Theses Doctoral

Age-Friendly Environment and Health among Older Americans

Cheung, Ethan Siu Leung

My dissertation focuses on investigating the associations of neighborhood environments—namely, built and social environments—with health among community-dwelling older Americans. The first paper examines groupwide variations in social participation patterns among older adults before and during the COVID-19 pandemic, and if community social cohesion and health during the pandemic were significantly associated with social participation patterns. Using Rounds 9 and 10 longitudinal data from the National Health and Aging Trend Study, I employed latent class analysis to identify the presence of groupwide variations in social participation, before and during the pandemic. I used logistic and linear regressions to examine the associations between social participation patterns, community social cohesion, and health during the pandemic. Results suggested two participation patterns, active and selective participants. Compared to active participants, older adults who were selective in their social participation were more likely to live in less socially cohesive communities and report substantial depressive and anxiety symptoms.

In the second paper, I examined cross-sectional and longitudinal relationships between neighborhood physical disorder, low social cohesion, and sleep problems among older Americans. Mediators of health behaviors (i.e., lack of physical activity and social participation) and mental health (i.e., depressive and anxiety symptoms) were also tested in these relationships. Data were derived from three rounds of panel data (Rounds 7-9) from the National Health and Aging Trends Study, involving a sample of 4,029 Americans aged 65 or older. I found statistically significant cross-sectional and longitudinal associations between physical disorder and low social cohesion, and late-life sleep problems. Only cross-sectional mediation effects of health behaviors and mental health were found in the relationship of physical disorder and sleep problems, whereas both cross-sectional and longitudinal associations between low social cohesion and sleep problems were significantly mediated by health behaviors and mental health.

In the third paper, I used annual data from the 2015-16 Poverty Tracker study to examine the roles of distance to grocery stores, neighborhood disadvantage, and social cohesion in explaining food insecurity among older adults in New York City. Multiple logistic regressions were conducted to assess these relationships. Results showed that greater distance to grocery stores (0.26–0.75 miles vs. 0.00–0.25 miles) and living in more disadvantaged neighborhoods increased the odds of food insecurity. Community social cohesion was a marginally significant protective factor against food insecurity.

The findings of these papers highlighted the associations between the neighborhood environment, social health, sleep quality, and food security status among older adults. These papers also emphasized the potential for environmental policy and social work program interventions to improve the well-being and quality of life among community-dwelling older adults.


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More About This Work

Academic Units
Social Work
Thesis Advisors
Liu, Jinyu
Ph.D., Columbia University
Published Here
June 28, 2023