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Preventing Chronic Disease Among the Aged: A Call for Evidence-Based Design Research


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									                                                                                                                                               PA P E R S
                                                                                                   PREVENTINg CHRONIC DISEASE AmONg THE AgED

Preventing Chronic Disease Among the Aged:
A Call for Evidence-Based Design Research
Stephen Verderber, ArchD

                             Abstract                                            Older Americans increasingly reside in a widening
                                                                                 array of community and neighborhood contexts
 The quality of the built environment and the public health                      that range from those dominated by the automo-
 and well-being of its inhabitants are profoundly interwoven.
 Among all age groups, the aged are particularly susceptible to
                                                                                 bile and suburban sprawl, where walkable ameni-
 disengagement or avoidance of the built environment and the                     ties are few and far between, to older community
 physical exercise options it affords; this can have a deleterious               and neighborhood contexts where the aged reside
 influence on personal health. In this discussion, concepts drawn
 from the fields of architecture, landscape research, urban and                  in traditionally planned yet deteriorated inner ur-
 regional planning, and environmental gerontology are drawn                      ban neighborhoods. In the latter contexts the fear
 together in the context of a hybrid conceptual and operative                    of crime may be a major concern. By contrast,
 model. This model is put forth to assist in the acquisition of
 knowledge in the field to further understanding of how chronic                  in suburban contexts the fear of crime may be
 diseases among the aged can be reduced through the provi-                       only a minor concern, yet the absence of nearby
 sion and utilization of sufficiently supportive outdoor physical
                                                                                 amenities that foster access to the outdoors may
 activity options in the everyday environment. This hybrid model,
 the Prospect-Refuge Competency Index (PRCI), combines key                       be the primary determinant in deciding whether
 elements of prospect-refuge theory and environmental press-                     or not to engage in health-promoting outdoor
 competency theory. It can be applied to diverse settings and
 user constituencies. The discussion concludes with the presen-
                                                                                 physical activity. This trend warrants attention on
 tation of a set of hypotheses for the neighborhood/community                    the part of the planning and design professions,
 level and the residential/exterior environs level of inquiry.                   medical and public health specialists, and pub-
 Key Words: Aged, chronic disease, elderly, research, urban
 planning and architecture, research methods, public health                      lic policy makers. Elderly persons in the United
                                                                                 States aged 65 and older numbered 37.9 million
Author Affiliation: Dr. Verderber is a prof
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