Neighbourhood characteristics influence community participation among older adults

Vaughan M, LaValley M, AlHeresh R, et al. Which features of the environment impact community participation of older adults? A systematic review and meta-analysis  Journal of Aging and Health. 2015; 28(6): 957-978.

Review question

Do certain environmental qualities of a neighbourhood, particularly social and street-level factors, improve the level of community participation among adults over the age of 55?

Background

Community participation and engagement is a key component of healthy aging; however, for older adults participating in social and community activities can involve challenges associated with medical conditions that are more prevalent in the aging population. Common medical conditions preventing older adults from engaging in activities outside the home include mobility limitations and conditions requiring frequent care, such as arthritis, respiratory disease or diabetes.

Although specific physical, social and policy features of the environment, such as providing benches to rest in cities where walking long distances is required, have been shown to improve the participation of older adults in community activities, opportunities for improvement still exist. A growing number of initiatives to create age-friendly cities and improve the person-environment “fit” for older adults have been adopted by cities worldwide.

Despite observed efforts towards age-friendly cities, limited empirical evidence links specific environmental factors to higher levels of community participation among older adults. The identification of evidence highlighting key environmental features to improve community participation will inform future age-friendly community initiatives. Thus, this systematic review aims to investigate the environmental factors proven to increase the participation of community-dwelling older adults.

How the review was done

A detailed search of a number of electronic databases for studies published from 2001 to 2017 was conducted. Studies that focused on social and street-level environmental factors of neighbourhood communities that affect the participation rates of adults over the age of 55 in non-domestic, outside-the-home activities were included in the review.

A total of 1,295 studies were identified in searches, and 12 were included in the review after assessments for eligibility.

This review was funded by a NIDILRR Center Grant (Enhancing Activity & Participation among Persons with Arthritis (ENACT)) and a NIAMS Multidisciplinary Clinical Research Center Grant.

What the researchers found

Based on the participants recruited from both urban and rural locations, this review found positive statistical significance between the following environmental factors and community participation of older adults: street connectivity/walkability; land-use diversity; perceived social support; neighbourliness; transportation services; and civil protection services.

Of these factors, the social support that comes with living with and near friends and family created a “togetherness-oriented participation feel,” which improved the likelihood of community participation for older adults the most.

The review also found that street connectivity and walkability, such as qood side-walk conditions, improved social engagement for older adults significantly.

Although a positive statistical significance was found, studies that highlighted the impact of transportation services and civil protection services to improve community participation were limited in scope to older adults with physical limitations and in strict urban settings.

Conclusion

The results of this review highlight the positive correlation between social and physical factors of neighbourhood environments, and community participation of older adults. Improving community participation outcomes can improve the healthy aging process, thus is relevant for planners, policymakers and public-health advocates.

Opportunities for research study improvements identified by the review include a more consistent approach to measuring specific environmental factors, addressing the interaction of personal factors with community participation (e.g., gender), and discussing the role of individual as well as summative effects on community engagement.