The Associations between Neighborhood Social Cohesion and Objective (GIS-Based) and Perceived Built Environments using a Latent Profile Approach in Seniors from Two US Regions

Background/Aim: Healthy aging increases seniors' quality of life and reduces society's healthcare costs, but requires support from both built and social environments. Prior studies often focused on a few built environment features without considering the complexity and multi-dimensionality of the built environment (BE). Using latent profile analysis (LPA), this study aims to examine the relations between objective (GIS-based) and perceived BE profiles and neighborhood social cohesion, and potential moderators (sociodemographic characteristics), that may exist between BE and neighborhood social cohesion in a regionally-derived cohort of seniors from two US locales. Methods: As part of the Senior Neighborhood Quality of Life Study (SNQLS), 693 participants aged 66-97 years (52.2% female, 30% racial minority) were sampled from Seattle-King County, WA and Baltimore, MD-Washington, DC regions in 2005-2008. Two previously published papers on SNQLS derived three objective and four perceived BE profiles. Participants' sociodemographic information and social cohesion were assessed using validated surveys. Mixed-effect models were used to examine the main and interaction effects of different BE profiles and sociodemographic characteristics in relation to social cohesion. Results: Objective BE profiles included 62.7% low, 29.3% mean and 5.8% high walkability/transit/recreation. Perceived profiles included three for Seattle [20.4% low walkable, transit and recreation (LWTR); 32.1% moderately walkable/moderately recreational (MWMR); and 47.2% high walkable/recreationally dense (HWRD)] and four for Baltimore [18.8% LWTR, 28.5% low walkable/recreationally sparse (LWRS), 37.4% MWMR and 15.3% HWRD]. No association was found between objective BE profiles and social cohesion; however, better perceived BE profiles were associated with higher social cohesion. Moderating effects were observed between race, gender, education and marital status and BE profiles, and varied by region. Conclusions: LPA offered a more comprehensive approach to assessing the built environment. Seniors living in high walkable and recreationally dense neighborhoods experienced higher neighborhood social cohesion, which may set the stage for more active lifestyles and healthy aging.