Older adults are particularly dependent on their local communities, and due to declining health and functional status, financial strain and social isolation, are vulnerable to barriers in the urban built environment (e.g. heavy traffic, unsafe sidewalks, and a lack of pedestrian amenities). Yet the effect of the built environment on independence in older adults is under-studied. The purpose of this research is to understand the role of the built environment in disability progression. Specifically, the aims of this project are threefold: 1) to characterize in detail the surrounding built environment for a high risk population of community-dwelling older adults; 2) to examine the relationship between the built environment and disability progression; and 3) to identify whether older adults living in less accessible neighborhoods are more likely to be admitted to a nursing home over time. The research objectives will be investigated through a program of secondary data analysis with existing population-based data (Michigan Minimum Data Set for Home Care) using a combination of quantitative multilevel methods and geographic information systems (CIS) software. Latent trajectory class analysis will be used to examine the effect of urban accessibility and urban design on trajectories of mobility disability and subsequent nursing home admission over a 15 month period. The skills needed to appropriately use GIS and spatial analysis techniques for this research will be obtained as a key component of the career development plan. The candidate will draw on a broad range of resources and training opportunities throughout the University of Michigan and elsewhere, to obtain the necessary skills to pursue a research career that appropriately situates person-centered variables within the larger social and environmental context in which people age. Current research on later life health and independence places almost exclusive emphasis on factors at the individual level. Yet, the role of the surrounding environment may play a key role in shaping patterns of independence and dependence among older adults. This project addresses one of CDC's Health Protection Goals, """"""""Healthy People in Healthy Places"""""""", by focusing on the design of built environments that define healthy communities for older adults at risk for disability. ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Center for Environmental Health (NCEH)
Type
Research Scientist Development Award - Research & Training (K01)
Project #
1K01EH000286-01
Application #
7395209
Study Section
Special Emphasis Panel (ZCD1-ZDQ (05))
Program Officer
Mehta, Paul
Project Start
2007-09-30
Project End
2010-09-29
Budget Start
2007-09-30
Budget End
2008-09-29
Support Year
1
Fiscal Year
2007
Total Cost
$136,992
Indirect Cost
Name
University of Michigan Ann Arbor
Department
Biostatistics & Other Math Sci
Type
Organized Research Units
DUNS #
073133571
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
Kim, MinHee; Clarke, Philippa (2015) Urban social and built environments and trajectories of decline in social engagement in vulnerable elders: findings from Detroit's Medicaid home and community-based waiver population. Res Aging 37:413-35
Clarke, Philippa; Gallagher, Nancy Ambrose (2013) Optimizing mobility in later life: the role of the urban built environment for older adults aging in place. J Urban Health 90:997-1009
Clarke, Philippa J; Ailshire, Jennifer A; House, James S et al. (2012) Cognitive function in the community setting: the neighbourhood as a source of 'cognitive reserve'? J Epidemiol Community Health 66:730-6
Clarke, Philippa J; Ailshire, Jennifer A; Nieuwenhuijsen, Els R et al. (2011) Participation among adults with disability: the role of the urban environment. Soc Sci Med 72:1674-84
Clarke, Philippa; Smith, Jacqui (2011) Aging in a cultural context: cross-national differences in disability and the moderating role of personal control among older adults in the United States and England. J Gerontol B Psychol Sci Soc Sci 66:457-67
Clarke, Philippa; Ailshire, Jennifer A; Lantz, Paula (2009) Urban built environments and trajectories of mobility disability: findings from a national sample of community-dwelling American adults (1986-2001). Soc Sci Med 69:964-70
Clarke, Philippa; Nieuwenhuijsen, Els R (2009) Environments for healthy ageing: a critical review. Maturitas 64:14-9
Clarke, Philippa (2009) Understanding the experience of stroke: a mixed-method research agenda. Gerontologist 49:293-302
Clarke, Philippa; Ailshire, Jennifer A; Bader, Michael et al. (2008) Mobility disability and the urban built environment. Am J Epidemiol 168:506-13