Associations between neighborhood environments and health status among Chinese older people during the pandemic: Exploring mediation effects of physical activity

Introduction: Improving neighborhood environments for healthy aging has attracted much attention. However, few studies have investigated the associations between multi-dimensional neighborhood environments and different aspects of older adults' health, and have paid attention to the mediation effects of various physical activities, particularly during the COVID-19 pandemic in Asia. Methods: Applying structural equation models to Chinese General Social Survey (CGSS) data in 2021, we investigated how neighborhood natural, built, and social environments are associated with older adults' physical, mental, and social health, focusing on the mediation effect of physical activity. Results: For older adults' physical and mental health, all neighborhood environmental dimensions had direct and positive effects, and the built environmental dimension was most important. For their social health, the social environment had a direct and positive effect. Regarding the indirect effect, the built environment was positively related to physical and mental health by increasing walking duration. Moreover, the built environment was related to decreased sedentary duration, leading to better mental health but worse social health. Conclusions: Our findings highlighted that neighborhood environments were important to older adults' physical activity and further contribute to health outcomes, even during the COVID-19 pandemic, which could shed some light on healthy aging in Asian countries.