Neighborhood and healthy aging in a German city: distances to green space and senior service centers and their associations with physical constitution, disability, and health-related quality of life

Abstract

The composition of the residential environment may have an independent influence on health, especially in older adults. In this cross-sectional study, we examined the associations between proximity to two features of the residential environment (green space and senior service centers) and three aspects of healthy aging (self-rated physical constitution, disability, and health-related quality of life). We included 1711 inhabitants from the city of Augsburg, Germany, aged 65 years or older, who participated in the KORA-Age study conducted in 2008/2009. We calculated the Euclidian distances between each participant’s residential address and the nearest green space or senior service center, using a geographic information system. Multilevel logistic regression models were fitted to analyze the associations, controlling for demographic and socioeconomic factors. Contrary to expectations, we did not find clear associations between the distances to the nearest green space or senior service center and any of the examined aspects of healthy aging. The importance of living close to green space may largely depend on the study location. The city of Augsburg is relatively small (about 267,000 inhabitants) and has a high proportion of greenness. Thus, proximity to green space may not be as important as in a densely populated metropolitan area. Moreover, an objectively defined measure of access such as Euclidian distance may not reflect the actual use. Future studies should try to assess the importance of resources of the residential environment not only objectively, but also from the resident’s perspective.

This is a preview of subscription content, access via your institution.

Fig. 1

References

  1. Baltes PB (1997) On the incomplete architecture of human ontogeny. Selection, optimization, and compensation as foundation of developmental theory. Am Psychol 52:366–380

    Article  Google Scholar 

  2. Bruce B, Fries JF (2003) The Stanford Health Assessment Questionnaire: dimensions and practical applications. Health Qual Life Outcomes 1:20. doi:10.1186/1477-7525-1-20

    Article  Google Scholar 

  3. Bruhlmann P, Stucki G, Michel BA (1994) Evaluation of a German version of the physical dimensions of the Health Assessment Questionnaire in patients with rheumatoid arthritis. J Rheumatol 21:1245–1249

    Google Scholar 

  4. Bundesagentur für Arbeit (2009) Kennzahlen für interregionale Vergleiche im Rechtskreis SGB II. Statistik der Bundesagentur für Arbeit, Nürnberg

    Google Scholar 

  5. Chakravarty EF, Hubert HB, Krishnan E, Bruce BB, Lingala VB, Fries JF (2012) Lifestyle risk factors predict disability and death in healthy aging adults. Am J Med 125:190–197. doi:10.1016/j.amjmed.2011.08.006

    Article  Google Scholar 

  6. Cho SK et al (2012) Do patients with elderly-onset rheumatoid arthritis have severe functional disability? Semin Arthritis Rheum 42:23–31. doi:10.1016/j.semarthrit.2012.02.004

    Article  Google Scholar 

  7. Coombes E, Jones AP, Hillsdon M (2010) The relationship of physical activity and overweight to objectively measured green space accessibility and use. Soc Sci Med 70:816–822. doi:10.1016/j.socscimed.2009.11.020

    Article  Google Scholar 

  8. Cosco TD, Prina AM, Perales J, Stephan BC, Brayne C (2014) Operational definitions of successful aging: a systematic review. Int Psychogeriatr 26:373–381. doi:10.1017/S1041610213002287

    Article  Google Scholar 

  9. Depp CA, Jeste DV (2006) Definitions and predictors of successful aging: a comprehensive review of larger quantitative studies. Am J Geriatr Psychiatry 14:6–20. doi:10.1097/01.JGP.0000192501.03069.bc

    Article  Google Scholar 

  10. Diez Roux AV (2002) Invited commentary: places, people, and health. Am J Epidemiol 155:516–519

    Article  Google Scholar 

  11. Ellaway A, Macintyre S, Bonnefoy X (2005) Graffiti, greenery, and obesity in adults: secondary analysis of European cross sectional survey. BMJ 331:611–612. doi:10.1136/bmj.38575.664549.F7

    Article  Google Scholar 

  12. Fitzpatrick K, LaGory M (2000) Unhealthy places: the ecology of risk in the urban landscape. Routledge, New York

    Google Scholar 

  13. Fries JF, Spitz PW, Young DY (1982) The dimensions of health outcomes: the health assessment questionnaire, disability and pain scales. J Rheumatol 9:789–793

    Google Scholar 

  14. Gerstorf D, Ram N, Goebel J, Schupp J, Lindenberger U, Wagner GG (2010) Where people live and die makes a difference: individual and geographic disparities in well-being progression at the end of life. Psychol Aging 25:661–676. doi:10.1037/a0019574

    Article  Google Scholar 

  15. Glass TA (2003) Assessing the success of successful aging. Ann Intern Med 139:382–383

    Article  Google Scholar 

  16. Greiner W, Claes C, Busschbach JJ, von der Schulenburg JM (2005) Validating the EQ-5D with time trade off for the German population. Eur J Health Econ 6:124–130

