The Relationship between Urbanization, the Built Environment, and Physical Activity among Older Adults in Taiwan

Abstract

Urbanization and ageing are global phenomena and offer unique challenges in different countries. A supportive environment plays a critical role in addressing the issue of behavioral change and health promotion among older adults. Many studies in the U.S., EU, and Australia have considered promoting physical activity in the community based on ecological models, whereas very few Asian studies have examined the relationships among urbanization, the built environment and physical activity in elderly at the ecological level, especially from a multi-level perspective. Due to the prevalence of post-war baby boomers and a very low birth-rate, the older population (aged 65 years old and older) in Taiwan has increased rapidly since 2011 and has exceeded the younger generation (0–14 years old) in 2017. Hence, the purpose of this study was first to examine the degree of urbanization in townships and the status of related built environments in Taiwan and then to investigate whether the built environment is associated with recommended amounts of physical activity among older adults. Three national datasets and a multi-level design were used in this research. Data at the individual level was obtained from the 2009 National Health Interview Survey (NHIS) which was taken from June 2009 to February 2010. Ecological data was obtained from the 2006 National Land Use Investigation of the National Geographic Information System and the 2010 Population and Housing Census. The analyses included a descriptive analysis, a bivariate analysis, a multiple logistic regression, and a multi-level analysis, utilizing a mostly hierarchical linear model (HLM). The results showed a significant relationship between factors at the environmental levels and physical activity in older adults. Urbanization, the built environment, and the median income of townships were positively correlated to the physical activity of the older adults. After controlling for individual-level factors, urbanization still exhibited this correlation. Parks and green spaces were associated with achieving the recommended amount of physical activity. However, there was no relationship after controlling for factors at the individual level. Detailed discussions were provided.

Self‐Potential Ambient Noise and Spectral Relationship With Urbanization, Seismicity, and Strain Rate Revealed via the Taiwan Geoelectric Monitoring Network

“…The fourth column is the number of the segments for estimating the PSDs using the WD, DT, and NT data. The fifth column is the urbanization level ( U ) estimated by Huang et al (). The sixth column is the slope of the Gutenberg‐Richter distribution ( b ) estimated by the catalog selected during 2012–2017 and within a 50‐km radius of each SP station.…”

“…Urbanization is the process of the population moving from rural areas to urban areas, which is mainly proportional to the degree of human activities. Huang et al () studied the degree of urbanization in Taiwan townships and used data for the 2010 population, housing census, and so on. Four indicators in their study were introduced including “number of residents,” “the percentage of people working in secondary industries,” “the percentage of people working in tertiary industries,” and “population density.” Finally, the urbanization level was divided into five levels.…”

Effects of Enriched Physical Activity Environments on Balance and Fall Prevention in Older Adults: A Scoping Review

“…The outcome measures that were reported in the selected studies included a combination of physical activity level (Colom et al, 2019;Forte et al, 2019;Gell, Rosenberg, Carlson, Kerr, & Belza, 2015;Giehl, Hallal, Corseuil, Schneider, & d'Orsi, 2016;Hanibuchi, Kawachi, Nakaya, Hirai, & Kondo, 2011;Huang, Kung, & Hu, 2018;Janssen et al, 2014;Kolbe-Alexander, Pacheco, Tomaz, Karpul, & Lambert, 2015;Li, Fisher, Brownson, & Bosworth, 2005; Y. Lu, Chen, Yang, & Gou, 2018;Mazzei, Gillan, & Cloutier, 2014;Nagel, Carlson, Bosworth, & Michael, 2008;Parra, Gomez, Fleischer, & Pinzon, 2010;Rosbergen, Grimley, Hayward, & Brauer, 2019;Rosbergen et al, 2017;Sato, Inoue, Du, & Funk, 2019;Timmermans et al, 2016;Winters et al, 2015), falling rates (Campbell et al, 2005;Cumming et al, 1999;Day et al, 2002;Lannin et al, 2007;Nikolaus & Bach, 2003;Pardessus et al, 2002;Stevens, Holman, Bennett, & De Klerk, 2001) Engel et al, 2016;Lannin et al, 2007;Lin, Wolf, Hwang, Gong, & Chen, 2007;Nicholson, McKean, & Burkett, 2014;Pighills, Torgerson, Sheldon, Drummond, & Bland, 2011;Rosbergen et al, 2017), ADL (Lannin et al, 2007;Law, Barnett, Yau, & Gray, 2013;Law, Fong, & Yau, 2018;Liu, Jones, Formyduval, & Clark, 2016;…”

Cross-sectional associations between the neighborhood built environment and physical activity in a rural setting: the Bogalusa Heart Study

“…Within rural areas, as density decreases the availability of sidewalks decreases and land use mixture for PA deteriorates, indicating that as population density declines in rural areas, the BE becomes less conducive to PA [13]. Relatedly, as degree of urbanization increases, opportunities to engage in PA increase [14]. Associations between BE and PA have been identified, with a systematic review of the literature reporting that pleasant aesthetics, the presence of trails, parks and walkable destinations and lower levels of crime were associated with more PA in adults who live in rural areas [15].…”