Exploring the Relationship between Built Environment and Health

By Scott King

In this study, researchers set out to explore different factors related to environmental support for senior independence in long-term care communities via a wide-ranging literature review. They based their research on a conceptual model that outlines the role the built environment plays in active behavior, falls prevention, and remaining independent later in life.

Several computerized databases were searched to identify English-language relevant studies, using combinations of the keywords: environment, aging in place, independence, physical activity, social, fall prevention, falls, and older adults. Thirty-one studies discussing the assessment of site-level physical environments were included, with 11 of them using active behavior as a dependent variable, and 20 of them with fall prevention as a dependent variable.

The researchers analyzed the studies with the goal of finding gaps and concerns in the current statistics, and to also develop ideal environmental design guidelines for preventing falls in the future. In the article, they include an extensive table detailing each study’s environmental focus, sample, analytic techniques, data collection methods, measures, factors of active behavior, and suggested design features.

The authors found that support for daily activity, physical activity, and social interaction have all been investigated as they relate to accessibility, but should also be studied further with an emphasis on fall prevention. Social factors should be taken into account more often, as most studies only examine gender and age. Cross-sectional studies were predominant, but more research is needed utilizing longitudinal and intervention designs. In terms of measurements and analysis, the authors advocate for more direct measurements of environmental elements, and for the use of advanced statistical models such as structural equation modeling.

The researchers' recommendations for design guidelines include space diversity; transitional areas surrounding a building; common areas designed for entertaining; exercise rooms; good window views; clear corridor systems with distinct décor; slip-resistant floors; abundant handrails; sufficient illumination; close proximity between private and common areas; walking paths with visual cues; and accessible outdoor green spaces. Finally, the authors suggest that the best way to design senior environments is an interdisciplinary approach, where designers, managers, and the older adults themselves all work together to meet the goal of promoting independence.

To obtain this report, contact Scott King at sking@matherlifeways.com.

Source: Wang, Z., & McCuskey Shepley, M. (2008). Site-level environmental support of active behavior and fall prevention for seniors. Seniors Housing & Care Journal, 16, 97-121.

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