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Optimizing Mobility in Later Life: The Role of the Urban Built Environment for Older Adults Aging in Place

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Abstract

Hazards in the urban built environment can create barriers to mobility among older adults aging in place. We investigated the relationship between urban built environment characteristics and 15-month trajectories of mobility disability in a sample of 1,188 older adults living in Detroit, MI, a city that has undergone rapid economic and structural decline. Data come from the Michigan Minimum Data Set for Home Care (2001–2008), an enumerative database of older adults in Michigan who qualify for federal or state-funded home and community-based long-term care through a Medicaid waiver program. Standardized assessments are made at intake and every 90 days by case managers. Built environments were assessed with a virtual audit using the “Street View” feature of Google Earth. A summary accessibility score was created for each block based on a count of the number of accessible features (e.g., continuous barrier-free sidewalks and proximity of public transportation). Using growth mixture models, two latent trajectories of outdoor mobility were identified: one capturing occasional outdoor mobility (representing 83 % of the sample) and one capturing almost no mobility outside the home. Controlling for sociodemographic and health risk factors, individuals living in more accessible environments had a 18 % higher odds of being in the more mobile group (OR = 1.18, 95 % CI = 1.01, 1.41). These findings emphasize the importance of the built environment for mobility among urban-dwelling older adults.

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Acknowledgments

This research was supported in part by Grant Number K01EH000286-01 from the Centers for Disease Control and Prevention (CDC). The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official views of the sponsors.

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Authors and Affiliations

  1. Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, 48104, USA

    Philippa Clarke

  2. Michigan State University, East Lansing, MI, USA

    Nancy Ambrose Gallagher

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  1. Philippa Clarke
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  2. Nancy Ambrose Gallagher
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Correspondence to Philippa Clarke.

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Clarke, P., Gallagher, N.A. Optimizing Mobility in Later Life: The Role of the Urban Built Environment for Older Adults Aging in Place. J Urban Health 90, 997–1009 (2013). https://doi.org/10.1007/s11524-013-9800-4

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