimated multilevel growth curve models for the effects of neighborhood environments on cognitive decline separately for men and women and for those aged 45 to 64 and those aged 65 and above. It showed that the cross-sectional effect of outdoor facility and longitudinal effect of handicapped access were more significant for men, but the cross-sectional effect of community social participation and longitudinal effects of raining days, number of disasters, employment service, and community SES were more significant for women. The cross-sectional effect of infrastructure advantages and longitudinal effects of employment service and old age income support were more significant for adults aged 65 and over. These findings suggest that community-level interventions may be more beneficial for older women.

Are Neighbors and Neighborhoods Still Important? Examining the Impact of Neighbors and Neighborhood Environments on Mothers’ Parenting Stress

The contemporary neighborhood literature discusses the complex relationships among neighborhood environments, social support, and parenting. Grounded in the Person-Process-Context-Time (PPCT) model, we examined how different sources of social support interact with Korean mothers’ perception of disorder in their neighborhoods, and if social support increases or decreases their parenting stress in rural and metropolitan areas. Using STATA 14.0, we conducted multiple regression modeling including tests for interaction effects. Our sample (from the 8th Wave PSKC) included 1,300 mothers of seven-year-old children who were transitioning to first grade. The results showed that for metropolitan mothers, support from neighbors was important. Interestingly, receiving social support from friends/colleagues could increase or reduce their parenting stress depending on the type of residential neighborhood. Both rural and metropolitan mothers who reported negative impressions of their neighborhood environment experienced more parenting stress. However, these relationships disappeared when controlling for the interactions between mothers’ perception of disorder in their neighborhood and social support. These findings suggest that the social support that mothers receive from neighbors, and friends/colleagues, in general, play an important role in relieving parenting stress when raising first graders. However, living in disorganized, unsafe, or stressful neighborhood environments may restrict mothers’ parenting choices due to anxiety and limited outdoor space, resulting in increased parenting stress. Therefore, careful consideration of neighborhood characteristics is required to develop community-based parenting support services as part of family-friendly policies to effectively reduce the burden of parenting school-aged children in Korea.

Methods to Address Self-Selection and Reverse Causation in Studies of Neighborhood Environments and Brain Health

Preliminary evidence suggests that neighborhood environments, such as socioeconomic disadvantage, pedestrian and physical activity infrastructure, and availability of neighborhood destinations (e.g., parks), may be associated with late-life cognitive functioning and risk of Alzheimer’s disease and related disorders (ADRD). The supposition is that these neighborhood characteristics are associated with factors such as mental health, environmental exposures, health behaviors, and social determinants of health that in turn promote or diminish cognitive reserve and resilience in later life. However, observed associations may be biased by self-selection or reverse causation, such as when individuals with better cognition move to denser neighborhoods because they prefer many destinations within walking distance of home, or when individuals with deteriorating health choose residences offering health services in neighborhoods in rural or suburban areas (e.g., assisted living). Research on neighborhood environments and ADRD has typically focused on late-life brain health outcomes, which makes it difficult to disentangle true associations from associations that result from reverse causality. In this paper, we review study designs and methods to help reduce bias due to reverse causality and self-selection, while drawing attention to the unique aspects of these approaches when conducting research on neighborhoods and brain aging.