The Impact of Home Environmental Hazards on Subjective Health Among Healthy Elderly Adults in Thailand
Article Sidebar
Main Article Content
Abstract
Thailand's aging population includes a growing number of near-centenarians and centenarians living at home. Grounded in Lawton’s Ecological Theory of Aging, this study aimed to examine whether an unsafe home environment (outdoor, indoor, and additional hazards) has an indirect negative effect on subjective health among elderly Thai adults. Participants were 141 elderly (ages 80–112) but healthy adults, most of whom were living in well-maintained, single-story homes. Instruments used in the study included the Self-Rated Health Question, the Social Contact Scale, the Loneliness Question, and the Home Environmental Hazards Checklist. Findings reveal common indoor hazards such as bathrooms and showers, sleeping areas, laundry areas, stairs, raised floors, and dim lighting. The group of elderly adults rated their health as moderately good, received more visits than they made, and reported little loneliness. Using a serial mediation model, the results demonstrated that raised floors and dim lighting, when combined with limited social contact and much loneliness, significantly lowered self-rated health. The finding extends previous research by showing that reducing home environmental hazards (i.e., enhancing lighting, removing raised flooring) and strengthening social connections (i.e., increasing social contact frequency, reducing feelings of loneliness) as key strategies for promoting self-rated health in this population. Local housing authorities, health promotion agencies, and community stakeholders should prioritize home modifications that reduce environmental hazards in the home and proactively implement social support programs to reduce loneliness for promote healthy longevity among Thailand’s elderly population.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
Andresen, E. M., Malmgren, J. A., Carter, W. B., & Patrick, D. L. (1994). Screening for depression in well older adults: Evaluation of a short form of the CES-D. American Journal of Preventive Medicine, 10(2), 77–84. https://doi.org/10.1016/S0749-3797(18)30622-6
Bower, M., Kent, J., Patulny, R., Green, O., McGrath, L., Teesson, L., Jamalishahni, T., Sandison, H., & Rugel, E. (2023). The impact of the built environment on loneliness: A systematic review and narrative synthesis. Health & Place, 79, Article 102962. https://doi.org/10.1016/j.healthplace.2022.102962
Carter, S. E., Campbell, E. M., Sanson-Fisher, R. W., Redman, S., & Gillespie, W. J. (1997). Environmental hazards in the homes of older people. Age and Ageing, 26(3), 195–202. https://doi.org/10.1093/ageing/26.3.195
Chindapol, S. (2025). Influence of Sociocultural Aspects and Home Modification on Fall Risks Mitigation Among the Elderly in Thailand. Nakhara: Journal of Environmental Design and Planning, 24(1), Article 501. https://doi.org/10.54028/NJ202524501
Czaja, S. J., Moxley, J. H., & Rogers, W. A. (2021). Social support, isolation, loneliness, and health among older adults in the PRISM randomized controlled trial. Frontiers in Psychology, 12, Article 728658. https://doi.org/10.3389/fpsyg.2021.728658
Cohen, J. (1992). A power primer. Psychological Bulletin, 112(1), 155–159. https://doi.org/10.1037/0033-2909.112.1.155
de Bruien, A., Picavet, H. S. J., & Nossikov, A. (Eds.). (1996). Health interview surveys: Towards international harmonization of methods and instruments. WHO regional publications, European series, No. 58. World Health Organization. https://eric.ed.gov/?id=ED394961
Department of Older Persons. (2023). Data on the elderly population in Thailand. Ministry of Social Development and Human Security. https://www.dop.go.th/th/know/side/1/1/2449
Economic and Social Commission for Asia and the Pacific (ESCAP). (2022). Ageing in Asia and the Pacific: Key facts. https://www.population-trends-asiapacific.org/data
Hayes, A. F. (2017). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach (2nd ed.). Guilford Press.
