Abstract
Increasing life expectancy in cities has heightened the urgency to understand how built environments affect the various health dimensions of the ageing population. This study explores community-dwelling older adults’ (n = 80; aged 52 and above) perceptions of the links between neighbourhood built environment and their physical, social and mental health in Singapore. Content analysis of focus group discussions reveals that Singaporean older adults associate different but overlapping built environment factors with the physical, social and mental dimensions of health. Safety, amenities, pedestrian-friendly spaces, transport infrastructure, and social and public spaces are most frequently identified with older adults’ health. In particular, safety and pedestrian-friendly spaces are considered most important to older adults’ physical health while safety and amenities are most important for social health, and aesthetics and wayfinding for mental health. These findings underscore the diversities and complexities of everchanging person-environment fit that must be considered while planning, designing and/or retrofitting neighbourhoods and outdoor spaces in high-density Asian cities.
Similar content being viewed by others
Notes
Singapore has a multi-ethnic population where the majority – 76.2% is Chinese and the remaining comprising Malay (15%), Indian (7.4%), Eurasians and other ethnic minority (1.4%).
References
Algilani, S., Östlund-Lagerström, L., Schoultz, I., Brummer, R. J., & Kihlgren, A. (2016). Increasing the qualitative understanding of optimal functionality in older adults: A focus group based study. BMC Geriatrics, 16(1), 70. https://doi.org/10.1186/s12877-016-0244-z.
Aw, S., Koh, G., Oh, Y. J., Wong, M. L., Vrijhoef, H. J., Harding, S. C., et al. (2017). Explaining the continuum of social participation among older adults in Singapore: From 'closed doors' to active ageing in multi-ethnic community settings. Journal of Aging Studies, 42, 46–55.
Bazeley, P., & Jackson, K. (2013). Qualitative data analysis with NVivo (2ed.). London: Sage.
Bond, L., Kearns, A., Mason, P., Tannahill, C., Egan, M., & Whitely, E. (2012). Exploring the relationships between housing, neighbourhoods and mental wellbeing for residents of deprived areas. B M C Public Health, 12(1), 48. https://doi.org/10.1186/1471-2458-12-48.
Bozovic-Stamenovic, R. (2015). A supportive healthful housing environment for ageing: Singapore experiences and potentials for improvements. Asia Pacific Journal of Social Work and Development, 25(4), 198–212.
Cachadinha, C. (2012) Characteristics of age-friendly neighbourhood built environments according to age-friendly community models. In CITTA 5th Annual Conference on Planning Research: Planning and Ageing. Think, Act and Share Age-friendly Cities, Porto: FEUP.
Cerin, E., Nathan, A., Cauwenberg, J., Barnett, D. W., & Barnett, A. (2017). The neighbourhood physical environment and active travel in older adults: A systematic review and meta-analysis. International Journal of Behavioral Nutrition and Physical Activity, 14, 15. https://doi.org/10.1186/s12966-017-0471-5.
Chong, K. H. (2018). Reclamation of urban voids and the return of the “kampung spirit” in Singapore’s public housing. In Creative Ageing Cities (pp. 19-46): Routledge.
Clarke, P., & Nieuwenhuijsen, E. R. (2009). Environments for healthy ageing: A critical review. Maturitas, 64(1), 14–19.
Day, R. (2008). Local environments and older people's health: Dimensions from a comparative qualitative study in Scotland. Health & Place, 14(2), 299–312.
Ewing, R., & Handy, S. (2009). Measuring the unmeasurable: Urban design qualities related to walkability. Journal of Urban Design, 14(1), 65–84.
Frank, L. D., & Engelke, P. (2005). Multiple impacts of the built environment on public health: Walkable places and the exposure to air pollution. International Regional Science Review, 28(2), 193–216.
Frank, L. D., Engelke, P., Engelke, S. F. P., & Schmid, T. (2003). Health and community design: The impact of the built environment on physical activity. Washington, DC: Island Press.
Frank, L. D., & Engelke, P. O. (2001). The built environment and human activity patterns: Exploring the impacts of urban form on public health. Journal of Planning Literature, 16(2), 202–218.
