Built Environment and Health Outcomes: Identification of Contextual Risk Factors for Mental Well-being of Older Adults

Abstract

The increasing proportion of elderly people is an emerging demographic trend globally. As the effect of the built environment on mental well-being of non-institutionalized older adults has been less studied, the present study tries to identify the risk factors in the built environment and its impact on the mental health of older adults. A questionnaire based cross-sectional survey was carried out to procure information from 1896 respondents nested within the households in Delhi, India. Nearly 28% of the respondents were reported for being depressed, followed by calm & peaceful (23.6%), emotionally stable (27.9%) and happy (20.5%). Indoor and outdoor environmental factors exhibited a significant graded relation with mental health. Depressed/downhearted mental condition was significantly related with overcrowding (OR = 2.9, p < 0.001), exposure to noise pollution (OR = 3.2, p < 0.001) and fear of crime (OR = 2.2, p < 0.001) after adjusting significant confounders. Whereas, living in low rise dwelling, better housing condition and healthy physical and social environment were demonstrated a significant impact on positive mental health, including emotionally stable (p < 0.01), peaceful & calm condition (p < 0.01) and happy (p < 0.001). The prevalence of depression in older adults in the study area was fairly high and a cause of concern. Features of the urban built environment are significant predictor of mental health and many of them have deleterious effects. Intensive research that integrates different parameters of the built environment and their impact on mental well-being across varying geographic scales and life stages is much needed.