Future Directions for the Demography of Aging Proceedings of a Workshop (2018) / Chapter Skim
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5 Place, Aging, and Health - Kathleen A. Cagney and Erin York Cornwell
5 Place, Aging, and Health - Kathleen A. Cagney and Erin York Cornwell
Pages 131-156
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From page 131... ...
Place suggests a physical space with environmental conditions that may directly impact older adults' health. Place also encompasses a built environment that may promote or impede mobility and an organizational, institutional, municipal, or policy setting that determines access to resources such as health care, fresh foods, and social services.
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Lawton and Nahemow's (1973) Ecological Model of Aging provided a foundation for environmental gerontology by explicitly introducing environmental considerations into research on health and aging, rather than relying solely on a biological framework.
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. Third, a large body of social, scientific, and epidemiological research has been devoted to examining how social context affects health.
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We describe this work in more detail below. Research has identified neighborhood effects on individual outcomes across the life course, but some researchers argue that neighborhood conditions may be particularly salient for health and well-being in later life (Robert and Li, 2001)
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The median age for adults in rural areas is 51, as compared to 45 in urban areas (U.S. Census Bureau, 2017)
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. Data are limited on the extent to which levels of social capital are lower in suburbs compared to cities, but if so, suburban older adults may lack proximal social support when faced with challenges related to navigating their areas and meeting routine needs.
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(2015) , in an analysis of subjective well-being, found that the U-shaped life evaluation documented in high-income English-speaking countries -- that life evaluation dips in middle age and rises again in old age -- did not hold in eastern Europe and the former Soviet Union, sub-Saharan Africa, and the Caribbean and Latin America (where life evaluation decreases with age)
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SOURCE: U.S. Census Bureau.
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Residential Neighborhoods While the work on neighborhood context and health is too vast to summarize effectively in this chapter, we note that neighborhood influences on health have been documented for physical and mental health, with neighborhood conditions linked to outcomes such as asthma (Cagney and Browning, 2004) , obesity (King et al., 2011)
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Coping with environmental challenges, particularly in a resource-poor environment, may sap time and energy, thereby depleting individuals' abilities to maintain social ties, which may negatively impact health. Indeed, older adults who reside in socioeconomically disadvantaged neighborhoods appear to have smaller social networks.
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Although depres 20 .... ;:j' 19 C J, 18 CII 0 17 "' Vl 16 E • 0 E 15 Vl CII 14 ·;;; CII 13 CII C 12 • 11 Low Mid High Low Mid High Low Mid High Low Mid High Low Mid High Low Mid High Concentrated Neighborhood Neighborhood Neighborhood Neighborhood Block Density Disadvantage Problems Social Cohesion Social Ties Safety FIGURE 5-3 Neighborhood conditions and depressive symptoms.
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From page 142... ...
Neighborhood social conditions, including cohesion, social ties, and safety, are negatively associated with depressive symptoms. Activity Spaces Research on neighborhood effects on health is primarily focused on the residential neighborhood, with little attention devoted to the other spaces that individuals encounter during their daily lives (Chaix, 2009; DiezRoux, 2007; Matthews and Yang, 2013)
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Residential neighborhood contexts, adjoining areas, and the availability of public transportation may also contribute to across-neighborhood dif
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That is, some older adults may be able to overcome limited local resources by accessing health care centers, pharmacies, and fresh food stores outside of their residential areas. Access to extra local resources may be influenced by individual characteristics, such as socioeconomic resources, social connectedness, health, and physical function (York Cornwell and Cagney, 2017; Kwan, 1999; Jones and Pebley, 2014)
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At the same time, patterns of residential mobility are themselves a structural property of place that may have consequences for community social context and individual outcomes. Residential instability may weaken neighborhood-level social cohesion (Sampson, 2012)
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Exposure to segregated and discriminatory contexts over the life course is thought to result in racial disparities in chronic illness and disability that widen through middle age and into later life (Geronimus et al., 2006)
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(2013) found that poverty was negatively associated with distances to parks and percentages of green spaces in urban and suburban areas while positively associated in rural areas.
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For example, greater distance to health care and other services may make local social ties and support particularly important for nonmetropolitan older adults. The effects of local exposure to stressors may also be conditioned by one's location in urban, suburban, or rural settings.
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that facilitate independent living for many older adults may substitute for interpersonal interaction and reduce the need for local social support. Detailed consideration of this literature is beyond the scope of this chapter, but this area is particularly relevant for future research on aging in place.
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From page 150... ...
. Moving beyond neighborhood: Activity spaces and ecological networks as contexts for youth development.
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. Associa tions of neighborhood problems and neighborhood social cohesion with mental health and health behaviors: The multi-ethnic study of atherosclerosis.
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From page 152... ...
. Redefining neighborhoods using common destinations: Social characteristics of activity spaces and home census tracts compared.
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. An ecological framework of place: Situating environmental gerontology within a life course perspective.
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. Social isolation of the urban poor: Race, class, and neighborhood effects on social resources.
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. Urbanism, neighborhood context, and social networks.
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