title: The influence of walkability on broader mobility for Canadian middle aged and older adults: An examination of Walk Score™ and the Mobility Over Varied Environments Scale (MOVES).
abstract: Neighborhood built environments may play an important role in shaping mobility and subsequent health outcomes. However, little work includes broader mobility considerations such as cognitive ability to be mobile, social connections with community, or transportation choices. We used a population-based sample of Canadian middle aged and older adults (aged 45 and older) from the Canadian Community Health Survey-Healthy Aging (CCHS-HA, 2008-2009) to create a holistic mobility measure: Mobility over Varied Environments Scale (MOVES). Data from CCHS-HA respondents from British Columbia with MOVES were linked with Street Smart Walk Score™ data by postal code (n=2046). Mean MOVES was estimated across sociodemographic and health characteristics. Linear regression, adjusted for relevant covariates, was used to estimate the association between Street Smart Walk Score™ and the MOVES. The mean MOVES was 30.67 (95% confidence interval (CI) 30.36, 30.99), 5th percentile 23.27 (CI 22.16, 24.38) and 95th percentile was 36.93 (CI 35.98, 37.87). MOVES was higher for those who were younger, married, higher socioeconomic status, and had better health. In unadjusted models, for every 10 point increase in Street Smart Walk Score™, MOVES increased 4.84 points (CI 4.52, 5.15). However, results attenuated after adjustment for sociodemographic covariates: each 10 point increase in Street Smart Walk Score™ was associated with a 0.10 (CI 0.00, 0.20) point increase in MOVES. The modest but important link we observed between walkability and mobility highlights the implication of neighborhood design on the health of middle aged and older adults.
authors.affiliation: Department of Epidemiology and Biostatistics, University of South Carolina, USA; Centre for Hip Health and Mobility, University of British Columbia, Canada. Electronic address: hijana@live.unc.edu.
authors.forename: Jana A
authors.initials: JA
authors.lastname: Hirsch
authors.affiliation: Centre for Hip Health and Mobility, University of British Columbia, Canada; Faculty of Health Sciences, Simon Fraser University, Canada.
authors.forename: Meghan
authors.initials: M
authors.lastname: Winters
authors.affiliation: Department of Epidemiology, University of Michigan, USA; Institute for Social Research, University of Michigan, USA.
authors.forename: Philippa J
authors.initials: PJ
authors.lastname: Clarke
authors.affiliation: Simon Fraser University, Canada.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Ste-Marie
authors.affiliation: Centre for Hip Health and Mobility, University of British Columbia, Canada; Department of Family Practice, University of British Columbia, Canada; Department of Orthopaedics, University of British Columbia, Canada.
authors.forename: Heather A
authors.initials: HA
authors.lastname: McKay
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001955:British Columbia; D004779:Environment Design; D005260:Female; D040362:Geographic Information Systems; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014186:Transportation / Q000706:statistics & numerical data; D016138:Walking
keywords: Environment design; Mobility limitation; Residence characteristics; Social environment; Walking