title: Neighborhood safety factors associated with older adults' health-related outcomes: A systematic literature review.
abstract: Neighborhood safety is important for older adults' health and wellbeing, but there has not been a synthesis in the literature of what is currently known about this construct.
  
  
  
  This systematic literature review, following the PRISMA guidelines, focuses on identifying neighborhood safety factors associated with health-related outcomes and behaviors of older adults in the U.S.
  
  
  
  A search was conducted in 2014 via Academic Search Complete, CINAHL, Embase, MEDLINE, SportDis, and Transportation Databases. Based on our inclusion and exclusion criteria, we identified thirty-two articles for review.
  
  
  
  Sixteen studies examined health outcomes such as health status, mental health, physical function, morbidity/mortality, and obesity; the other sixteen studies focused on health behaviors, such as physical activity and walking. Four domains of neighborhood safety were identified: overall/general neighborhood safety; crime-related safety; traffic-related safety; and proxies for safety (e.g., vandalism, graffiti). Overall/general neighborhood safety appeared most relevant to mental health and physical function. Traffic-related safety was most pertinent to physical activity, while crime-related safety was more consistently associated with mental health and walking. While all safety variables were significantly associated with mental health, no significant associations were found for obesity. We also found that specific measures or constructs of safety were not applied consistently across the examined studies, making it difficult to compare the results.
  
  
  
  This review identified several important gaps in the existing studies dealing with neighborhood safety-health relationships among older adults. Further studies are needed that examine the different roles of multidimensional neighborhood safety in promoting the community health, not only in the U.S., but globally.
authors.affiliation: Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, 3137 TAMU, College Station, TX, 77843-3137, USA. Electronic address: jaewoongwon@tamu.edu.
authors.forename: Jaewoong
authors.initials: J
authors.lastname: Won
authors.affiliation: Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, 3137 TAMU, College Station, TX, 77843-3137, USA. Electronic address: chanam@tamu.edu.
authors.forename: Chanam
authors.initials: C
authors.lastname: Lee
authors.affiliation: Department of Family & Community Medicine, Texas A&M HSC College of Medicine, Baylor Scott & White Health, Santa Fe - Century Square, 1402 West Ave H, Temple, TX 76504-5342, USA; Department of Health Promotion and Community Health Sciences, Texas A&M HSC School of Public Health, TAMU 1266, College Station, TX, 77843-1266, USA. Electronic address: Samuel.Forjuoh@BSWHealth.org.
authors.forename: Samuel N
authors.initials: SN
authors.lastname: Forjuoh
authors.affiliation: Department of Health Promotion and Community Health Sciences, Texas A&M HSC School of Public Health, TAMU 1266, College Station, TX, 77843-1266, USA. Electronic address: MOry@sph.tamhsc.edu.
authors.forename: Marcia G
authors.initials: MG
authors.lastname: Ory
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003153:Community Health Services / Q000379:methods / Q000592:standards; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D061214:Patient Safety / Q000592:standards*; D012111:Residence Characteristics; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States
keywords: Health behaviors; Health outcomes; Neighborhood safety; Older adults; Systematic review