A Typology of Livable Communities and Older Adults’ Health in the U.S

TL;DR

This study explores how different types of age-friendly neighborhoods in the U.S. affect the health of older adults, especially those with physical limitations.

Contribution

The study introduces a typology of age-friendly neighborhoods and examines how they relate to health outcomes, particularly for older adults with functional limitations.

Findings

Four neighborhood types were identified: 'Connected yet Limited Services,' 'Service Integrated,' 'Healthy Environment Zones,' and 'Supportive Social Engagement.'

Older adults in 'Connected yet Limited Services' and 'Service Integrated' neighborhoods reported worse self-rated health compared to those in socially supportive neighborhoods.

Those with functional limitations benefited most from neighborhoods with strong health support and social engagement opportunities.

Abstract

Neighborhoods with high-quality built environments and social environments are linked with older adults’ well-being. However, research on the complex interplay of neighborhood types and health outcomes is limited, as is the role of functional limitations. This study aims to: 1) identify neighborhood types based on the World Health Organization’s age-friendly community framework, 2) explore the association of neighborhood type and older adults’ health, and 3) assess whether functional status affects this association. We merged data from the 2017 AARP Age-Friendly Communities Surveys and the AARP Livability Index. Our sample included 3,211 adults aged 65 and older; the majority (59%) were female. Participants identified as non-Hispanic White (81%), Hispanic (8%), Black (6%), and a member of another racial/ethnic group (2%). We conducted latent class analysis to identify neighborhood type. We then explored the relationship between neighborhood type and self-rated health, adjusting for individual sociodemographic and health-related characteristics. We identified a four-class model of neighborhood types: “Connected yet Limited Services,” “Service Integrated,” “Healthy Environment Zones,” and “Supportive Social Engagement.” Older adults in “connected yet limited services” and “service integrated” neighborhoods had worse self-rated health than those in socially supportive neighborhoods, especially among those who reported functional limitations. Our findings indicate that older adults with functional limitations particularly benefit from neighborhoods with robust health support and social engagement opportunities, highlighting the importance of designing inclusive and adaptable age-friendly environments to address diverse and changing needs.