Restricted accessResearch articleFirst published online 2021-12
The Contribution of Sense of Community to the Association Between Age-Friendly Built Environment and Health in a High-Density City: A Cross-Sectional Study of Middle-Aged and Older Adults in Hong Kong
Sense of community may be shaped by the quality of the physical environment and has potential health implications. Based on a survey of 2,247 community-dwelling middle-aged and older adults living in Hong Kong, we tested the mediation effect of sense of community on the relationship between the quality of the built environment and physical and mental health using path analysis. The quality of the built environment was indicated by the age-friendliness of outdoor spaces and buildings. No direct association was found between the built environment and health outcomes, although age-friendly outdoor spaces were associated with better mental health. Sense of community mediated 14% of the total effect between outdoor spaces and mental health and 44.8% of the total effect between buildings and physical health, underscoring the importance of accommodating the social needs of middle-aged and older people in urban development in high-density cities.
BlackK.HyerK. (2019). Generational distinctions on the importance of age-friendly community features by older age groups. Journal of Applied Gerontology, 39(9), 1025–1034.
2.
BrossoieN.BurnsD. (2020). What makes a city a good place to live and grow old?Journal of Applied Gerontology. Advance online publication. https://doi.org/10.1177/0733464820957149
Census and Statistics Department. (2017b). Hong Kong population projections 2017-2066. Hong Kong Census and Statistics Department.
5.
ChanG. M.LouV. W.KoL. S. (2016). Age-friendly Hong Kong. In MoulaertT.GaronS. (Eds.), Age-friendly cities and communities in international comparison (pp. 121–151). Springer.
6.
ChuiC. H.ChanO. F.TangJ. Y. M.LumT. Y. S. (2020). Fostering civic awareness and participation among older adults in Hong Kong: An empowerment-based participatory photo-voice training model. Journal of Applied Gerontology, 39(9), 1008–1015. https://doi.org/10.1177/0733464819838448
7.
ChuiC. H.TangJ. Y. M.KwanC. M.Fung ChanO.TseM.ChiuR. L. H.LouV. W. Q.ChauP. H.LeungA. Y. M.LumT. Y. S. (2019). Older adults’ perceptions of age-friendliness in Hong Kong. The Gerontologist, 59(3), 549–558. https://doi.org/10.1093/geront/gny052
8.
de VriesS.VerheijR. A.GroenewegenP. P.SpreeuwenbergP. (2003). Natural environments—Healthy environments? An exploratory analysis of the relationship between greenspace and health. Environment and Planning A, 35, 1717–1731. https://doi.org/10.1068/a35111
9.
DoganH.CanbazS.TanderB.PeksenY.CanturkF.OrucN. O. (2010). The prevalence of home injuries among elderly people in Samsun, Turkey, and the influencing factors. Turkish Journal of Medical Sciences, 40(4), 651–658. https://doi.org/10.3906/sag-0903-17
10.
FowlerK.Wareham-FowlerS.BarnesC. (2013). Social context and depression severity and duration in Canadian men and women: Exploring the influence of social support and sense of community belongingness. Journal of Applied Social Psychology, 43(Suppl. 1), E85–E96. https://doi.org/10.1111/jasp.12050
11.
FrancisJ.WoodL. J.KnuimanM.Giles-CortiB. (2012). Quality or quantity? Exploring the relationship between Public Open Space attributes and mental health in Perth, Western Australia. Social Science & Medicine, 74(10), 1570–1577. https://doi.org/10.1016/j.socscimed.2012.01.032
12.
FukunagaR.AbeY.NakagawaY.KoyamaA.FujiseN.IkedaM. (2012). Living alone is associated with depression among the elderly in a rural community in Japan. Psychogeriatrics, 12(3), 179–185. https://doi.org/10.1111/j.1479-8301.2012.00402.x
13.
GasconM.VrijheidM.NieuwenhuijsenM. J. (2016). The built environment and child health: An overview of current evidence. Current Environmental Health Reports, 3, 250–257. https://doi.org/10.1007/s40572-016-0094-z
14.
GattinoS.De PiccoliN.FassioO.RolleroC. (2013). Quality of life and sense of community. A study on health and place of residence. Journal of Community Psychology, 41(7), 811–826. https://doi.org/10.1002/jcop.21575
15.
The Government of the Hong Kong Special Administrative Region. (2016). 2016 policy address. Office of the Chief Executive. https://www.policyaddress.gov.hk/2016
16.
HandyS. L.BoarnetM. G.EwingR.KillingsworthR. E. (2002). How the built environment affects physical activity: Views from urban planning. American Journal of Preventive Medicine, 23(Suppl. 2), 64–73. https://doi.org/10.1016/s0749-3797(02)00475-0
17.
HosseiniH.HosseiniN. (2008). Epidemiology and prevention of fall injuries among the elderly. Hospital Topics, 86(3), 15–20. https://doi.org/10.3200/HTPS.86.3.15-20
18.
HouldenV.WeichS.PortodeAlbuquerqueJ.JarvisS.ReesK. (2018). The relationship between greenspace and the mental wellbeing of adults: A systematic review. PLOS ONE, 13(9), Article e0203000. https://doi.org/10.1371/journal.pone.0203000
19.
HystadP.CarpianoR. M. (2012). Sense of community-belonging and health-behaviour change in Canada. Journal of Epidemiology and Community Health, 66(3), 277–283. https://doi.org/10.1136/jech.2009.103556
20.