    Article  Google Scholar 

  17. Hartman-Stein PE, Potkanowicz ES (2003) Behavioral determinants of healthy aging: good news for the baby boomer generation. Online J Issues Nurs 8:6

    Google Scholar 

  18. Holle R, Happich M, Löwel H, Wichmann H (2005) KORA—a research platform for population based health research. Das Gesundheitswesen 67:19–25. doi:10.1055/s-2005-858235

    Article  Google Scholar 

  19. Huang IC, Frangakis C, Atkinson MJ, Willke RJ, Leite WL, Vogel WB, Wu AW (2008) Addressing ceiling effects in health status measures: a comparison of techniques applied to measures for people with HIV disease. Health Serv Res 43:327–339. doi:10.1111/j.1475-6773.2007.00745.x

    Article  Google Scholar 

  20. Informationssystem Stadt und Umwelt (2009) Umweltatlas Berlin: Versorgung mit öffentlichen, wohnungsnahen Grünanlagen. Senatsverwaltung für Stadtentwicklung, Berlin

    Google Scholar 

  21. Lawton MP (1990) Residential environment and self-directedness among older people. Am Psychol 45:638–640

    Article  Google Scholar 

  22. Lee AC, Maheswaran R (2011) The health benefits of urban green spaces: a review of the evidence. J Public Health (Oxf) 33:212–222. doi:10.1093/pubmed/fdq068

    Article  Google Scholar 

  23. Li L, Fu AZ (2009) Some methodological issues with the analysis of preference-based EQ-5D index score. Health Serv Outcomes Res Method 9:162–176. doi:10.1007/s10742-009-0053-3

    Article  Google Scholar 

  24. Maas J, Verheij RA, Groenewegen PP, de Vries S, Spreeuwenberg P (2006) Green space, urbanity, and health: how strong is the relation? J Epidemiol Community Health 60:587–592. doi:10.1136/jech.2005.043125

    Article  Google Scholar 

  25. Maas J, Verheij RA, de Vries S, Spreeuwenberg P, Schellevis FG, Groenewegen PP (2009) Morbidity is related to a green living environment. J Epidemiol Community Health 63:967–973. doi:10.1136/jech.2008.079038

    Article  Google Scholar 

  26. Macintyre S, Macdonald L, Ellaway A (2008) Lack of agreement between measured and self-reported distance from public green parks in Glasgow, Scotland. Int J Behav Nutr Phys Act 5:26. doi:10.1186/1479-5868-5-26

    Article  Google Scholar 

  27. Michael YL, Perdue LA, Orwoll ES, Stefanick ML, Marshall LM (2010) Physical activity resources and changes in walking in a cohort of older men. Am J Public Health 100:654–660. doi:10.2105/AJPH.2009.172031

    Article  Google Scholar 

  28. Mitchell R, Popham F (2008) Effect of exposure to natural environment on health inequalities: an observational population study. Lancet 372:1655–1660. doi:10.1016/S0140-6736(08)61689-X

    Article  Google Scholar 

  29. Mowafi M, Khadr Z, Bennett G, Hill A, Kawachi I, Subramanian SV (2012) Is access to neighborhood green space associated with BMI among Egyptians? A multilevel study of Cairo neighborhoods. Health Place 18:385–390. doi:10.1016/j.healthplace.2011.12.002

    Article  Google Scholar 

  30. Nielsen TS, Hansen KB (2007) Do green areas affect health? Results from a Danish survey on the use of green areas and health indicators. Health Place 13:839–850. doi:10.1016/j.healthplace.2007.02.001

    Article  Google Scholar 

  31. Parra DC et al (2010) Perceived and objective neighborhood environment attributes and health related quality of life among the elderly in Bogota, Colombia. Soc Sci Med 70:1070–1076. doi:10.1016/j.socscimed.2009.12.024

    Article  Google Scholar 

  32. Peace S (1982) The activity patterns of elderly people in Swansea, South Wales, and South East England. In: Warnes A (ed) Geographical Perspectives on the Elderly. Wiley, New York, pp 281–301

    Google Scholar 

  33. Peters A et al (2011) Multimorbidity and successful aging: the population-based KORA-Age study. Z Gerontol Geriatr 44(Suppl 2):41–54. doi:10.1007/s00391-011-0245-7

    Article  Google Scholar 

  34. Phelan EA, Anderson LA, LaCroix AZ, Larson EB (2004) Older adults’ views of “successful aging”—how do they compare with researchers’ definitions? J Am Geriatr Soc 52:211–216

