Home and neighborhood environments and older adults' well-being

Thesis advisor: Christina Matz-CostaGiven the rising numbers of community-dwelling older adults in the United States (US), understanding the effect of home and community factors on health and well-being is critically important. Although important contributions have been made, most existing studies have used unidimensional measures of neighborhoods, which provide insufficient empirical evidence to develop holistic interventions. Also, despite the prevalence of disability among older adults, only a handful of studies have explored the effect of physical functioning in the relationship between home and neighborhood environments and older adults’ well-being. Finally, the role of the global assessment of community in mediating the effect of home and neighborhood environments on older adults’ well-being has not been explored. To fill these knowledge gaps, this dissertation examined the relationship between home and community environments and well-being (i.e., self-reported health, global assessment of community, and likelihood of aging-in-place) among adults age 65 and older (n=4,066). Based on the press-competence model, differences in hypothesized relationships by respondents’ physical functioning was also examined. Further, this dissertation explored the mediating effect of older adults’ global assessments of their community to see if the effect of home and neighborhood environments on older adults’ likelihood of aging-in-place operates through the global assessment of community. Data were analyzed from the AARP Age-Friendly Communities 2015 survey, which was collected from 14 communities in the US and includes 66 items capturing aspects of home and community environments under eight domains. Results of multi-level regression analyses suggest that both availability of resources and the fit between respondents’ needs and available resources are associated with their health, global assessment of community, and the likelihood of aging-in-place. The impact of home and neighborhood environments was greater among respondents with functional limitations and with low income. Home and neighborhood environments are associated with older adults’ likelihood of aging-in-place through their effect on the global assessment of community. These findings provide a fuller understanding of the impact of surrounding environments on older adults’ well-being, which will inform policy and practice efforts to better serve community-dwelling older adults.Thesis (PhD) — Boston College, 2017.Submitted to: Boston College. Graduate School of Social Work.Discipline: Social Work