Examining the association between perceived neighbourhood safety and health services utilization: A cross-sectional study among older adults in the United States of America

Abstract

Objective

To assess the association between perceived neighbourhood safety and health services use among older adults.

Methods

The Health and Retirement Study was used to assess the association of perceived neighbourhood safety with inpatient hospital utilization, contact with a physician, home health use, and any health services utilization in the United States of America (n = 10,844). Logistic regression models were used, while controlling for a large number of potential confounders.

Results

The odds of any contact with a physician were greater among those who perceived their neighbourhood safety to be excellent (odds ratio (OR): 1.81, 95% confidence interval (CI): 1.20, 2.72) or very good (OR: 1.56, 95% CI: 1.04, 2.32) compared with those who perceived their neighbourhood safety as fair or poor, controlling for all model covariates. The odds of any health services utilization were greater among those who perceived their neighbourhood safety to be excellent (OR: 1.95, 95% CI: 1.26, 3.00) or very good (OR: 1.63, 95% CI: 1.06, 2.50) compared with those who perceived their neighbourhood safety as fair or poor controlling for all other model covariates. The odds of inpatient care were higher among those who perceived their neighbourhood to be excellent compared with those who compared their neighbourhood to be fair/poor (OR: 1.22, 95% CI: 1.01, 1.48). Results were not statistically significant for home health utilization.

Conclusions

These analyses show a relationship between perceived neighbourhood safety and contact with a physician and any health services utilization among older adults and a weaker relationship between perceived neighbourhood safety and inpatient services. Future research should continue to examine this relationship between perceived neighbourhood safety and health services utilization among older adults.

Keywords

perceived safety older adults neighbourhoods utilization health services

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References

Selye

The physiology and pathology of exposure to stress. Montreal: Acta Inc., 1950.

Cannon

Bodily changes in pain, hunger, fear, and rage. 2nd ed. New York: Appleton, 1929.

Freeman

Physiological basis of stress. Proc R Soc Med 1975; 68: 427–429.

Sapolsky

RM.

Why zebras don’t get ulcers. 3rd ed. New York: WH Freeman, 2004.

Hellhammer

Schlotz

Stone

, et al. Allostatic load, perceived stress, and health: a prospective study in two age groups. Ann New York Acad Sci 2006; 1: 1032–1038.

Van Cauwenberg

Clarys

De Bourdeaudhuij

, et al. Physical environmental factors related to walking and cycling in older adults: the Belgian aging studies. BMC Public Health 2012; 12: 142.

Stafford

Chandola

Marmot

Association between fear of crime and mental health and physical functioning. Am J Public Health 2007; 97: 2076–2081.

Foster

Knuiman

Hooper

, et al. Do changes in residents’ fear of crime impact their walking? Longitudinal results from RESIDE. Prev Med 2014; 62: 161–166.

Foster

Giles-Corti

Knuiman

Does fear of crime discourage walkers? A social-ecological exploration of fear as a deterrent to walking. Environ Behav 2014; 46: 698–717.

10.

Pearson

Breetzke

GD.

The association between the fear of crime, and mental and physical wellbeing in New Zealand. Soc Indic Res 2014; 119: 281–294.

11.

Macassa

Winersjo

Wijk

, et al. Fear of crime and its relationship to self-reported health and stress among men. J Public Health Res 2017; 3: 169–174.

12.

Chandola

The fear of crime and area differences in health. Health Place 2001; 7: 105–116.

13.

Qin

Yan

The impacts of fear of crime on the mental health and avoidance behaviors of older Chinese. Eur Psychiatry 2013; 28: 1–1.

14.

Skogan

Of crime and neighborhood change. Crime Justice 1986; 8: 203–229.

15.

Miethe

TD.

Fear and withdrawal from urban life. Ann Am Acad Pol Soc Sci 1995; 539: 14–27.

16.

Grinshteyn

Sugar

JA.

Perceived neighbourhood safety and volunteerism among older adults. Ageing Soc 2020; 22: 1–19.

17.

Garofalo

The fear of crime: causes and consequences. J Crim Law Criminol 1981; 72: 839–857.

