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PA P E R S THEORY PREVENTINg CHRONIC DISEASE AmONg THE AgED Preventing Chronic Disease Among the Aged: A Call for Evidence-Based Design Research Stephen Verderber, ArchD Introduction 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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