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Difficulty and independence in shopping among older Americans: more than just leaving the house.
Disabil Rehabil. 2019 01; 41(2):191-200.DR

Abstract

BACKGROUND

The built, social and economic environments are associated with disability, but knowledge of how these environmental characteristics simultaneously influence older adults' ability to shop independently is limited.

OBJECTIVE

We investigated cross-sectional associations between the outdoor home, local neighborhood and macrosocioeconomic levels of the environment and shopping difficulty and interactions between environmental factors and shopping difficulty.

METHODS

Using nationally representative data from a study of Medicare-eligible adults, we conducted a cross-sectional secondary data analysis to examine associations between the environment and difficulty shopping (N = 5504).

RESULTS

Sidewalk conditions, broken steps, neighborhood social cohesion and neighborhood socioeconomic disadvantage were associated with more difficulty shopping, although health factors partially accounted for associations between broken steps and disadvantage and shopping difficulty. The association between social cohesion and shopping difficulty also depended on the degree of socioeconomic disadvantage in the neighborhood.

CONCLUSIONS

Overall, results suggest that factors in the outdoor and local neighborhood environment influence the ability to shop independently for older adults, but that it also may depend on the socioeconomic context of the neighborhood. Interventions aimed at improving the built environment directly outside of older adults' homes and helping increase social cohesion among neighbors, has the potential to reduce difficulty in carrying out this important activity. Implications for rehabilitation Built features of the outdoor home environment including sidewalks and broken steps influence whether older adults are able to safely leave their home to conduct daily activities such as shopping, so it is important that clinicians and rehabilitation professionals are aware of these challenges when helping their patients resume daily activities such as shopping. The physical condition and safety of the immediate outdoor home and neighborhood environment is critical for maintaining independence and well-being for older adults, which is critical for physical rehabilitation as well as maintenance of essential activities such as shopping. Living in more socially cohesive neighborhoods may aid in physical rehabilitation efforts by helping older adults feel more comfortable and able to shop independently in neighborhoods with social and economic disadvantages.

Authors+Show Affiliations

a Survey Research Center at the Institute for Social Research , University of Michigan , Ann Arbor , MI , USA.a Survey Research Center at the Institute for Social Research , University of Michigan , Ann Arbor , MI , USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

29117730

Citation

Brenner, Allison B., and Philippa J. Clarke. "Difficulty and Independence in Shopping Among Older Americans: More Than Just Leaving the House." Disability and Rehabilitation, vol. 41, no. 2, 2019, pp. 191-200.
Brenner AB, Clarke PJ. Difficulty and independence in shopping among older Americans: more than just leaving the house. Disabil Rehabil. 2019;41(2):191-200.
Brenner, A. B., & Clarke, P. J. (2019). Difficulty and independence in shopping among older Americans: more than just leaving the house. Disability and Rehabilitation, 41(2), 191-200. https://doi.org/10.1080/09638288.2017.1398785
Brenner AB, Clarke PJ. Difficulty and Independence in Shopping Among Older Americans: More Than Just Leaving the House. Disabil Rehabil. 2019;41(2):191-200. PubMed PMID: 29117730.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Difficulty and independence in shopping among older Americans: more than just leaving the house. AU - Brenner,Allison B, AU - Clarke,Philippa J, Y1 - 2017/11/09/ PY - 2017/11/10/pubmed PY - 2019/7/6/medline PY - 2017/11/10/entrez KW - Disability KW - environment KW - instrumental activities of daily living KW - neighborhood KW - older adults KW - shopping SP - 191 EP - 200 JF - Disability and rehabilitation JO - Disabil Rehabil VL - 41 IS - 2 N2 - BACKGROUND: The built, social and economic environments are associated with disability, but knowledge of how these environmental characteristics simultaneously influence older adults' ability to shop independently is limited. OBJECTIVE: We investigated cross-sectional associations between the outdoor home, local neighborhood and macrosocioeconomic levels of the environment and shopping difficulty and interactions between environmental factors and shopping difficulty. METHODS: Using nationally representative data from a study of Medicare-eligible adults, we conducted a cross-sectional secondary data analysis to examine associations between the environment and difficulty shopping (N = 5504). RESULTS: Sidewalk conditions, broken steps, neighborhood social cohesion and neighborhood socioeconomic disadvantage were associated with more difficulty shopping, although health factors partially accounted for associations between broken steps and disadvantage and shopping difficulty. The association between social cohesion and shopping difficulty also depended on the degree of socioeconomic disadvantage in the neighborhood. CONCLUSIONS: Overall, results suggest that factors in the outdoor and local neighborhood environment influence the ability to shop independently for older adults, but that it also may depend on the socioeconomic context of the neighborhood. Interventions aimed at improving the built environment directly outside of older adults' homes and helping increase social cohesion among neighbors, has the potential to reduce difficulty in carrying out this important activity. Implications for rehabilitation Built features of the outdoor home environment including sidewalks and broken steps influence whether older adults are able to safely leave their home to conduct daily activities such as shopping, so it is important that clinicians and rehabilitation professionals are aware of these challenges when helping their patients resume daily activities such as shopping. The physical condition and safety of the immediate outdoor home and neighborhood environment is critical for maintaining independence and well-being for older adults, which is critical for physical rehabilitation as well as maintenance of essential activities such as shopping. Living in more socially cohesive neighborhoods may aid in physical rehabilitation efforts by helping older adults feel more comfortable and able to shop independently in neighborhoods with social and economic disadvantages. SN - 1464-5165 UR - https://www.unboundmedicine.com/medline/citation/29117730/Difficulty_and_independence_in_shopping_among_older_Americans:_more_than_just_leaving_the_house_ L2 - http://www.tandfonline.com/doi/abs/10.1080/09638288.2017.1398785 DB - PRIME DP - Unbound Medicine ER -