title: Access to commercial destinations within the neighbourhood and walking among Australian older adults.
abstract: BACKGROUND
  Physical activity, particularly walking, is greatly beneficial to health; yet a sizeable proportion of older adults are insufficiently active. The importance of built environment attributes for walking is known, but few studies of older adults have examined neighbourhood destinations and none have investigated access to specific, objectively-measured commercial destinations and walking.
  
  
  METHODS
  We undertook a secondary analysis of data from the Western Australian state government's health surveillance survey for those aged 65-84 years and living in the Perth metropolitan region from 2003-2009 (n = 2,918). Individual-level road network service areas were generated at 400 m and 800 m distances, and the presence or absence of six commercial destination types within the neighbourhood service areas identified (food retail, general retail, medical care services, financial services, general services, and social infrastructure). Adjusted logistic regression models examined access to and mix of commercial destination types within neighbourhoods for associations with self-reported walking behaviour.
  
  
  RESULTS
  On average, the sample was aged 72.9 years (SD = 5.4), and was predominantly female (55.9%) and married (62.0%). Overall, 66.2% reported some weekly walking and 30.8% reported sufficient walking (≥150 min/week). Older adults with access to general services within 400 m (OR = 1.33, 95% CI = 1.07-1.66) and 800 m (OR = 1.20, 95% CI = 1.02-1.42), and social infrastructure within 800 m (OR = 1.19, 95% CI = 1.01-1.40) were more likely to engage in some weekly walking. Access to medical care services within 400 m (OR = 0.77, 95% CI = 0.63-0.93) and 800 m (OR = 0.83, 95% CI = 0.70-0.99) reduced the odds of sufficient walking. Access to food retail, general retail, financial services, and the mix of commercial destination types within the neighbourhood were all unrelated to walking.
  
  
  CONCLUSIONS
  The types of neighbourhood commercial destinations that encourage older adults to walk appear to differ slightly from those reported for adult samples. Destinations that facilitate more social interaction, for example eating at a restaurant or church involvement, or provide opportunities for some incidental social contact, for example visiting the pharmacy or hairdresser, were the strongest predictors for walking among seniors in this study. This underscores the importance of planning neighbourhoods with proximate access to social infrastructure, and highlights the need to create residential environments that support activity across the life course.
authors.affiliation: Centre for the Built Environment and Health, School of Population Health, The University of Western Australia, Crawley, Australia. andrea.nathan@uwa.edu.au
authors.forename: Andrea
authors.initials: A
authors.lastname: Nathan
authors.forename: Gavin
authors.initials: G
authors.lastname: Pereira
authors.forename: Sarah
authors.initials: S
authors.lastname: Foster
authors.forename: Paula
authors.initials: P
authors.lastname: Hooper
authors.forename: Dick
authors.initials: D
authors.lastname: Saarloos
authors.forename: Billie
authors.initials: B
authors.lastname: Giles-Corti
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D003132:Commerce / Q000706:statistics & numerical data*; D004779:Environment Design; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D012111:Residence Characteristics; D012931:Social Environment; D016138:Walking / Q000523:psychology* / Q000706:statistics & numerical data*