Neighbourhood built Environment, physical activity, and physical health among older adults in Singapore: A simultaneous equations approach

Introduction: An increasing body of evidence suggests that regular physical activity can have important beneficial effects on individuals’ health into later years. This research investigated the inter-relationships between neighbourhood built environment, physical activity and three physical health outcomes among older adults in Singapore. Methods: Drawing on 2018 data from 810 community-dwelling older adults in Singapore, a simultaneous equation approach was utilised to disentangle the complex interactions among built environment (both objective and self-reported measurements), physical activity and physical health (i.e., body mass index, functional capability and presence or absence of ‘three high’ chronic diseases) while controlling for other confounding factors, including socio-demographics and health behaviour. Results: The accessibility to destinations (e.g., parks, open spaces, playgrounds) and other walkability features (e.g., neighbourhood safety, covered footpath) could promote transportation or recreational outdoor physical activity and therefore, health among older residents in Singapore. Interestingly, built environment characteristics related differently to physical activity undertaken for transportation and recreational purposes. There was a bi-directional relationship between an older adult's functional status and transport-related physical activity. There was also evidence that the connection between number of chronic diseases and recreational physical activity was reciprocal. Conclusion: Insights into the built environment-physical activity-physical health relationships highlight the importance of supportive built environment in the process of health enhancement for older people.