    Article  Google Scholar 

  35. Richardson E, Pearce J, Mitchell R, Day P, Kingham S (2010) The association between green space and cause-specific mortality in urban New Zealand: an ecological analysis of green space utility. BMC Public Health 10:240. doi:10.1186/1471-2458-10-240

    Article  Google Scholar 

  36. Salkeld G, Cameron ID, Cumming RG, Easter S, Seymour J, Kurrle SE, Quine S (2000) Quality of life related to fear of falling and hip fracture in older women: a time trade off study. BMJ 320:316–341

    Article  Google Scholar 

  37. Sokka T, Krishnan E, Hakkinen A, Hannonen P (2003) Functional disability in rheumatoid arthritis patients compared with a community population in Finland. Arthritis Rheum 48:59–63. doi:10.1002/art.10731

    Article  Google Scholar 

  38. Soziale Fachberatung für Senioren (2013) http://www.seniorenfachberatung-augsburg.de/. Accessed 20 Feb 2013

  39. Soziale Fachberatung für Senioren in den Augsburger Stadtteilen (2010) Jahresbericht 2009

  40. Stadt Augsburg. Amt für Statistik und Stadtforschung (2013) Statistik Augsburg interaktiv. https://www3.augsburg.de/jserv/Statistik/content/main.jsp?year=2009&mode=1&area=3&id=-1&indi=0

  41. Stigsdotter UK, Ekholm O, Schipperijn J, Toftager M, Kamper-Jorgensen F, Randrup TB (2010) Health promoting outdoor environments–associations between green space, and health, health-related quality of life and stress based on a Danish national representative survey. Scand J Public Health 38:411–417. doi:10.1177/1403494810367468

    Article  Google Scholar 

  42. Takano T, Nakamura K, Watanabe M (2002) Urban residential environments and senior citizens’ longevity in megacity areas: the importance of walkable green spaces. J Epidemiol Community Health 56:913–918

    Article  Google Scholar 

  43. The EuroQol Group (1990) EuroQol–a new facility for the measurement of health-related quality of life. Health Policy 16:199–208

    Article  Google Scholar 

  44. U.S. Department of Health and Human Services (1996) Physical activity and health: A report of the surgeon general. Atlanta

  45. Villeneuve PJ, Jerrett M, Su JG, Burnett RT, Chen H, Wheeler AJ, Goldberg MS (2012) A cohort study relating urban green space with mortality in Ontario, Canada. Environ Res 115:51–58. doi:10.1016/j.envres.2012.03.003

    Article  Google Scholar 

  46. Voigtländer S, Berger U, Razum O (2010) The impact of regional and neighbourhood deprivation on physical health in Germany: a multilevel study. BMC Public Health 10:403. doi:10.1186/1471-2458-10-403

    Article  Google Scholar 

  47. Vries Sd, Verheij RA, Groenewegen PP, Spreeuwenberg P (2003) Natural environments—healthy environments? An exploratory analysis of the relationship between greenspace and health. Environment and Planning A 35:1717–1731. doi:10.1068/a35111

    Article  Google Scholar 

  48. White DK et al (2010) Are features of the neighborhood environment associated with disability in older adults? Disabil Rehabil 32:639–645. doi:10.3109/09638280903254547

    Article  Google Scholar 

Download references

Acknowledgments

The authors would like to thank the Department for Open Space Planning, Nature Conservation and Cemeteries of the city of Augsburg for providing the geocodes of the public green space in Augsburg. Furthermore, we would like to thank the Department for Statistics and Urban Studies of the city of Augsburg for providing data necessary for calculating regional area deprivation, and the Department of Geospatial Data of the city of Augsburg for providing the geocodes of the ‘senior care regions’. In particular, we would like to thank Christin Abel for her support in calculating the distances.

Funding

The KORA (Cooperative Health Research in the Region of Augsburg) research platform, funded by the German Federal Ministry of Education, Science, Research and Technology and the State of Bavaria, was initiated and financed by the Helmholtz Zentrum München, German Research Center for Environmental Health. As part of the ‘Health in old age’ program, the KORA-Age Study was financed by the German Federal Ministry of Education and Research (BMBF FKZ 01ET0713 and 01ET1003A). The KORA-Age study was further funded by the German Research Foundation (Deutsche Forschungsgemeinschaft) (GR 3608/1-1).

Conflict of interest

The authors declare that they have no competing interests.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Susanne Vogt.

Additional information

Responsible editor: H.W. Wahl.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Vogt, S., Mielck, A., Berger, U. et al. Neighborhood and healthy aging in a German city: distances to green space and senior service centers and their associations with physical constitution, disability, and health-related quality of life. Eur J Ageing 12, 273–283 (2015). https://doi.org/10.1007/s10433-015-0345-0

Download citation

Keywords

  • Residential environment
  • Green space
  • Distance
  • Geographic information system
  • Healthy aging