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Public health researchers at UMMS glean insights to help get more elders walking

New study points to ways to encourage and support walking in varied neighborhood environments

  Elizabeth Procter-Gray , PhD, and Wenjin Li, PhD
 

Elizabeth Procter-Gray, PhD, and Wenjun Li, PhD

Few older adults walk on a regular basis even though it’s easy, free and good for their health. A new study by public health researchers at UMass Medical School examines how neighborhood conditions influence walking habits for adults 65 and older.

“The purpose of the study was to look at the different communities around Boston and compare the rates of walking by elders, and to see if their types of walking varied as well as their amount of overall walking,” said lead author Elizabeth Procter-Gray, PhD, a biostatistician in the Division of Preventive & Behavioral Medicine’s Health Statistics and Geography Laboratory.

“Surprisingly, we found the rates of recreational walking were pretty similar across communities, whereas the rates of utilitarian walking varied a great deal,” she said.

Published in the Journal of Aging Research, the study analyzed walking habits of 745 community-dwelling men and women aged 65 years or older in 16 urban and suburban Boston neighborhoods. Communities where elders did the most walking, defined as at least five days a week, were those where they did the greatest amount of utilitarian walking. The rate of regular walking ranged from a low of 17 percent in Hyde Park to a high of 48 percent in Boston downtown. 

These unexpected findings suggest that city planners, elder advocates, public health policymakers and community organizations should reconsider how to help seniors increase how often they walk to get things done without increasing their risk of falls. For example, in some neighborhoods the environmental emphasis on developing better parks and walking trails to encourage recreational walking could be shifted to creating more destinations where elderly residents can walk to do errands. Conversely, social approaches like walking clubs at local shopping malls could encourage more seniors to engage in recreational walking in suburban communities where there are few opportunities for utilitarian walking.

“Approaches to promoting walking should differ according to neighborhood conditions,” said principal investigator Wenjun Li, PhD, associate professor of medicine and director of the Health Statistics and Geography Lab.

The study is the first in the area to survey the influences both individual and community factors have on elders’ walking habits in order to inform local public health initiatives designed to make neighborhoods more walkable for them. Individual characteristics that were measured include health status, history of falls, and income and education levels. Neighborhood characteristics analyzed included socioeconomic demographics and access to amenities like stores and public transportation.

Upon correlating these many variables, the research team found that the strongest community factor influencing utilitarian walking is the distance to shops and amenities. Habitual walking was associated with shorter distances to the nearest subway stop, hospital, post office and food store.

“Age-friendly communities with close access to utilitarian amenities are very important for older people,” said Dr. Li,. “It isn’t as easy for elders to walk, so some kind of supportive environment is required. As the U.S. older population grows quickly, accelerated development of age-friendly, walkable neighborhoods is a national priority.”

The novel findings have been recognized by the American Public Health Association, which bestowed its2015 Rural and Environment Award for best scientific paper in that category. The award will be presented during the APHA’s annual meeting in November.

The study was informed by previous Health Statistics and Geography Lab studies of elder walking and falls, including Li’s Neighborhood Risk Factors for Falls in the Elderly, which was funded by the National Institute on Aging. Procter-Gray’s and Li’s evolving researchinto elders’ rates and types of walking, and their rates of falls and resulting injuries, is timely as it supports the U.S. Surgeon General’s “Step It Up!” campaign to promote walking and walkable communities.

“Our goal is to connect the dots to get a bigger picture, so that in the future we can develop and assess interventions that increase elders’ physical activity while decreasing their risk of fall injury, no matter where they live,” said Li. “Next we are looking at how older persons’ perception about their neighborhood walking environment affects their walking behaviors, and how both perception, behaviors and actual built environment jointly affect their rates of fall injuries, walking and health.”

Related links on UMassMedNow:
For the elderly, all falls are not the same
When designing fall prevention, gender matters
Older adults who walk out of necessity are at highest risk for outdoor falls
Meyers Primary Care Institute at UMMS part of $30 million national falls study