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AJPH First Look, published online ahead of print Sep 29, 2005
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American Journal of Public Health, 10.2105/AJPH.2004.054494

Analytic Essay Forum

The Role of the Built Environment in the Disablement Process

Philippa Clarke 1* Linda K. George 1

1 Duke University

* To whom correspondence should be addressed. E-mail: pjc{at}geri.duke.edu.


  Abstract

The Disablement Process model explicates the transition from health conditions to disability, and specifically emphasizes the role of intervening factors that speed up or slow down the pathway between pathology and disability. In this paper we focus on the role of the built environment as a modifying factor in the pathway between lower extremity functional limitations and activities of daily living using hierarchical Poisson regression analyses with data on older adults from Central North Carolina. With declining physical function we find that older adults report greater independence in instrumental activities when they live in environments with more land-use diversity. Independence in self care activities is modified by housing density, in part through the effect of substandard and inadequate housing.

Key Words: Aging, Community Health, Disability, Environment, Rural Health




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