KerrJ.RosenbergD.FrankL. (2012). The role of the built environment in healthy aging: Community design, physical activity, and health among older adults. Journal of Planning Literature, 27(1), 43–60. https://doi.org/10.1177/0885412211415283
21.
KitchenP.WilliamsA.ChowhanJ. (2012). Sense of community belonging and health in Canada: A regional analysis. Social Indicators Research, 107(1), 103–126. https://doi.org/10.1007/s11205-011-9830-9
LamC. L. K.TseE. Y. Y.GandekB. (2005). Is the standard SF-12 Health Survey valid and equivalent for a Chinese population?Quality of Life Research, 14, 539–547. https://doi.org/10.1007/s11136-004-0704-3
24.
LawtonM. P.NahemowL. (1973). Ecology and the aging process. In EisdorferC.LawtongM. P. (Eds.), The psychology of adult development and aging (pp. 619–674). American Psychological Association.
25.
LeydenK. M. (2003). Social capital and the built environment: The importance of walkable neighborhoods. American Journal of Public Health, 93(9), 1546–1551. https://www.ncbi.nlm.nih.gov/pubmed/12948978
26.
MaasJ.VerheijR. A.GroenewegenP. P.de VriesS.SpreeuwenbergP. (2006). Green space, urbanity, and health: How strong is the relation?Journal of Epidemiology and Community Health, 60(7), 587–592. https://doi.org/10.1136/jech.2005.043125
27.
MakW. W.CheungR. Y.LawL. S. (2009). Sense of community in Hong Kong: Relations with community-level characteristics and residents’ well-being. American Journal of Community Psychology, 44(1–2), 80–92. https://doi.org/10.1007/s10464-009-9242-z
28.
McCormackG. R.ShiellA. (2011). In search of causality: A systematic review of the relationship between the built environment and physical activity among adults. International Journal of Behavioral Nutrition and Physical Activity, 8, 125. https://doi.org/10.1186/1479-5868-8-125
29.
MenecV. H.NowickiS. (2014). Examining the relationship between communities’ “age-friendliness” and life satisfaction and self-perceived health in rural Manitoba, Canada. Rural and Remote Health, 14, 2594. https://www.rrh.org.au/journal/article/2594
30.
PetersonN. A.SpeerP. W.McMillanD. W. (2008). Validation of a brief sense of community scale: Confirmation of the principal theory of sense of community. Journal of Community Psychology, 36(1), 61–73. https://doi.org/10.1002/jcop.20217
31.
PlouffeL.KalacheA. (2010). Towards global age-friendly cities: Determining urban features that promote active aging. Journal of Urban Health, 87(5), 733–739. https://doi.org/10.1007/s11524-010-9466-0
32.
PutnamR. D. (2000). Bowling alone: The collapse and revival of American community. Simon & Schuster.
33.
SharifiA.MurayamaA. (2013). Changes in the traditional urban form and the social sustainability of contemporary cities: A case study of Iranian cities. Habitat International, 38, 126–134. https://doi.org/10.1016/j.habitatint.2012.05.007
34.
StahlS. T.BeachS. R.MusaD.SchulzR. (2017). Living alone and depression: The modifying role of the perceived neighborhood environment. Aging and Mental Health, 21(10), 1065–1071. https://doi.org/10.1080/13607863.2016.1191060
35.
StedmanR. C. (2003). Is it really just a social construction? The contribution of the physical environment to sense of place. Society & Natural Resources, 16(8), 671–685. https://doi.org/10.1080/08941920390217627
36.
TangF.ChiI.DongX. (2017). The relationship of social engagement and social support with sense of community. Journal of Gerontology: Series A, Biological Sciences and Medical Sciences, 72(Suppl. 1), S102–S107. https://doi.org/10.1093/gerona/glw187
37.
ThompsonC. W.RoeJ.AspinallP.MitchellR.ClowA.MillerD. (2012). More green space is linked to less stress in deprived communities: Evidence from salivary cortisol patterns. Landscape and Urban Planning, 105(3), 221–229. https://doi.org/10.1016/j.landurbplan.2011.12.015
38.
UlrichR. S.SimonsR. F.LositoB. D.FioritoE.MilesM. A.ZelsonM. (1991). Stress recovery during exposure to natural and urban environments. Journal of Environmental Psychology, 11(3), 201–230. https://doi.org/10.1016/S0272-4944(05)80184-7
39.
van den BergM.Wendel-VosW.van PoppelM.KemperH.van MechelenW.MaasJ. (2015). Health benefits of green spaces in the living environment: A systematic review of epidemiological studies. Urban Forestry & Urban Greening, 14(4), 806–816. https://doi.org/10.1016/j.ufug.2015.07.008
40.
WahlH. W.IwarssonS.OswaldF. (2012). Aging well and the environment: Toward an integrative model and research agenda for the future. The Gerontologist, 52(3), 306–316. https://doi.org/10.1093/geront/gnr154
WuY. T.PrinaA. M.JonesA.MatthewsF. E.BrayneC. F. A. C. (2015). Older people, the natural environment and common mental disorders: Cross-sectional results from the Cognitive Function and Ageing Study. BMJ Open, 5(9), Article e007936. https://doi.org/10.1136/bmjopen-2015-007936
43.
YungE. H. K.ConejosS.ChanE. H. W. (2016). Social needs of the elderly and active aging in public open spaces in urban renewal. Cities, 52, 114–122. https://doi.org/10.1016/j.cities.2015.11.022
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