Jarutach, T., & Lertpradit, N. (2020). Housing conditions and improvement guidelines for the elderly living in urban areas: Case studies of four Bangkok districts. Nakhara: Journal of Environmental Design and Planning, 18, 117–138. https://doi.org/10.54028/NJ202018117138
Jarutach, T. (2023). Guidelines for healthy housing development for all. Journal of Architectural/Planning Research and Studies (JARS), 20(2), 57–70. https://doi.org/10.56261/jars.v20.251159
Jürges, H., Avendano, M., & Mackenbach, J. P. (2008). Are different measures of self-rated health comparable? An assessment in five European countries. European Journal of Epidemiology, 23(12), 773–781. https://doi.org/10.1007/s10654-008-9287-6
Kim, D. (2021). Understanding how older adults negotiate environmental hazards in their home. Journal of Aging and Environment, 36(2), 173–193. https://doi.org/10.1080/26892618.2021.1918814
Lawton, M. P., & Nahemow, L. (1973). Ecology and the aging process. In C. Eisdorfer & M. P. Lawton (Eds.), The psychology of adult development and aging (pp. 619–674). American Psychological Association. https://doi.org/10.1037/10044-020
Lawton, M. P. (1977). An ecological theory of aging applied to elderly housing. Journal of Architectural Education, 31(1), 8–10. https://www.jstor.org/stable/1424527
Lu, X., Park, N.-K., & Ahrentzen, S. (2019). Lighting effects on older adults’ visual and nonvisual performance: A systematic review. Journal of Housing for the Elderly, 33(3), 298–324. https://doi.org/10.1080/02763893.2018.1562407
Lubben, J. E. (1988). Assessing social networks among elderly populations. Family & Community Health: The Journal of Health Promotion & Maintenance, 11(3), 42–52. https://doi.org/10.1097/00003727-198811000-00008
Mackenzie, L., Byles, J., & Higginbotham, N. (2002). Reliability of the home falls and accidents screening tool (HOME FAST) for identifying older people at increased risk of falls. Disability and rehabilitation, 24(5), 266–274. https://doi.org/10.1080/09638280110087089
Moore, K. D., VanHaitsma, K., Curyto, K., & Saperstein, A. (2003). A pragmatic environmental psychology: A metatheoretical inquiry into the work of M. Powell Lawton. Journal of Environmental Psychology, 23(4), 471–482. https://doi.org/10.1016/S0272-4944(02)00116-0
Mund, M., Maes, M., Drewke, P. M., Gutzeit, A., Jaki, I., & Qualter, P. (2022). Would the real loneliness please stand up? The validity of loneliness scores and the reliability of single-item scores. Assessment, 30(4), 1226–1248. https://doi.org/10.1177/10731911221077227
National Statistical Office. (2024). The 2024 survey of the older persons in Thailand. https://www.nso.go.th/nsoweb/storage/survey_detail/2025/20241209145003_88327.pdf
Perlman, D., & Peplau, L. A. (1998). Loneliness. In H. S. Friedman (Ed.), Encyclopedia of mental health (Vol. 2, pp. 571–581). Academic Press.
Pekalee, A., & Gray, R. S. (2023). In-home environment and happiness among older adults in Thailand. Frontiers in Public Health, 11, Article 1159350. https://doi.org/10.3389/fpubh.2023.1159350
Pengpid, S., & Peltzer, K. (2023). Prevalence and associated factors of incident and persistent loneliness among middle-aged and older adults in Thailand. BMC Psychology, 11, Article 70. https://doi.org/10.1186/s40359-023-01115-4
Robine, J. M., Jagger, C., Mathers, C. D., Crimmins, E. M., & Suzman, R. M. (Eds.). (2003). Determining health expectancies. John Wiley & Sons.
Sattin, R. W., Rodriguez, J. G., DeVito, C. A., Wingo, P. A., Waxweiler, R. J (1998). Home environmental hazards and the risk of fall injury events among community-dwelling older persons. The study to assess falls among the elderly (SAFE) Group. Journal of the American Geriatrics Society, 46(6), 669–676. https://doi.org/10.1111/j.1532-5415.1998.tb03799.x
Shor, E., & Roelfs, D. J. (2015). Social contact frequency and all-cause mortality: A meta-analysis and meta-regression. Social Science & Medicine, 128, 76–86. https://doi.org/10.1016/j.socscimed.2015.01.010
Stavrova, O., & Ren, D. (2021). Is more always better? Examining the nonlinear association of social contact frequency with physical health and longevity. Social Psychological and Personality Science, 12(6), 1058–1070. https://doi.org/10.1177/1948550620961589
Thinuan, P., Siviroj, P., Lerttrakarnnon, P., & Lorga, T. (2020). Prevalence and potential predictors of frailty among community-dwelling older persons in Northern Thailand: A cross-sectional study. International Journal of Environmental Research and Public Health, 17(11), Article 4077. https://doi.org/10.3390/ijerph17114077
Tsuchiya-Ito, R., Slaug, B., & Ishibashi, T. (2019). The physical housing environment and subjective well-being among older people using long-term care services in Japan. Journal of Housing for the Elderly, 33(4), 413–432. https://doi.org/10.1080/02763893.2019.1597803
United Nations. (1976). Report of habitat: United Nations conference on human settlements. vancouver, Canada, 31 May- 11 June 1976. https://digitallibrary.un.org/record/793768?ln=en&v=pdf
van Bemmel, T., Vandenbroucke, J. P., Westendorp, R. G., & Gussekloo, J. (2005). In an observational study elderly patients had an increased risk of falling due to home hazards. Journal of Clinical Epidemiology, 58(1), 63–67. https://doi.org/10.1016/j.jclinepi.2004.06.007
World Health Organization. (1948). Summary reports on proceedings, minutes, and final acts of the International Health Conference held in New York from 19 June to 22 July 1946. https://apps.who.int/iris/handle/10665/85573
World Health Organization. (2007). International classification of functioning, disability, and health: Children & youth version: ICF-CY. World Health Organization.
Zaccaria, D., Cavalli, S., Masotti, B., Gomes Da Rocha, C., von Gunten, A., & Jopp, D. S. (2022). Social isolation and loneliness among near-centenarians and centenarians: Results from the Fordham Centenarian Study. International Journal of Environmental Research and Public Health, 19(10), Article 5940. https://doi.org/10.3390/ijerph19105940
