Exploring the group heterogeneity in the impact of social cohesion on the walking frequency of older adults in China

Background Walkable neighborhoods are closely related to an increase in walking frequency and the strengthening of social cohesion. These factors, in turn, contribute to lower BMI and other positive health-related outcomes. However, with a rapid increase in aging populations in China and the fact that women are facing more challenges than men as they age, especially mobility challenges because they tend to live longer leading to probabilities to become widowed. Nevertheless, less attention has been paid to understanding the gender difference between these relationships.Methods Based on a survey of 533 older adults in Dalian, China, this study tried to investigate the intertwined relationship between perceived walkability, social cohesion, walking frequency, and BMI. A Structural Equation Model (SEM) and multiple-group analysis were applied to test the proposed framework.Results First, results show that gender differences existed among the above interrelationships, and the most substantial gender gap was found in effects of social cohesion on BMI. Second, perceived walkability only has a direct effect (0.149) on walking frequencies for female seniors. Third, although the relationships between perceived walkability and BMI are not directly related in both male and female models, the indirect connection (-0.053) is substituted for female seniors. Besides, the inhibiting effect of walking on BMI, which is -0.511, is also valid for female seniors. Finally, in terms of the role of social cohesion, both the positive impacts of perceived walkability on it (0.225 for males and 0.325 for females) and its promoting effects on walking have been confirmed in male (0.142) and female models (0.103). The negative direct effect of social cohesion on BMI (-0.083) is only confirmed in male seniors.Conclusion Insights derived from this analysis can help bring forward gender-specific interventions to build a more inclusive walkable and social environment to improve the mobility and physical health of older adults.