Smart Built Environments and Independent Living: A Public Health Perspective

  • Blaine ReederEmail author
  • George Demiris
  • Hilaire J. Thompson
Conference paper
Part of the Lecture Notes in Computer Science book series (LNCS, volume 8456)


To address the projected global shortfall of gerontological health care workers, we outline a research approach that is informed by the past successes of public health toward the goal of developing and implementing smart homes at the community-level to support independent living. Specifically, we discuss the epidemiologic triad consisting of host, environment, and agent factors in relation to other person-environment fit models. We propose this model as the underlying framework for a smart homes development approach that focuses on creating task advantages to support independence at home. We provide recommendations to implement the approach by including community-level stakeholders and policy makers in research that uses a model well-recognized by public health professionals.


Smart homes Public health Independent aging Older adults 


  1. 1.
    Institute of Medicine: Retooling for an aging America: building the health care workforce. Institute of Medicine (2008)Google Scholar
  2. 2.
    Cohen, S.A.: A review of demographic and infrastructural factors and potential solutions to the physician and nursing shortage predicted to impact the growing US elderly population. J. Publ. Health Manage. Pract. 15, 352–362 (2009)CrossRefGoogle Scholar
  3. 3.
    Rice, D.P., Fineman, N.: Economic implications of increased longevity in the United States. Annu. Rev. Publ. Health 25, 457–473 (2004)CrossRefGoogle Scholar
  4. 4.
    Koch, S., Hägglund, M.: Health informatics and the delivery of care to older people. Maturitas 63, 195–199 (2009)CrossRefGoogle Scholar
  5. 5.
    Boult, C., Green, A.F., Boult, L.B., Pacala, J.T., Snyder, C., Leff, B.: Successful models of comprehensive care for older adults with chronic conditions: evidence for the institute of medicine’s “Retooling for an Aging America” report. J. Am. Geriatr. Soc. 57, 2328–2337 (2009)CrossRefGoogle Scholar
  6. 6.
    Houde, S.C., Melillo, K.D.: Public policy – caring for an aging population: review of policy initiatives. J. Gerontological Nurs. 138, 8 (2009)CrossRefGoogle Scholar
  7. 7.
    Eysenbach, G.: What is e-health? J. Med. Internet Res. 3, e20 (2001)CrossRefGoogle Scholar
  8. 8.
    Demiris, G., Hensel, B.K.: Technologies for an aging society: a systematic review of “smart home” applications. Yearb. Med. Inf. 47(Suppl 1), 33–40 (2008)Google Scholar
  9. 9.
    Reeder, B., Meyer, E., Lazar, A., Chaudhuri, S., Thompson, H.J., Demiris, G.: Framing the evidence for health smart homes and home-based consumer health technologies as a public health intervention for independent aging: a systematic review. Int. J. Med. Inf. 82, 565–579 (2013)CrossRefGoogle Scholar
  10. 10.
    Joe, J., Demiris, G.: Older adults and mobile phones for health: a review. J. Biomed. Inf. 46, 947–954 (2013)CrossRefGoogle Scholar
  11. 11.
    Chaudhuri, S., Thompson, H., Demiris, G.: Fall detection devices and their use with older adults: a systematic review. J. Geriatr. Phys. Ther. 37(4), 178–196 (2013)CrossRefGoogle Scholar
  12. 12.
    Tomita, M.R., Mann, W.C., Stanton, K., Tomita, A.D., Sundar, V.: Use of currently available smart home technology by frail elders: process and outcomes. Top. Geriatr. Rehabil. 23, 24 (2007)CrossRefGoogle Scholar
  13. 13.
