Neighborhood characteristics and disability in older adults.
OBJECTIVE
To characterize the influence of the residential neighborhood of older adults on the prevalence of disability.


METHODS
We combined Census data on disability in older adults living in New York City with environmental information from a comprehensive geospatial database. We used factor analysis to derive dimensions of compositional and physical neighborhood characteristics and linear regression to model their association with levels of disability. Measures of neighborhood collective efficacy were added to these models to explore the impact of the social environment.


RESULTS
Low neighborhood socioeconomic status, residential instability, living in areas with low proportions of foreign born and high proportions of Black residents, and negative street characteristics were associated with higher prevalence of both "physical" disability and "going outside the home" disability. High crime levels were additionally associated with physical disability, although this relationship disappeared when misdemeanor arrests were removed from the crime variable. Low levels of collective efficacy were associated with more going-outside-the-home disability, with racial/ethnic composition dropping out of this model to be replaced by an interaction term.


CONCLUSIONS
The urban environment may have a substantial impact on whether an older adult with a given level of functional impairment is able to age actively and remain independent.
Beard
John R
JR
Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029-5202, USA. jbeard@nyam.org
Blaney
Shannon
S
Cerda
Magda
M
Frye
Victoria
V
Lovasi
Gina S
GS
Ompad
Danielle
D
Rundle
Andrew
A
Vlahov
David
D
D000368:Aged; D003415:Crime / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D018864:Cultural Diversity; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D004779:Environment Design; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009519:New York City; D012111:Residence Characteristics; D012307:Risk Factors; D012927:Social Control, Informal; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data*