Garin, N., Olaya, B., Miret, M., Ayuso-Mateos, J. L., Power, M., Bucciarelli, P., & Haro, J. M. (2014). Built environment and elderly population health: A comprehensive literature review. Clinical Practice & Epidemiology in Mental Health, 10, 103–105.
Golant, S. M. (1984). A place to grow old: The meaning of environment in old age: Columbia University press New York.
Golant, S. M. (2003). Conceptualizing time and behavior in environmental gerontology: A pair of old issues deserving new thought. The Gerontologist, 43(5), 638–648.
Government of Singapore (2019). Singapore residents by age group, ethnic group and gender, June, Annual.
Halaweh, H., Dahlin-Ivanoff, S., Svantesson, U., & Willen, C. (2018). Perspectives of older adults on aging well: A focus group study. Journal of Aging Research, 2018, 9858252. 98582.
Iwarsson, S. (2005). A long-term perspective on person–environment fit and ADL dependence among older Swedish adults. The Gerontologist, 45(3), 327–336.
Kahana, E., Lovegreen, L., Kahana, B., & Kahana, M. (2003). Person, environment, and person-environment fit as influences on residential satisfaction of elders. Environment and Behavior, 35(3), 434–453.
Kerr, J., Rosenberg, D., & Frank, L. (2012). The role of the built environment in healthy aging: Community design, physical activity, and health among older adults. Journal of Planning Literature, 27, 43–60.
King, A. C., Sallis, J. F., Frank, L. D., Saelens, B. E., Cain, K., Conway, T. L., Chapman, J. E., Ahn, D. K., & Kerr, J. (2011). Aging in neighborhoods differing in walkability and income: Associations with physical activity and obesity in older adults. Social Science & Medicine, 73(10), 1525–1533.
Krueger, R. A., & Casey, M. A. (2015). Focus groups: A practical guide for applied research (5ed.). London: Sage.
Lane, A. P., Hou, Y., Wong, C. H., & Yuen, B. (2020). Cross-sectional associations of neighborhood third places with social health among community-dwelling older adults. Social Science & Medicine, 258. https://doi.org/10.1016/j.socscimed.2020.113057.
Lawton, M. P. (1977). The impact of the environment on aging and behavior. In J. E. Birren & K. W. Schaie (Eds.), Handbook of the psychology of aging. New Yor: Van Nostrand.
Lawton, M. P. (1983). Environment and other determinants of wellbeing in older people. The Gerontologist, 23, 349–357.
Lawton, M. P., & Nahemow, L. (1973). Ecology and the aging process. In C. Eisdorfer & M. P. Lawton (Eds.), The psychology of adult development and aging (pp. 619–674). Washington, DC: American Psychological Association.
Leung, F.-H., & Savithiri, R. (2009). Spotlight on focus groups. Canadian Family Physician, 55(2), 218–219.
Loukaitou-Sideris, A. (2006). Is it safe to walk? Neighborhood safety and security considerations and their effects on walking. Journal of Planning Literature, 20(3), 219–232.
Michael, Y. L., Green, M. K., & Farquhar, S. A. (2006). Neighborhood design and active aging. Health & Place, 12(4), 734–740.
Michael, Y. L., Nagel, C. L., Gold, R., & Hillier, T. A. (2014). Does change in the neighborhood environment prevent obesity in older women? Social Science & Medicine, 102, 129–137.
Moore, T. H. M., Kesten, J. M., López-López, J. A., Ijaz, S., McAleenan, A., Richards, A., Gray, S., Savović, J., & Audrey, S. (2018). The effects of changes to the built environment on the mental health and well-being of adults: Systematic review. Health & Place, 53, 237–257.
Moran, M., Van Cauwenberg, J., Hercky-Linnewiel, R., Cerin, E., Deforche, B., & Plaut, P. (2014). Understanding the relationships between the physical environment and physical activity in older adults: A systematic review of qualitative studies. International Journal of Behavioral Nutrition and Physical Activity, 11, 79. http://www.ijbnpa.org/content/11/71/79.
Morgan, D. L. (1997). The focus group guidebook (Vol. 1). London: Sage.
Ng, T. P., Nyunt, M. S. Z., Shuvo, F. K., Eng, J. Y., Yap, K. B., Hee, L. M., Chan, S. P., & Scherer, S. (2018). The neighborhood built environment and cognitive function of older persons: Results from the Singapore longitudinal ageing study. Gerontology, 64(2), 149–156.
