Relative Association of Multi-Level Supportive Environments on Poor Health among Older Adults.
Relative Association of Multi-Level Supportive Environments on Poor Health among Older Adults.
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DOI：
10.3390/ijerph14040387
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发表时间：
2017-04-06
影响因子：
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通讯作者：
Smith ML
中科院分区：
文献类型：
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作者：
Mier N;Ory MG;Towne SD;Smith ML
背景：美国人口老龄化对美国的医疗保健和非正式医疗体系构成了重大挑战。需要进行更多的研究，以了解基于社会生态视角的健康促进方案和政策如何影响老年人的健康和福祉。本研究的目的是调查个人特征和支持环境与65岁及以上老年人健康状况不佳。研究方法：本研究采用横断面设计，并由作者开发的概念框架来描述与健康状况不佳相关的个人特征和环境之间的关系。这项研究中包括的环境类型是家庭，家庭，金融，邻里和医疗保健。样本由1319名居住在德克萨斯州中部的65岁及以上的成年人组成。从随机选择的家庭中，参与者接受了由社区合作努力创建的基于邮件的调查。描述性统计和三个二元逻辑回归模型被拟合以检查与健康状况不佳的关联（即，身体、心理和身体/心理组合）。结果：两个个人特征（慢性病的数量和教育水平）与健康结果一致相关（p < 0.05）。支持性的家庭、家庭、经济、邻里和卫生保健环境因素与身心健康结果的各个方面相关（p < 0.05）。结论：包括个人特征和保护环境在内的多维因素与老年人的健康状况有关。每种环境的独特作用都有助于为公共卫生干预提供信息，以创造和加强对老年人参与健康活动的支持，并改善他们的身心健康。
Background: The aging of the United States population poses significant challenges to American healthcare and informal caregiving systems. Additional research is needed to understand how health promotion programs and policies based on a socio-ecological perspective impact the health and well-being of older persons. The purpose of this study was to investigate personal characteristics and supportive environments associated with poor health among older individuals aged 65 and over. Methods: This study used a cross-sectional design and was guided by a conceptual framework developed by the authors to depict the relationship between personal characteristics and environments associated with poor health status. Environment types included in this study were family, home, financial, neighborhood, and healthcare. The sample was comprised of 1319 adults aged 65 years and older residing in Central Texas. From a random selection of households, participants were administered a mail-based survey created by a community collaborative effort. Descriptive statistics and three binary logistic regression models were fitted to examine associations with poor health status (i.e., physical, mental, and combined physical/mental). Results: Two personal characteristics (number of chronic conditions and educational level) were consistently related (p < 0.05) to health outcomes. Supportive family, home, financial, neighborhood, and health care environmental factors were shown to be related (p < 0.05) to various aspects of physical or mental health outcomes. Conclusions: Multidimensional factors including personal characteristics and protective environments are related to health status among older individuals. The unique roles of each environment can help inform public health interventions to create and enhance support for older adults to engage in healthful activities and improve their physical and mental health.