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Objectives. We compared the social participation of older adults living in metropolitan, urban, and rural areas, and identified associated environmental factors.
Methods. From 2004 to 2006, we conducted a cross-sectional study using an age-, gender-, and area-stratified random sample of 1198 adults (aged 67-82 years). We collected data via interviewer-administered questionnaires and derived from Canadian censuses.
Results. Social participation did not differ across living areas (P = .09), but after controlling for potential confounding variables, we identified associated areaspecific environmental variables. In metropolitan areas, higher social participation was associated with greater proximity to neighborhood resources, having a driver's license, transit use, and better quality social network (R^sup 2^ = 0.18). In urban areas, higher social participation was associated with greater proximity to neighborhood resources and having a driver's license (R^sup 2^ = 0.11). Finally, in rural areas, higher social participation was associated with greater accessibility to key resources, having a driver's license, children living in the neighborhood, and more years lived in the current dwelling (R^sup 2^ = 0.18).
Conclusions. To enhance social participation of older adults, public health interventions need to address different environmental factors according to living areas. (Am J Public Health. 2015;105:1718-1725. doi:10.2105/AJPH.2014.302415)
Social participation, which is defined as the involvement of the person in activities that provide interactions with others in the community,1 is a key element of successful2 and healthy3,4 aging that ensures survival and development of people in society throughout their existence.5 As a modifiable target of health interventions, social participation is conceptualized by the Human Development Model and Disability Creation Process to be the result of bidirectional interaction between personal and environmental factors.5 Some personal factors,6 including age, gender, and health, are recognized as being related to social participation.2 Environmental factors (i.e., aspects that are extrinsic to individuals and generate a reaction from them)7 relate to the immediate social and physical environment to which individuals, especially older adults, are exposed. Environmental factors may act as facilitators or barriers to the accomplishment of social and community activities.5 Environmental factors are also important because interventions targeting the environment may have a greater impact on an individual's social participation than those targeting individual factors.8
To date, some theoretical and empirical evidence supports associations between specific environmental factors and social participation.9...