Exploring the Influence of the Perceived Neighborhood Built Environment on the Fall Risks among Older Adults in China
Abstract
:1. Introduction
2. Literature Review and Research Framework
2.1. Neighborhood Built Environment and Fall Risks
2.2. Perceived Built Environment
2.3. Research Framework
3. Methods
3.1. Data
3.2. Measurement of Variables
3.2.1. Falling History
3.2.2. PBE Score
3.2.3. Covariates
3.3. Statistical Analysis
4. Results
4.1. Descriptive Statistics
4.2. The Relationship between the PBE and Fall Risk among Older Adults
4.3. Heterogeneity
5. Discussion
6. Conclusions
Author Contributions
Funding
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Major Factors | Key Findings | References |
---|---|---|
Quality of pavements | Unevenness, slipperiness, the presence of obstacles, and the material’s composition directly influence the walking patterns of older adults | [5,8,18] |
Design of facilities | Inadequate facilities such as seating areas, stairs, utility poles, and other locations contribute to falls | [19,20] |
Transportation system | High traffic speeds, the volume of vehicles, pedestrian density, etc. contribute to falls | [21] |
Natural environment | A superposition effect on risks related to the neighborhood built environment | [22,23,24,25] |
Dimensions | Items | Responses | Operationalization |
---|---|---|---|
Road conditions | What is the level of satisfaction regarding road conditions within your neighborhood? | Each item used a 5-point Likert-like scale: 1 = very dissatisfied 2 = relatively dissatisfied 3 = fair 4 = relatively satisfied 5 = very satisfied | Adding up the responses from the six dimensions to derive a composite score that reflected respondents’ PBE of their neighborhood. The range of the PBE score was from 6 to 30. |
Fitness and recreational spaces | What is the level of satisfaction regarding fitness and recreational spaces within your neighborhood? | ||
Neighborhood safety | What is the level of satisfaction regarding neighborhood safety in the environment within your neighborhood? | ||
Environmental cleanness | What is the level of satisfaction regarding environmental cleanness within your neighborhood? | ||
Road lighting | What is the level of satisfaction regarding road lighting within your neighborhood? | ||
Accessibility facilities | What is the level of satisfaction regarding accessibility facilities within your neighborhood? |
Mean/% | S.D. | Range | |
---|---|---|---|
PBE score | 22.21 | 3.61 | [6, 30] |
Incidence of falls (≥1) (wave 2018) % | 7.19 | ||
Incidence of falls (≥1) (wave 2020) % | 7.71 | ||
Age | 70.84 | 6.25 | [60, 98] |
Gender (1 = male) % | 50.34 | ||
Place of residence (1 = urban) % | 50.07 | ||
Marital status (1 = married) % | 72.86 | ||
Retirement status (1 = retired) % | 35.31 | ||
Education | |||
Illiteracy % | 25.13 | ||
Primary school % | 40.89 | ||
Junior high school % | 24.22 | ||
Senior high school and above % | 9.75 | ||
Living arrangement (1 = living alone) % | 11.73 | ||
Health status (1 = poor, to 5 = excellent) | 3.37 | 0.86 | [1, 5] |
Necessity of using stairs (1 = not necessary to use stairways in the home) % | 70.93 | ||
Brightness at home (1 = bright) % | 87.75 | ||
Flatness of the flooring at home (1 = flat) % | 92.47 | ||
N | 8686 |
Model 1 | Model 2 | |
---|---|---|
PBE score | −0.003 | −0.212 * |
(0.012) | (0.085) | |
PBE score squared | 0.005 * | |
(0.002) | ||
Falls in the previous survey | 3.134 *** | 3.137 *** |
(0.087) | (0.087) | |
Age | 0.040 *** | 0.041 *** |
(0.007) | (0.007) | |
Gender (1 = male) | 0.007 | 0.005 |
(0.087) | (0.087) | |
Place of residence (1 = urban) | 0.213 * | 0.215 * |
(0.106) | (0.107) | |
Marital status (1 = married) | 0.027 | 0.024 |
(0.105) | (0.105) | |
Retirement status (1 = retired) | 0.285 * | 0.301 ** |
(0.113) | (0.114) | |
Education (rf. illiteracy) | ||
Primary school | −0.289 ** | −0.281 ** |
(0.103) | (0.104) | |
Junior high school | −0.025 | −0.025 |
(0.131) | (0.132) | |
Senior high school and above | −0.235 | −0.233 |
(0.173) | (0.172) | |
Living arrangement (1 = living alone) | −0.185 | −0.196 |
(0.139) | (0.139) | |
Health status (1 = poor, to 5 = excellent) | −0.189 *** | −0.189 *** |
(0.048) | (0.048) | |
Necessity of using stairs (1 = not necessary to use stairways in the home) | −0.051 | −0.053 |
(0.102) | (0.102) | |
Brightness in the home (1 = bright) | 0.067 | 0.068 |
(0.117) | (0.117) | |
Flatness of the flooring in the home (1 = flat) | −0.409 ** | −0.405 ** |
(0.140) | (0.140) | |
Intercept | −5.295 *** | −3.081 ** |
(0.609) | (1.064) | |
Log-likelihood | −1535.11 *** | −1532.40 *** |
N | 8686 | 8686 |
Logit Regression | Firth Logit Regression | Threshold Regression | |
---|---|---|---|
PBE score | −0.227 * | −0.236 * | |
(0.102) | (0.101) | ||
PBE score squared | 0.005 * | 0.005 * | |
(0.002) | (0.002) | ||
Threshold point | 18.74 | ||
Controls | YES | YES | YES |
N | 8686 | 8686 | 8686 |
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Du, S.; Wang, C.; Mao, L. Exploring the Influence of the Perceived Neighborhood Built Environment on the Fall Risks among Older Adults in China. Buildings 2024, 14, 2631. https://doi.org/10.3390/buildings14092631
Du S, Wang C, Mao L. Exploring the Influence of the Perceived Neighborhood Built Environment on the Fall Risks among Older Adults in China. Buildings. 2024; 14(9):2631. https://doi.org/10.3390/buildings14092631
Chicago/Turabian StyleDu, Shichao, Chunyu Wang, and Longjian Mao. 2024. "Exploring the Influence of the Perceived Neighborhood Built Environment on the Fall Risks among Older Adults in China" Buildings 14, no. 9: 2631. https://doi.org/10.3390/buildings14092631