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Study aims to discover what makes neighborhoods healthy for residents

BY SUSAN IPAKTCHIAN

Doctors routinely advise their older patients to walk more, but what if the sidewalks are crumbling or if they don't know a neighbor who could serve as a walking partner to help them feel safe?

Just how much a neighborhood's environment affects the health and quality of life of older adults will be addressed by a new study conducted by researchers at the Stanford School of Medicine, San Diego State University, the University of Cincinnati and the research firm of Lawrence Frank and Co. Inc. of Vancouver, British Columbia.

The researchers are recruiting 500 residents of the Seattle area age 66 or older to determine what factors make for the healthiest neighborhoods, and will do a similar study in Baltimore when the Seattle portion concludes. They hope their findings will help city planners and agencies for the elderly identify elements that help—and hinder—the ability to stay independent and healthy as people age.

"So much of our health-promotion activities have focused on the person and the individual characteristics that make it easier to be healthy," said Abby King, PhD, professor of health research and policy and of medicine at the Stanford Prevention Research Center, who is the principal investigator for the study. "But you can only go so far talking about personal characteristics. You need to better understand the context in which people live so that you can have more of an impact on their health behaviors."

For example, the study will attempt to determine whether older adults know more of their neighbors in suburban vs. urban neighborhoods, as well as whether a lively or a relaxing neighborhood leads to a better quality of life.

Another focus of the study, known as the Neighborhood Quality of Life Study for Seniors, is the effect of a neighborhood's environment on physical activity. King noted that older adults remain one of the most inactive segments of the U.S. population even though regular exercise can aid in preventing and controlling such diseases as hypertension, heart disease, type-2 diabetes, some forms of cancer and osteoporosis. However, to date there has been no systematic investigation of the relationship between environmental factors and physical activity among older adults, she added.

The study will examine such issues as: Can the participant walk to local shops or community centers easily? Are the streets safe? Do traffic lights allow enough time to cross streets? Must a participant drive or ride in order to access basic services?

Participants will fill out questionnaires at two different times during a one-year period. They will be asked to rate their local environment for safety, access to amenities and services, availability of public transportation and other characteristics. Participants will also wear a small monitor to record their level of physical activity for two one-week periods during the year. Researchers will collect geographic data and make on-site observations, assessing roads, traffic, crime, even the weather.

Seattle and Baltimore were chosen because there is already a wealth of data about their neighborhoods and because they have both urban and suburban settings, King said.

In Seattle, the researchers are working with the Seattle-King County Area Agency on Aging to identify diverse neighborhoods for the study. A randomly selected group of older adults from those areas will be contacted about possible participation. The first round of recruitments will take place in the communities of Redmond, Auburn, Kirkland and Skyway. The second round will involve the Beacon Hill, First Hill, Central District and Newport/New Castle areas. Additional communities are still being determined.

The study's goals have the backing of Seattle's mayor. "This research will help us determine how neighborhood design inspires physical activity and enhances the quality of life for elderly people," said Mayor Greg Nickels. "I encourage Seattle seniors to participate."

The two co-principal investigators of the study are James Sallis, PhD, professor of psychology at San Diego State University; and Lawrence Frank, PhD, founder of Lawrence Frank and Co. The study is funded by the National Institutes of Health.