Quality of Life Research

, Volume 28, Issue 9, pp 2393–2407 | Cite as

Association of the built environments and health-related quality of life in community-dwelling older adults: a cross-sectional study

  • Nuan-Ching Huang
  • Cordia Chu
  • Shiann-Far Kung
  • Susan C. HuEmail author



The relationship between built environments and the quality of life (QoL) of the elderly has gained great attention in recent years. However, most QoL studies have been conducted in western countries; thus, limited research was found in Asia, in which the population density, urban forms, narrow roadways, and land use patterns are more compact and highly mixed in terms of use. Therefore, the purpose of this study was an interdisciplinary analysis of two national datasets, the National Land Use Investigation and the National Health Interview Survey, to explore the relationship between built environments and the health-related quality of life of older adults in Taiwan.


Eight types of built environments at the township level were calculated, and 1222 nationally representative older adults aged 65 and older were recruited. The outcome variable was health-related QoL as measured using the EQ-5D, including utility score and the EQ-VAS. Statistical methods included descriptive analysis, bivariate analysis, and mixed-effects logistic regression analysis, which were conducted using SAS 9.4 software.


The results showed that a significant relationship exists between cultural and historical facilities and low EQ-VAS; none of the built environments were found to be related to the EQ-5D. Individual factors are the main determinants of the EQ-5D of older adults in Taiwan. Positive relationships were found if older adults were engaging in physical activities and social participation.


We suggest that building a supportive environment in which elderly people could consistently engage in physical activities and social participation is another potential approach that might contribute to active aging.


Built environments Quality of life The elderly EQ-5D Multi-level analysis 



We’d like to express our appreciation for the suggestions of the professors, researchers, and members of the Centre for Environment and Population Health, Griffith University.


This work was supported by the Ministry of Science and Technology, Taiwan (Grant Number: 106-2917-I-006-011) and a project of active aging from the Health Promotion Administration, Ministry of Health and Welfare, Taiwan (Grant Number: MOHW106-HPA-M-114-134709, MOHW107-HPA-M-114-144703).

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

Ethical approval

This analysis was based on a dataset from the National Health Interview Survey. However, the interpretation and conclusions contained herein do not represent those of the Health Promotion Administration, Ministry of Health and Welfare, Taiwan. All procedures performed in this study were in accordance with the ethical standards of Institutional Review Board of National Cheng Kung University Hospital, by Human Study Approval (IRB No: B-ER-104-087).

Supplementary material

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Supplementary material 1 (PDF 175 kb)


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Nuan-Ching Huang
    • 1
    • 2
  • Cordia Chu
    • 3
  • Shiann-Far Kung
    • 1
    • 2
  • Susan C. Hu
    • 1
    • 4
    Email author
  1. 1.Healthy Cities Research Center, Research and Services HeadquartersNational Cheng Kung UniversityTainanTaiwan
  2. 2.Department of Urban Planning, College of Planning and DesignNational Cheng Kung UniversityTainanTaiwan
  3. 3.Centre for Environment and Population Health, School of MedicineGriffith UniversityNathanAustralia
  4. 4.Department of Public Health, College of MedicineNational Cheng Kung UniversityTainanTaiwan

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