With the growing number of older adults and, therefore, the increasing importance of disability as a public health outcome, it is important to better understand the causes and correlates of functional decline and disability in the elderly. Traditionally, most research on disability has focused on individual risk factors. However, a growing body of research is finding evidence of the role of the social and physical environment in health outcomes generally. But to date, limited research has examined the neighborhood environment as a causal factor in disability among older adults. This dissertation examines the influence of the socioeconomic and social characteristics of neighborhoods and municipalities in Allegheny County, Pennsylvania on individual functional status prevalence and change among a sample of adults 65 and older in the County. The research suggests that some effects of neighborhood social environments on functional status may be present, but are weak relative to individual risk factors. Neighborhood effects were not found for disability prevalence in this sample, but were found for change in function over a period of 20 months. The analysis indicates that neighborhoods with higher rates of serious crime are associated with declines in function. Also, neighborhoods with more concentrated social and economic disadvantages as well as those with more concentrated affluence were both associated with some improvement in function. The association of disadvantage with improvement in function requires further clarification. The analysis suggests that more sensitive measures of disability and function may be required to detect neighborhood effects. This type of research is of great public health relevance because it has the potential to suggest and inform a range of new community-based public health interventions to improve the functional health of the elderly.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-04152005-170637 |
| Date | 09 June 2005 |
| Creators | Musa, Donald |
| Contributors | Jeanette Trauth, PhD, John Marx, PhD, Ravi Sharma, PhD, Myrna Silverman, PhD |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-04152005-170637/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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