Effect of street connectivity on incidence of lower-body functional limitations among middle-aged African Americans.
OBJECTIVE
We hypothesize that lower street connectivity increases the risk of incident lower-body functional limitations (LBFLs) among urban African Americans aged 49-65 years.


METHODS
This population-based cohort was interviewed in home visits. Five items measuring LBFL were obtained at baseline and after 3 years. Participants were considered to have LBFL if they reported difficulty on at least two of the five tasks. Census-tract street connectivity was measured as the ratio of the number of street intersections to the maximum possible number of intersections.


RESULTS
Of 563 subjects with zero or one LBFL at baseline, 109 (19.4%) experienced two or more LBFLs at the 3-year follow-up. Adjusted logistic regression showed that persons who lived in census tracts with the lowest quartile of street connectivity were 3.45 times (95% confidence interval, 1.21-9.78) more likely to develop two or more LBFLs than those who lived in census tracts with the highest quartile of street connectivity independent of other important environmental factors.


CONCLUSIONS
Areas with low street connectivity appear to be an independent contributor to the risk of incident LBFL in middle-aged African Americans.
Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA. mschootm@im.wustl.edu
Mario
M
Schootman
Elena M
EM
Andresen
Fredric D
FD
Wolinsky
Theodore K
TK
Malmstrom
J Philip
JP
Miller
Douglas K
DK
Miller
D000203:Activities of Daily Living; D001741:Black or African American; D000368:Aged; D015331:Cohort Studies; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D054624:Health Status Disparities; D006798:Housing / Q000145:classification; D006801:Humans; D015994:Incidence; D007407:Interviews as Topic; D016013:Likelihood Functions; D008297:Male; D008875:Middle Aged; D008923:Missouri / Q000453:epidemiology; D051346:Mobility Limitation; D011446:Prospective Studies; D012111:Residence Characteristics; D012307:Risk Factors; D012959:Socioeconomic Factors