Community welfare resources and late-life depression among older adults in Seoul: A multi-level analysis

OBJECTIVES

This study aimed to examine whether community welfare resources in neighborhoods (recreational facilities, healthcare access, and public welfare expenditure) are associated with late-life depression among older adults in Seoul, South Korea.

METHODS

Data for this study were obtained by merging two different data sources: the 2018 Seoul Elderly Survey for individual-level variables and publicly available administrative data for neighborhood-level variables. The sample included 3036 older adults (unweighted n = 3034) living in 25 neighborhoods (Gu) in Seoul. Multilevel regression models examined the effects of neighborhood-level variables on late-life depression while controlling for individual-level variables. We also explored the extent to which individual characteristics moderate the main effects of neighborhood characteristics on late-life depression.

RESULTS

The results indicated that recreational facilities, health care centers, and public welfare expenditure in the neighborhoods were associated with late-life depression among older adults beyond individuals' predisposing conditions. Also, the effects of recreational facilities and public welfare expenditure on depressive symptoms were larger for those with higher education level.

CONCLUSIONS

Older adults living in neighborhoods with more recreational facilities, more health care centers, and high public welfare expenditure were less likely to experience late-life depression. Of note is that the effects of neighborhoods' recreational facilities and public welfare expenditure varied by certain individual characteristics. Hence, local governments should introduce neighborhood-based health promotion policies to prevent depression among older adults. In doing so, local governments should also consider ways to improve access to community welfare resources for underprivileged older adults.

The Associations Between Access to Recreational Facilities and Adherence to the American Heart Association's Physical Activity Guidelines in US Adults

Physical activity decreases the risk of long-term health consequences including cardiac diseases. According to the American Health Association (AHA), adults should perform at least 75 min of vigorous physical activity (PA) or 150 min of moderate PA per week to impact long-term health. Results of previous studies are varied and have yet to integrate perceived access to facilities with AHA PA guidelines. We investigated whether access to free or low-cost recreational facilities was associated with meeting the AHA PA guidelines. Methodology: This cross-sectional study utilized data extracted from the Family Life, Activity, Sun, Health, and Eating (FLASHE) database collected in 2017 (n = 1,750). The main exposure variable was access to free or low-cost recreational facilities. The main outcome variable was meeting the AHA guidelines of 150 min moderate PA or 75 min vigorous PA per week. Covariates included age, sex, level of education, overall health, BMI, ethnicity, hours of work per week, income, and time living at current address. Unadjusted and adjusted logistic regression analysis were used to calculate measures of odds ratio (OR) and corresponding 95% confidence interval (CI). Results: Of the 1,750 included participants, 61.7% (n = 1,079) reported to have access to recreational facilities. Of those with access to facilities, 69.9% met AHA PA guidelines while 30.4% did not. After adjusting for covariates, participants who reported access to recreational facilities were 42% more likely to meet AHA PA guidelines compared with participants who did not (adjusted OR 1.42; 95% CI 1.14-1.76). Secondary results suggest that healthier individuals were more likely to have met AHA PA guidelines. Conclusions: Having access to free or low-cost recreational facilities such as parks, walking trails, bike paths and courts was associated with meeting the AHA PA guidelines. Increasing prevalence and awareness of neighborhood recreational facilities could assist in access to these facilities and increase the ability of individuals to meet AHA PA guidelines. Future research should determine which types of recreational facilities impact physical activity strongest and discover methods of increasing their awareness.

Public Perception of Quality and Support for Required Access to Drinking Water in Schools and Parks

PURPOSE

We assessed public support for required water access in schools and parks and perceived safety and taste of water in these settings to inform efforts to increase access to and consumption of tap water.

DESIGN

Cross-sectional survey of the US public collected from August to November 2011.

SETTING

Random digit-dialed telephone survey.

PARTICIPANTS

Participants (n = 1218) aged 17 and older from 1055 US counties in 46 states.

MEASURES

Perceived safety and taste of water in schools and parks as well as support for required access to water in these settings.

ANALYSIS

Survey-adjusted perceived safety and taste as well as support for required access were estimated.

RESULTS

There was broad support for required access to water throughout the day in schools (96%) and parks (89%). Few participants believed water was unsafe in schools (10%) or parks (18%).

CONCLUSION

This study provides evidence of public support for efforts to increase access to drinking water in schools and parks and documents overall high levels of perceived taste and safety of water provided in these settings.

Parental Perception of Neighborhood Safety and Children's Physical Activity

BACKGROUND

We examined the relationship between parents' perception of neighborhood safety and children's physical activity and use of recreation facilities in a US nationally representative sample of fifth grade children.

