Community participation may be especially important for older adults, who are often at risk for unwanted declines in participation. We estimated the prevalence of community participation restriction (PR) due to perceived environmental barriers among older adults (≥50 years) and compared the impact among those with selected chronic conditions. Individuals with low-prevalence conditions reported high community PR (9.1–20.4%), while those with highly prevalent conditions (e.g., arthritis) had relatively low community PR (5.1–10.0%) but represented the greatest absolute numbers of condition-associated burden (>1 million). Across all conditions, more than half of those with community PR reported being restricted “always or often.” Community PR most often resulted from modifiable environmental barriers. Promising targets to reduce community PR among adults ≥50 years with chronic conditions, particularly arthritis, include building design, sidewalks/curbs, crowd control, and interventions that improve the built environment. 1. Introduction The World Health Organization (WHO) defines “participation restriction” (PR), a key feature of the revised International Classification of Functioning, Disability and Health (ICF), as “problems an individual may experience in involvement in life situations,” and it reflects the negative consequences of health conditions on important personal and societal domains [1]. Community participation is an important type of participation because having and maintaining valued life roles and activities is associated with better psychological well-being and self-rated health [2–4] and may be especially important for older adults, who are often at risk for unwanted declines in participation [5–7]. There is a growing interest in PR from public health, medical, and social perspectives, partly because “even when poor health persists, participation may still be maintained” [8]. PR from an ICF perspective considers the influence of environment, in all its forms, on one’s ability to engage in life situations. A recent independent validity study found that the ICF model, including its conceptualization of participation, is useful for examining disability in aging research [9]. Despite some studies [10–14], gaps remain in research on the interaction between older adults and their environment. Among limited findings, arthritis has consistently been associated with high levels of PR and disability in both cross-sectional and longitudinal studies [2, 15–21]. Also, features of the “built environment” and poor “walkability” of neighborhoods have been
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