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Walking through the life course: Evaluation of total walking patterns among older adults, adults with disabilities, and immigrants in the United States

Abstract

Public health and transportation literature documents links between walking and overall wellbeing among people of all ages. However, quantifications of these links frequently reflect only one type of walking, such as exercise walking or walking for transportation. Often, this work concentrates on healthy, working age adults. This results in limited understanding of how total walking cumulatively relates to overall health status, especially among other populations. Demographic shifts in the United States will result in population aging, which informs a sense of urgency around understanding how older and more disability-burdened groups will engage in walking, and how socioeconomic contexts in which they reside will shape these patterns. This dissertation used data from the 2017 National Household Travel Survey, which measures travel behaviors to quantify total walking patterns among subsamples of older adults, people with disabilities, and young adults. Each of the three interrelated studies used a theoretical framework informed by the Life Course Perspective and Social Ecological Model to develop multivariable statistical models predicting walking outcomes. Findings indicate that older adult walking frequency correlates most strongly with gender, overall health status, and household vehicle access. Mobility disability status, overall health status, use of mobility devices, and educational attainment were also highly correlated with any walking among older adults. Among disabled and non-disabled working-age adults, number of household vehicles and population density of residential area correlated with total weekly walk count; health and disability statuses did not. Mobility disability and health statuses did, however, predict odds of participation in any total walking in the past week among this group. Among young adults (18-25,) patterns in total walking vary according to immigrant status. Each study contextualizes these results and potential applications to public health research and practice. For example, findings could help guide community-based organizations’ interventions to promote walking, highlighting specific subpopulations amenable to such efforts. Taken together, results of this dissertation highlight the need for more nuanced analyses of walking as it relates to physical activity and transportation mobility, both of which relate to overall wellbeing across the life course.

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