We examined associations between the presence of objectively-measured access to specific commercial destination types within the neighbourhood and older Australian’s walking, and found some differences in the types of commercial destinations associated with seniors’ walking compared with those generally reported among adults. This lends support to the need for policy-makers and practitioners to plan or retrofit neighbourhood environments that support physical activity across the life course.
Our findings suggest that access to destinations providing more opportunities for social interaction – such as restaurants and religious institutions – and destinations enabling some incidental social contact on a more regular basis for older people – such as pharmacies and hairdressers – appear to be positively associated with walking among older adults. This follows some findings in adult populations, where closer proximity to restaurants and religious or cultural areas positively related to walking for transport-related purposes
[16, 17]. However, providing neighbourhood destinations where people can meet and engage with others may have important implications for the ageing population beyond physical health and walking. For example, access to proximate socially-based facilities has the potential to increase levels of social engagement and participation in retired older adults, who no longer have work-related social contact opportunities and who generally travel shorter distances from home
[30, 31]. Social activity is a key component of successful ageing
, and is consistently linked with health and well-being
[33–35]. This underscores the importance of planning neighbourhoods with proximate access to social infrastructure, not only for physical activity and health, but also for optimising the ageing process.
Retail destinations were found to be non-significantly related to walking in our sample. This is somewhat surprising and contrasts previous findings among adults, in which proximity to retail destinations such as local convenience stores, supermarkets or grocery stores, and newsagents are consistently and positively associated with transportation walking
[14–17]. It is possible that proximity to retail destinations is less important for seniors compared with adults; however there are several other factors that warrant consideration. The purpose of travelling to retail destinations is to shop and purchase goods, and older adults may have less muscle strength to enable them in carrying their shopping home
. Furthermore, the additional weight associated with carrying shopping may reduce self-efficacy, which is an important mediator between fear of falling and functional ability
. Issues of self-efficacy may also relate to the quality of walking infrastructure, such as footpaths and the presence of benches or resting places along the route to retail destinations. The supportiveness or quality of neighbourhood environments for older adults’ walking has been previously reported
We found the presence of medical care services to be negatively associated with sufficient walking, replicating the finding of Wang and Lee
. There may be some possible explanations for this, for example the reduced likelihood of walking may reflect unaccounted for self-selection bias. Seniors may purposefully seek to live in neighbourhoods with proximate access to medical care services, and planners and medical practitioners may intentionally locate medical care services in neighbourhoods with higher proportions of older adults. Though older adults are more likely to use such medical care services and to report them as being important destinations to access within the neighbourhood
, others report that older adults have an increased propensity to carpool or be driven by family members when traveling to medical appointments
. It may be that even when medical care services are accessible within the neighbourhood, it is not the type of destination in which someone would necessarily walk when physically unwell and in need of medical care. Moreover, medical care services may occupy such large land parcels that other destinations, which older adults may indeed walk to, cannot also be located in the area. It is also important to note that the older adult population is not homogenous, and the needs of the ‘young-old’ and ‘old-old’ may differ greatly in terms of the importance of close proximity to medical care services and whether or not they walk to this destination type. Future research should consider self-selection effects and age moderation effects when examining commercial destinations of importance across the life course.
When adjusting for the effects of street connectivity, we found access to destinations within the 400 m neighbourhood service areas to remain significantly associated with walking, however within the 800 m service areas, previously positive relationships between walking and access to general services and social infrastructure were no longer significant. It is worth noting that street connectivity and access to destinations are related, as a more connected street network encompasses more possible routes along the street network, increasing the area or size of service areas, and larger services areas are more likely to have destinations present within them. Nonetheless, the findings suggest that street connectivity may not impact the association between destinations and shorter walks (i.e., within 400 m), as much as it does for longer walks (i.e., within 800 m). It may be that street connectivity plays a different sort of role in influencing walking when destinations are located further away, and may mediate relationships between walking and access to destinations within 800 m. Evidence supporting the role of street connectivity on physical activity in older adults is mostly mixed, with some reporting positive associations
[40–42], others reporting negative associations
[20, 43, 44], and still others reporting no relationship
[18, 40, 45]. This may be because the importance of street connectivity, and the direction of its influence, may be dependent upon the environmental scale considered. However, it is also possible that other attributes may be important to consider when examining access to destinations within 800 m service areas. For example, perceptions of distance and the directness of possible walking routes may contribute to the attenuating associations at 800 m. Future research considering objective and perceived measures of the same built environment attributes at the same environmental scale, and then across varying environmental scales, would assist in attempts to further disentangle relationships.
The current study has several limitations to consider. While we attempted to categorise commercial destinations by type or domain, it is possible that these require further specification and understanding, based on the purpose and frequency for which older adults visit such destinations. For example, fast-food outlets have been categorised as food retail in previous studies
[46, 47], but we chose to include it within the social infrastructure category based on findings among older adults
. It is also possible that food retail requires further specification in that supermarkets or grocery stores are probably visited more often than other types of food retail destinations. In addition, destinations that are frequently used by older adults (e.g., bank, post office, supermarket) generally had low proportions in this study, indicating that our sample had poor access to commercial destination types overall.
Other limitations include the cross-sectional design, which limits causality, and the influence of self-selection bias cannot be discounted. Also, utilising existing data from a surveillance system was a limitation in that our behavioural outcome measures were self-reported and assessed total, not purpose specific, walking. The influence of neighbourhood environmental attributes on walking appears to differ according to walking purpose, i.e., for recreational walking and transport walking
, and the need for measures that are context and behaviour specific has been previously highlighted
. This may explain why many commercial destination types within the neighbourhood were not associated with walking in our study.