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      The Urban Built Environment and Mobility in Older Adults: A Comprehensive Review

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          Abstract

          Mobility restrictions in older adults are common and increase the likelihood of negative health outcomes and premature mortality. The effect of built environment on mobility in older populations, among whom environmental effects may be strongest, is the focus of a growing body of the literature. We reviewed recent research (1990–2010) that examined associations of objective measures of the built environment with mobility and disability in adults aged 60 years or older. Seventeen empirical articles were identified. The existing literature suggests that mobility is associated with higher street connectivity leading to shorter pedestrian distances, street and traffic conditions such as safety measures, and proximity to destinations such as retail establishments, parks, and green spaces. Existing research is limited by differences in exposure and outcome assessments and use of cross-sectional study designs. This research could lead to policy interventions that allow older adults to live more healthy and active lives in their communities.

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          The disablement process

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            Multilevel analyses of neighbourhood socioeconomic context and health outcomes: a critical review.

            Interest in the effects of neighbourhood or local area social characteristics on health has increased in recent years, but to date the existing evidence has not been systematically reviewed. Multilevel or contextual analyses of social factors and health represent a possible reconciliation between two divergent epidemiological paradigms-individual risk factor epidemiology and an ecological approach. Keyword searching of Index Medicus (Medline) and additional references from retrieved articles. All original studies of the effect of local area social characteristics on individual health outcomes, adjusted for individual socioeconomic status, published in English before 1 June 1998 and focused on populations in developed countries. The methodological challenges posed by the design and interpretation of multilevel studies of local area effects are discussed and results summarised with reference to type of health outcome. All but two of the 25 reviewed studies reported a statistically significant association between at least one measure of social environment and a health outcome (contextual effect), after adjusting for individual level socioeconomic status (compositional effect). Contextual effects were generally modest and much smaller than compositional effects. The evidence for modest neighbourhood effects on health is fairly consistent despite heterogeneity of study designs, substitution of local area measures for neighbourhood measures and probable measurement error. By drawing public health attention to the health risks associated with the social structure and ecology of neighbourhoods, innovative approaches to community level interventions may ensue.
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              Multilevel analyses of neighbourhood socioeconomic context and health outcomes: a critical review

              K Pickett (2001)
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                Author and article information

                Journal
                J Aging Res
                JAR
                Journal of Aging Research
                SAGE-Hindawi Access to Research
                2090-2204
                2090-2212
                2011
                30 June 2011
                : 2011
                : 816106
                Affiliations
                Department of Epidemiology and Biostatistics, Drexel University School of Public Health, 1505 Race Street, Mail Stop 1033, Bellet 6th Floor, Philadelphia, PA 19102, USA
                Author notes
                *Andrea L. Rosso: alr44@ 123456drexel.edu

                Academic Editor: Thomas R. Prohaska

                Article
                10.4061/2011/816106
                3134204
                21766033
                a956f29d-665d-47f7-ba10-05157d4a14fd
                Copyright © 2011 Andrea L. Rosso et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 16 December 2010
                : 3 May 2011
                Categories
                Review Article

                Molecular medicine
                Molecular medicine

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