Perceived neighborhood safety, crime exposure, and chronic diseases among older Indians: The role of functional disabilities.

IF 2.5
PLOS global public health Pub Date : 2025-09-24 eCollection Date: 2025-01-01 DOI:10.1371/journal.pgph.0005151
Manacy Pai, T Muhammad, Adedayo Adeagbo, Waad Ali
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Abstract

We examined the associations between perceived neighborhood safety, crime exposure, and the prevalence of chronic conditions and multimorbidity among older adults in India. Moreover, we examined whether these associations varied by functional disabilities measured by difficulties in activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Data came from the World Health Organization's Study on Global AGEing and Adult Health (SAGE), India Wave 2, conducted in 2015. Neighborhood safety was measured by perceptions of safety at home and while walking after dark, whereas crime exposure was assessed through reports of household victimization by violent crime in the past year. Chronic conditions were self-reported physician diagnoses of hypertension, diabetes, stroke, arthritis, angina, asthma, and lung disease, with multimorbidity defined as the presence of more than two chronic diseases. Multivariable regression analyses were used to examine the main associations and interaction terms to test the moderating role of ADL/IADL disabilities. The mean score of neighborhood safety (on a scale of 0-10) was 7.72 (SD: 2.05). Approximately 6% of the participants reported that they or someone in their household had been victims of violent crime in the previous year. Older adults with perceived neighborhood safety reported a lower number of chronic conditions (adjusted beta: -0.03, confidence interval [CI]: -0.04 to 0.01) and lower odds of multimorbidity (adjusted OR: 0.95, CI: 0.91 - 0.99). Those with crime exposure reported a higher number of chronic conditions (adjusted beta: 0.10, CI: 0.02 - 0.19). These associations were significantly more pronounced among those with ADL/IADL disabilities. Perceived neighborhood safety and crime exposure were significantly linked to chronic diseases and multimorbidity among older adults in India, particularly among those with functional disabilities. These findings underscore the need for targeted strategies to improve neighborhood safety and support among older Indians with functional disabilities.

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感知社区安全、犯罪暴露和印度老年人慢性疾病:功能残疾的作用。
我们研究了感知社区安全、犯罪暴露与印度老年人慢性病和多病患病率之间的关系。此外,我们研究了这些关联是否因日常生活活动困难(ADLs)和日常生活工具活动(IADLs)测量的功能障碍而变化。数据来自世界卫生组织2015年进行的全球老龄化和成人健康研究(SAGE),印度第二波。社区安全是通过对家中和天黑后散步时的安全感知来衡量的,而犯罪暴露是通过过去一年中家庭暴力犯罪受害的报告来评估的。慢性疾病是自我报告的医生诊断高血压、糖尿病、中风、关节炎、心绞痛、哮喘和肺病,多病定义为存在两种以上的慢性疾病。采用多变量回归分析检验主要关联和交互项,以检验ADL/IADL残疾的调节作用。社区安全平均得分为7.72 (SD: 2.05)(分值0-10)。大约6%的参与者报告说,他们或他们的家人在过去一年中曾是暴力犯罪的受害者。有社区安全意识的老年人报告的慢性病数量较少(调整后的贝塔系数:-0.03,可信区间[CI]: -0.04至0.01),多病的几率较低(调整后的OR: 0.95,可信区间[CI]: 0.91 - 0.99)。那些暴露于犯罪的人报告了更多的慢性疾病(调整贝塔系数:0.10,CI: 0.02 - 0.19)。这些关联在ADL/IADL残疾者中更为明显。感知到的社区安全和接触犯罪与印度老年人,特别是有功能残疾的老年人的慢性疾病和多种疾病有显著关联。这些发现强调需要有针对性的策略来改善社区安全和对印度老年功能性残疾人士的支持。
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