    Brownsell, S., Blackburn, S., Hawley, M.S.: An evaluation of second and third generation telecare services in older people’s housing. J. Telemed. Telecare 14, 8–12 (2008)CrossRefGoogle Scholar
  14. 14.
    Dodge, H.H., Mattek, N.C., Austin, D., Hayes, T.L., Kaye, J.A.: In-home walking speeds and variability trajectories associated with mild cognitive impairment. Neurology 78, 1946–1952 (2012)CrossRefGoogle Scholar
  15. 15.
    Wettstein, M., Wahl, H.-W., Shoval, N., Oswald, F., Voss, E., Seidl, U., Frölich, L., Auslander, G., Heinik, J., Landau, R.: Out-of-home behavior and cognitive impairment in older adults: findings of the SenTra project. J. Appl. Gerontol. 68(5), 691–702 (2012)Google Scholar
  16. 16.
    Chen, K.-Y., Harniss, M., Patel, S., Johnson, K.: Implementing technology-based embedded assessment in the home and community life of individuals aging with disabilities: a participatory research and development study. Disabil. Rehabil. Assistive Technol. 9, 112–120 (2014)CrossRefGoogle Scholar
  17. 17.
    Reeder, B., Chung, J., Lazar, A., Joe, J., Demiris, G., Thompson, H.J.: Testing a theory-based mobility monitoring protocol using in-home sensors: a feasibility study. Res. Gerontol. Nurs. 6, 253–263 (2013)CrossRefGoogle Scholar
  18. 18.
    Ten great public health achievements–United States, 1900–1999. MMWR Morb Mortal Wkly Rep. 48, 241–243 (1999)Google Scholar
  19. 19.
    Clark, M.J.: Community Health Nursing: Advocacy For Population Health. Prentice Hall, Pennsylvania (2007)Google Scholar
  20. 20.
    Haddon, W., Jr.: Advances in the epidemiology of injuries as a basis for public policy. Publ. Health Rep. (Washington, D.C. 1974), 95, 411–421 (1980)Google Scholar
  21. 21.
    Egger, G., Swinburn, B., Rossner, S.: Dusting off the epidemiological triad: could it work with obesity? Obes. Rev. 4, 115–119 (2003)CrossRefGoogle Scholar
  22. 22.
    Motor-vehicle safety: a 20th century public health achievement. MMWR Morb Mortal Wkly Rep. 48, 369–374 (1999)Google Scholar
  23. 23.
    Whittaker, S., Terveen, L., Nardi, B.A.: Let’s stop pushing the envelope and start addressing it: a reference task agenda for HCI. Hum. Comput. Interact. 15, 75–106 (2000)CrossRefGoogle Scholar
  24. 24.
    McGrenere, J., Ho, W.: Affordances: clarifying and evolving a concept. In: Graphics Interface, vol. 2000, pp. 179–186. Graphics Interface, Montreal (2000)Google Scholar
  25. 25.
    Friedman, C.P.: A “Fundamental Theorem” of biomedical informatics. J. Am. Med. Inform. Assoc. 16, 169 (2009)CrossRefGoogle Scholar
  26. 26.
    Law, M.: The person-environment-occupation model: a transactive approach to occupational performance. Can. J. Occup. Ther. 63, 9–23 (1996)CrossRefGoogle Scholar
  27. 27.
    Lawton, M.P.: An ecological theory of aging applied to elderly housing. J. Aging Environ. 31, 8–10 (1977)Google Scholar
  28. 28.
    Iwarsson, S., Stahl, A.: Accessibility, usability and universal design–positioning and definition of concepts describing person-environment relationships. Disabil. Rehabil. 25, 57 (2003)Google Scholar
  29. 29.
    Demiris, G.: Independence and shared decision making: the role of smart home technology in empowering older adults. In: 2009 Annual International Conference of the IEEE, Engineering in Medicine and Biology Society, EMBC 2009, pp. 6432–6436 (2009)Google Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Blaine Reeder
    • 1
    Email author
  • George Demiris
    • 2
  • Hilaire J. Thompson
    • 2
  1. 1.University of Colorado Anschutz Medical CampusAuroraUSA
  2. 2.University of WashingtonSeattleUSA

Personalised recommendations