Built environment and elderly population health: a comprehensive literature review.

Global population aging over recent years has been linked to poorer health outcomes and higher healthcare expenditure. Policies focusing on healthy aging are currently being developed but a complete understanding of health determinants is needed to guide these efforts. The built environment and other external factors have been added to the International Classification of Functioning as important determinants of health and disability.

The COURAGE Built Environment Outdoor Checklist: an objective built environment instrument to investigate the impact of the environment on health and disability.

Unlabelled: A tool to assess the built environment, which takes into account issues of disability, accessibility and the need for data comparable across countries and populations, is much needed. The Collaborative Research on Ageing in Europe (COURAGE) in Europe Built Environment Outdoor Checklist (CBE-OUT) helps us to understand when features of the neighbourhood environment have either a positive or negative impact on the accessibility of neighbourhoods for healthy ageing. The CBE-OUT is composed of 128 items that can be recorded when present in the evaluated environment.

Validation of the COURAGE Built Environment Self-Reported Questionnaire.

Unlabelled: The built environment (BE) impacts on people's disability and health, in terms of overweight, depression, alcohol abuse, poor self-rated health and presence of psychological symptoms; it is reasonable to assume that BE also impacts on participation levels. This paper presents the validation of the COURAGE Built Environment Self-Reported Questionnaire (CBE-SR), an instrument designed to evaluate BE in the context of health and disability. Subjects participating to COURAGE, a cross-sectional study conducted on 10,800 citizens of Poland, Finland and Spain, completed a protocol inclusive of the CBE-SR.

Linking COURAGE in Europe built environment instrument to the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY).

Objectives: The aim of the paper is to prove that the COURAGE in Europe Built Environment (CBE) instrument selected items are relevant to health and disability assessment and evaluation.

Study Design: The two lists of the CBE preliminary items--outdoor checklist and self-reported questionnaire--were linked to the World Health Organization's International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) through established linking rules.

Results: The pool of the CBE 162 preliminary items were linked to a total of 184 categories of ICF-CY, and belonged mainly to two out of the four of the ICF-CY components.

The selection of items for the preliminary version of the COURAGE in Europe built environment instrument.

The built environment can increase or decrease disability through its impact on mobility or accessibility to infrastructures, and through its relation to social environment. There is a need for the development of a tool which allows to assess built environment in both objective and self-reported manner, contemplating also issues of accessibility and disability, and that allows data comparability across countries and populations. The present paper describes the preliminary process of the development of a new built environment instrument.