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Abstract：
There have been few consistencies in the effects and pathways of neighborhood socioeconomic status (SES) on functional limitations. This study aimed to investigate whether neighborhood socioeconomic status influences ADL/IADL in older residents in China through the neighborhood built environment and social environment.
Activities of daily living/IADL were assessed in a sample of 5,887 Chinese individuals aged 60 or older, utilizing data obtained from the 2011 China Health and Retirement Longitudinal Study (CHARLS 2011). Neighborhood SES was measured by the neighborhood per-capita net income. Neighborhood built environment was measured by the security resources, motion resources, living resources, service resources for older adults, and medical resources of neighborhood. Neighborhood social environment was measured by the organizations, unemployment subsidies, minimum living allowance, subsidies to persons older than 65, and pensions to persons older than 80 of the neighborhood. The two-level logistical regression model and multilevel structural equation model (MSEM) were used.
The rate of ADL/IADL loss among Chinese older adults aged 60 and above in 2011 were 32.17 and 36.87%, respectively. Neighborhood SES was significantly associated with ADL/IADL in older adults. Compared with the respondents living in communities with lower SES, those living in communities with higher SES possessed better ADL (β = -0.33, p < 0.05) and IADL (β = -0.36, p < 0.05) status. The path of neighborhood socioeconomic status on ADL was completely mediated by the neighborhood built environment (β = -0.110, p < 0.05) and neighborhood social environment (β = -0.091, p < 0.05). Additionally, the effect of neighborhood socioeconomic status on IADL was fully mediated by the neighborhood built environment (β = -0.082, p < 0.05) and neighborhood social environment (β = -0.077, p < 0.05).
Neighborhood SES was significantly correlated with ADL/IADL through the neighborhood environment. Improving the ADL/IADL status of older adults residing in low socioeconomic neighborhoods requires enhancing the built and social environment by provisioning additional neighborhood resources.
Activities of daily living/IADL were assessed in a sample of 5,887 Chinese individuals aged 60 or older, utilizing data obtained from the 2011 China Health and Retirement Longitudinal Study (CHARLS 2011). Neighborhood SES was measured by the neighborhood per-capita net income. Neighborhood built environment was measured by the security resources, motion resources, living resources, service resources for older adults, and medical resources of neighborhood. Neighborhood social environment was measured by the organizations, unemployment subsidies, minimum living allowance, subsidies to persons older than 65, and pensions to persons older than 80 of the neighborhood. The two-level logistical regression model and multilevel structural equation model (MSEM) were used.
The rate of ADL/IADL loss among Chinese older adults aged 60 and above in 2011 were 32.17 and 36.87%, respectively. Neighborhood SES was significantly associated with ADL/IADL in older adults. Compared with the respondents living in communities with lower SES, those living in communities with higher SES possessed better ADL (β = -0.33, p < 0.05) and IADL (β = -0.36, p < 0.05) status. The path of neighborhood socioeconomic status on ADL was completely mediated by the neighborhood built environment (β = -0.110, p < 0.05) and neighborhood social environment (β = -0.091, p < 0.05). Additionally, the effect of neighborhood socioeconomic status on IADL was fully mediated by the neighborhood built environment (β = -0.082, p < 0.05) and neighborhood social environment (β = -0.077, p < 0.05).
Neighborhood SES was significantly correlated with ADL/IADL through the neighborhood environment. Improving the ADL/IADL status of older adults residing in low socioeconomic neighborhoods requires enhancing the built and social environment by provisioning additional neighborhood resources.
摘要：
■邻里社会经济地位（SES）对功能限制的影响和途径几乎没有一致性。本研究旨在调查社区社会经济地位是否通过社区建筑环境和社会环境影响中国老年居民的ADL/IADL。
■在5887名60岁或以上的中国人的样本中评估了日常生活活动/IADL，利用2011年中国健康与退休纵向研究(CHARLS2011)获得的数据。邻里SES是通过邻里人均纯收入来衡量的。邻里环境是由安全资源来衡量的，运动资源,生活资源,面向老年人的服务资源，和邻里的医疗资源。邻里社会环境是由组织来衡量的，失业补贴,最低生活津贴,向65岁以上的人提供补贴，向80岁以上的人提供养老金。采用两级逻辑回归模型和多级结构方程模型(MSEM)。
■2011年中国60岁及以上老年人ADL/IADL损失率分别为32.17%和36.87%，分别。在老年人中，邻里SES与ADL/IADL显著相关。与生活在SES较低社区的受访者相比，生活在SES较高的社区中的人具有更好的ADL（β=-0.33，p<0.05）和IADL（β=-0.36，p<0.05）状态。邻域社会经济地位在ADL上的路径完全由邻域建筑环境（β=-0.110，p<0.05）和邻域社会环境（β=-0.091，p<0.05）介导。此外,邻里社会经济地位对IADL的影响完全由邻里建筑环境（β=-0.082，p<0.05）和邻里社会环境（β=-0.077，p<0.05）介导。
■通过邻域环境，邻域SES与ADL/IADL显著相关。改善居住在低社会经济社区的老年人的ADL/IADL状况需要通过提供额外的社区资源来改善建筑和社会环境。
■在5887名60岁或以上的中国人的样本中评估了日常生活活动/IADL，利用2011年中国健康与退休纵向研究(CHARLS2011)获得的数据。邻里SES是通过邻里人均纯收入来衡量的。邻里环境是由安全资源来衡量的，运动资源,生活资源,面向老年人的服务资源，和邻里的医疗资源。邻里社会环境是由组织来衡量的，失业补贴,最低生活津贴,向65岁以上的人提供补贴，向80岁以上的人提供养老金。采用两级逻辑回归模型和多级结构方程模型(MSEM)。
■2011年中国60岁及以上老年人ADL/IADL损失率分别为32.17%和36.87%，分别。在老年人中，邻里SES与ADL/IADL显著相关。与生活在SES较低社区的受访者相比，生活在SES较高的社区中的人具有更好的ADL（β=-0.33，p<0.05）和IADL（β=-0.36，p<0.05）状态。邻域社会经济地位在ADL上的路径完全由邻域建筑环境（β=-0.110，p<0.05）和邻域社会环境（β=-0.091，p<0.05）介导。此外,邻里社会经济地位对IADL的影响完全由邻里建筑环境（β=-0.082，p<0.05）和邻里社会环境（β=-0.077，p<0.05）介导。
■通过邻域环境，邻域SES与ADL/IADL显著相关。改善居住在低社会经济社区的老年人的ADL/IADL状况需要通过提供额外的社区资源来改善建筑和社会环境。
