The Effects of Early Life Factors on Elder Physical Activity Disparities in High and Middle Income Countries.

Abstract

To delay chronic disease and promote general health among older adults, physical activity (PA) is often recommended and promoted in a public health setting. Unfortunately, there are a number multi-level factors associated with low PA that occur prior to old age, known as early life adversities. It is well established across the globe that social and economic adversity are associated with poor health outcomes and behaviors. This dissertation presents findings from two quantitative studies with a global sample and one qualitative study with a local sample to examine the effect of life course factors and older adult physical performance and PA behavior disparities. The first two studies utilized global health data from the International Mobility in Aging Study (IMIAS), and found that site location, gender, income, and sex were associated to PA. In addition, economic adversity transition is associated to physical performance. The third study found that neighborhood type (urban vs. rural) played a role in Native Hawaiian older adult PA type and physical performance. This relationship could possibly be mediated by how discrimination and poverty are perceived, as they were perceived differently by older adults from the two different neighborhoods. Results from this dissertation support targeting childhood and life course environmental and socio-demographic factors as effective ways to improve older adult PA and physical performance. Future PA promoting interventions should be tailored to their target population based on region, and not just ethnicity. To build on findings from this dissertation, future research is needed to further examine how childhood adversity and perceived discrimination plays a role in older adult physical performance and PA behaviors.