Journal of applied gerontology : the official journal of the Southern Gerontological SocietyApr 11, 2014

Environmental factors linked to unmet home and community care needs in older adults

Longevity & Aging Weekly Brief ↗PubMed ↗DOI ↗

Updated Mar 27, 2026

Abstract

The model predicted 54% of the variance in unmet home- and community-based service needs among older adults.

Lack of access to healthy foods is significantly related to unmet home- and community-based service needs.
Poor housing quality is significantly associated with unmet home- and community-based service needs.
Previous models accounted for only 10% to 15% of the variance in predicting unmet needs.
Environmental factors may explain the previously low explanatory power of these models.
Identifying environmental barriers could help reduce older adults' future need for health services and home- and community-based services.

Simplified

Home- and community-based services (HCBS) for many older adults are an essential component of aging-in-place. Andersen developed the contemporary model used to predict service use. Researchers have modified the model to examine need. Studies that attempt to predict unmet needs have explained only 10% to 15% of the variance. This study is based on the supposition that lack of accounting for environmental factors has resulted in such small explanatory power. Through the use of 2008 Southeastern Pennsylvania Household Health Survey data, this exploratory study modeled predictors of unmet HCBS needs. Findings reveal that lack of access to healthy foods and poor housing quality have a significant relationship to unmet HCBS needs. This model predicted 54% of the variance. Results reveal environmental questions to ask, a way to identify older adults with unmet HCBS needs and environmental barriers that if addressed may reduce older adults' eventual need for health services and HCBS.

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Environmental factors linked to unmet home and community care needs in older adults

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