Nickelson, J., Wang, A. R., Mitchel, Q. P., Hendricks, K., & Paschal, A. (2013). Inventory of the physical environment domains and subdomains measured by neighborhood audit tools: A systematic literature review. Journal of Environmental Psychology, 39, 179–189.
O'Campo, P., Salmon, C., & Burke, J. G. (2009). Neighbourhoods and mental well-being: What are the pathways? Health & Place, 15, 56–68.
Roux, A. V. D., & Mair, C. (2010). Neighborhoods and health. Annals of New York Academy of Sciences, 1186, 125–145.
Sallis, J. F., Cervero, R. B., Ascher, W., Henderson, K. A., Kraft, M. K., & Kerr, J. (2006). An ecological approach to creating active living communities. Annual Review of Public Health, 27, 297–322.
Smithson, J. (2000). Using and analysing focus groups: Limitations and possibilities. International Journal of Social Research Methodology, 3(2), 103–119.
Song, S., Yap, W., Hou, Y., & Yuen, B. (2020). Neighbourhood built environment, physical activity, and physical health among older adults in Singapore: A simultaneous equations approach. Journal of Transport & Health, 18, 100881. https://doi.org/10.1016/j.jth.2020.100881.
Takano, T., Nakamura, K., & Watanabe, M. (2002). Urban residential environments and senior citizens’ longevity in megacity areas: The importance of walkable green spaces. Journal of Epidemiology and Community Health, 56(12), 913–918.
Van den Berg, P., Kemperman, A., de Kleijn, B., & Borgers, A. (2016). Ageing and loneliness: The role of mobility and the built environment. Travel Behaviour and Society, 5, 48–55.
Van Dijk, H. M., Cramm, J. M., Van Exel, J. O. B., & Nieboer, A. P. (2015). The ideal neighbourhood for ageing in place as perceived by frail and non-frail community-dwelling older people. Ageing and Society, 35(8), 1771–1795.
WHO. (2007). Global age-friendly cities: A guide. Geneva: World Health Organization.
WHO. (2010). Environment and health risks: A review of the influence and effects of social inequalities. Copenhagen, WHO Regional Office for Europe.
WHO (Ed.). (2020). Basic documents: Forty-ninth edition (including amendments adopted up to 31 may 2019). Geneva: World Health Organization.
Yuen, B. (Ed.). (2019). Ageing and the built environment in Singapore. Cham: Springer.
Yuen, B., & Soh, E. (2017). Housing for older people in Singapore: An annotated bibliography (springer briefs in aging). Cham: Springer.
Yung, E. H., Conejos, S., & Chan, E. H. (2016). Social needs of the elderly and active aging in public open spaces in urban renewal. Cities, 52, 114–122.
Acknowledgements
This material is based on a research project funded by the National Research Foundation, Singapore and Singapore’s Ministry of National Development under the L2NIC Award No. L2NICTDF1-2017-2. The authors acknowledge the contribution of Anna Dieterich for her support in focus group participant recruitment, data collection, and draft report writing. The authors are thankful to the project research team at the Lee Kuan Yew Centre for Innovative Cities, Singapore University of Technology and Design, Geriatric Education and Research Institute Ltd, Lekker Architects Pte Ltd, Tierra Design Studio Pte Ltd, CPG Consultants Pte Ltd as partners and collaborators in this study. Special thanks go to all research participants for generously giving their timeand sharing their experiences. This research/project is supported by the National Research Foundation, Singapore, and Singapore’s Ministry of National Development under the L2NIC Award No. L2NICTDF1-2017-2. Any opinions, findings and conclusions or recommendations expressed in this material are those of the authors and do not reflect the views of the National Research Foundation, Singapore and Singapore’s Ministry of National Development.
Author information
Authors and Affiliations
Corresponding author
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Annex
Annex
Rights and permissions
About this article
Cite this article
Bhuyan, M.R., Yuen, B. Older Adults’ Views of the Connections between Neighbourhood Built Environment and Health in Singapore. Population Ageing 15, 279–299 (2022). https://doi.org/10.1007/s12062-021-09328-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12062-021-09328-4