METHODS

We used data from the Early Childhood Longitudinal Study Kindergarten cohort, fifth grade sample (N = 9827). Multivariate logistic and linear regression models were used to examine associations between parents' perception of neighborhood safety for outside play and number of days children engage in physical activity, as well as children's use of recreational facilities for physical activity.

RESULTS

Children who used recreational facilities engaged in physical activity on more days of the week compared with children who did not use a facility (3.3 days vs. 3.8 days, P < .0001). Children from neighborhoods perceived as unsafe by parents engaged in almost 1 less day per week in physical activity (β = -.89, P < .0001). Children from neighborhoods perceived as unsafe were less likely to use recreational facilities compared with children from neighborhoods perceived as safe (odds ratio = 0.72, P < .0001). Children from less affluent families across rural and urban areas had half the odds of using recreational facilities compared with children from the wealthiest families living in urban areas.

CONCLUSIONS

Parents' perception of neighborhood safety for outside play can deter or promote children's physical activity and use of recreational facilities. Children from less affluent families are less likely to use facilities than children from wealthy families, regardless of place of residence.

Longitudinal associations between neighborhood recreational facilities and change in recreational physical activity in the multi-ethnic study of atherosclerosis, 2000-2007

Many cross-sectional studies have investigated the relationship between neighborhood physical environment and physical activity. However, few studies have examined this relationship longitudinally, and no study has examined the association between change in objective measurements of physical activity resources and change in physical activity in adults. We used longitudinal data from the Multi-Ethnic Study of Atherosclerosis (2000-2007) of 6,814 adults who were aged 45-84 years at baseline. Physical activity was assessed via a semiquantitative questionnaire at baseline and at 2 follow-up visits (approximately 1.6 and 3.2 years later). We measured the density of recreational facilities within 1 mile of each participant's home address and used linear mixed-effects models to estimate the association between change in recreational facility density and change in physical activity. After adjusting for potential confounders, we found that a greater increase in recreational density was associated with a less pronounced decline in physical activity (mean difference in annual change in physical activity for each 1-unit increase in recreational density over time = 10.3 (95% confidence interval: 0.7, 19.9)). This association was stronger in older adults. Better access to recreational facilities may benefit middle-aged and older adults by enabling them to maintain activity levels as they age.

Perceived environment and public open space use: a study with adults from Curitiba, Brazil

BACKGROUND

The aim of this study was to investigate the association between the perceived environment and the use of public open spaces (POS).

METHODS

A cross-sectional study with household surveys was conducted in 1,461 adults from Curitiba, Brazil interviewed in person. The perceived environment was evaluated with the Neighborhood Environment Walkability Scale, and the POS use was evaluated using the ordinal scale (increased use).

RESULTS

The presence of interesting objects, heavy traffic, and the number of positive attributes of the environment was positively associated with POS use among men, and the presence of trees was associated with the use among women.

CONCLUSIONS

Managers should invest in the architectural attractiveness of neighborhoods and should plant and conserve trees to encourage POS use.

Comparing perceived and objectively measured access to recreational facilities as predictors of physical activity in adolescent girls

A number of studies in recent years have identified both self-report and objectively measured accessibility of recreational facilities as important predictors of physical activity in youth. Yet, few studies have: (1) examined the relationship between the number and proximity of objectively measured neighborhood physical activity facilities and respondents' perceptions and (2) compared objective and self-report measures as predictors of physical activity. This study uses data on 1,367 6th-grade girls who participated in the Trial of Activity for Adolescent Girls (TAAG) to explore these issues. Girls reported whether nine different types of recreational facilities were easily accessible. These facilities included basketball courts, golf courses, martial arts studios, playing fields, tracks, skating rinks, swimming pools, tennis courts, and dance/gymnastic clubs. Next, geographic information systems (GIS) were used to identify all the parks, schools, and commercial sites for physical activity located within a mile of each girl's home. These sites were then visited to inventory the types of facilities available. Girls wore accelerometers to measure their weekly minutes of non-school metabolic equivalent weighted moderate-to-vigorous physical activity (MW-MVPA). The number of facilities within a half-mile of girls' homes strongly predicted the perception of easy access to seven out of nine facility types. Both individual facility perceptions and the total number of facilities perceived were associated with increased physical activity. For each additional facility perceived, girls clocked 3% more metabolic equivalent weighted moderate-to-vigorous physical activity (p < 0.001). Although girls tended to record 3% more of this kind of physical activity (p < 0.05) per basketball court within a mile of their homes, objective facility measures were otherwise unrelated to physical activity. The results from this study suggest that raising the profile of existing facilities may help increase physical activity among adolescent girls.