- Published on Sept 09, 2008
- Contact Diane Swanbrow
These kinds of conditions quadruple disabilities among older adults who are already struggling with leg strength and balance, according to a University of Michigan study published in the September 2008 issue of the American Journal of Epidemiology.
"Becoming disabled is not just a response to aging or health problems," said Philippa Clarke, lead author of the article and a social epidemiologist at the U-M Institute for Social Research (ISR). "The environment plays an important role as well."
Supported by grants from the National Institutes of Health, Clarke and colleagues used data from an innovative study to examine how the physical conditions of city streets and sidewalks affected whether middle-aged and older adults in varying shape were able to get around.
The Chicago Community Adult Health Study, conducted in 2002, included interviews with 1,195 men and women age 45 or older. The study also included observations and ratings of neighborhood street and sidewalk conditions.
Half of the respondents were ages 45 to 59 and the other half were ages 60 or older. More than 25 percent had less than high school education, and more than half reported some degree of economic hardship. The vast majority of respondents reported no trouble getting around, while 20 percent reported at least some difficulty walking two to three blocks, and 18 percent reported more than some difficulty with leg strength and balance.
On average, more than 60 percent of the residential blocks had some or many cracked sidewalks, potholes and broken curbs. To isolate the impact of street and sidewalk condition, the researchers controlled for other aspects of the neighborhood environment, including graffiti, garbage, litter, broken glass, cigarette butts, empty liquor bottles or abandoned cars, drug paraphernalia or condoms, that could also serve as social or physical barriers to mobility.
Not surprisingly, the researchers found that older age, a greater number of health problems, and cigarette smoking increased the odds that people had problems getting around. They also found that males and African Americans were more likely to experience mobility disability compared with females and Caucasians. Because of small numbers in the sample, Hispanics were included with other race/ethnic groups in the analyses.
Controlling for physical health problems, the researchers found that among people with leg weakness and balance problems, those living on streets in fair or poor condition were over four times as likely as those living on streets in good condition to report a lot of difficulty walking two or three blocks.
"These results show that physical impairments are not necessarily catastrophic for mobility," said Clarke. "The negative consequences of severe restrictions in lower extremity strength and balance can be minimized when adults live in environments with fewer obstacles."
If street quality could be improved even a little, adults at greatest risk of disability would benefit, according to Clarke and colleagues.
"They would be better able to work, engage in recreation and social interactions, access health-care facilities, or simply go shopping for their daily needs," Clarke said. "Just improving sidewalks, curbs and streets could postpone and maybe even prevent disability in groups at high risks."
Established in 1948, the University of Michigan Institute for Social Research (ISR) is among the world's oldest academic survey research organizations, and a world leader in the development and application of social science methodology. ISR conducts some of the most widely-cited studies in the nation, including the Reuters/University of Michigan Surveys of Consumers, the American National Election Studies, the Monitoring the Future Study, the Panel Study of Income Dynamics, the Health and Retirement Study, and the National Survey of Black Americans. ISR researchers also collaborate with social scientists in more than 60 nations on the World Values Surveys and other projects, and the Institute has established formal ties with universities in Poland, China and South Africa. ISR is also home to the Inter-University Consortium for Political and Social Research (ICPSR), the world's largest computerized social science data archive. Visit the ISR web site at www.isr.umich.edu for more information.