18.

Fish

Ettner

Ang

, et al. Association of perceived neighborhood safety on body mass index. Am J Public Health 2010; 100: 2296–2303.

19.

Grinshteyn

Muennig

Pabayo

Using the general social survey – national death index cohort to study the relationship between neighbourhood fear and mortality in the USA. BMJ Open 2019; 9: e030330.

20.

Wilson-Genderson

Pruchno

Effects of neighborhood violence and perceptions of neighborhood safety on depressive symptoms of older adults. Soc Sci Med 2013; 85: 43–49.

21.

Choi

Matz-Costa

Perceived neighborhood safety, social cohesion, and psychological health of older adults. Gerontologist 2017; 1: 196–206.

22.

Berglund

Lytsy

Westerling

Living environment, social support, and informal caregiving are associated with healthcare seeking behaviour and adherence to medication treatment: a cross‐sectional population study. Health Soc Care Community 2019; 27: 1260–1270.

23.

Ceasar

Ayers

Andrews

, et al. Unfavorable perceived neighborhood environment associates with less routine healthcare utilization: data from the Dallas heart study. PLoS One 2020; 15: e0230041.

24.

Andersen

RM.

Behavioral model of families’ use of health services. Research series. Chicago, IL: University of Chicago Center for Health Administration Studies, 1968.

25.

Andersen

RM.

Revisiting the behavioral model and access to medical care: does it matter?

J Health Soc Behav 1995; 36: 1–10.

26.

HRS Staff. Sample Sizes and Response Rates. Ann Arbor, MI: Survey Research Center, Institute for Social Research, University of Michigan, http://hrsonline.isr.umich.edu/sitedocs/sampleresponse.pdf (2017, accessed 12 April 2019).

27.

Ofstedal

Weir

Chen

K-T

, et al. Updates to HRS Sample Weights, http://hrsonline.isr.umich.edu/sitedocs/userg/dr-013.pdf. (2011, accessed 29 May 2019).

28.

Roberts

Bergstralh

Schmidt

, et al. Comparison of self-reported and medical record health care utilization measures. J Clin Epidemiol 1996; 49: 989–995.

29.

Ritter

Stewart

Kaymaz

, et al. Self-reports of health care utilization compared to provider records. J Clin Epidemiol 2001; 54: 136–141.

30.

Longobardi

Walker

Graff

, et al. Health service utilization in IBD: comparison of self-report and administrative data. BMC Health Serv Res 2011; 11: 137.

31.

Tisnado

Adams

Liu

What is the concordance between the medical record and patient self-report as data sources for ambulatory care?

Med Care 2006; 44: 132–140.

32.

Lubeck

Hubert

HB.

Self-report was a viable method for obtaining health care utilization data in community-dwelling seniors. J Clin Epidemiol 2005; 58: 286–290.

33.

Wallihan

Stump

Callahan

CM.

Accuracy of self-reported health services use and patterns of care among urban older adults. Med Care 1999; 37: 662–670.

34.

StataCorp. Stata Multiple Imputation Reference Manual, http://www.stata.com/manuals13/mi.pdf (2013, accessed 13 January 2019).

35.

StataCorp. Stata statistical software: release 13. College Station. TX: StataCorp LP, 2013.

36.

Manning

Newhouse

Duan

, et al. Health insurance and the demand for medical care: evidence from a randomized experiment. Am Econ Rev 1987; 77: 251–277.

37.

Collins

RE.

Addressing the inconsistencies in fear of crime research: a meta-analytic review. J Crim Justice 2016; 47: 21–31.

38.

Gomez

Violent crime and outdoor physical activity among inner-city youth. Prev Med 2004; 39: 876–881.

39.

Ferraro

KF.

Fear of crime: interpreting victimization risk. Albany, NY: State University of New York Press, 1995.

40.

Hale

Fear of crime: a review of the literature. Int Rev Vict 1996; 4: 79–150.

41.

Snedker

KA.

Neighborhood conditions and fear of crime a reconsideration of sex differences. Crime Delinquency 2015; 61: 45–70.