Perceived neighborhood safety, crime exposure, and chronic diseases among older Indians: The role of functional disabilities

We examined the associations between perceived neighborhood safety, crime exposure, and the prevalence of chronic conditions and multimorbidity among older adults in India. Moreover, we examined whether these associations varied by functional disabilities measured by difficulties in activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Data came from the World Health Organization's Study on Global AGEing and Adult Health (SAGE), India Wave 2, conducted in 2015. Neighborhood safety was measured by perceptions of safety at home and while walking after dark, whereas crime exposure was assessed through reports of household victimization by violent crime in the past year. Chronic conditions were self-reported physician diagnoses of hypertension, diabetes, stroke, arthritis, angina, asthma, and lung disease, with multimorbidity defined as the presence of more than two chronic diseases. Multivariable regression analyses were used to examine the main associations and interaction terms to test the moderating role of ADL/IADL disabilities. The mean score of neighborhood safety (on a scale of 0-10) was 7.72 (SD: 2.05). Approximately 6% of the participants reported that they or someone in their household had been victims of violent crime in the previous year. Older adults with perceived neighborhood safety reported a lower number of chronic conditions (adjusted beta: -0.03, confidence interval [CI]: -0.04 to 0.01) and lower odds of multimorbidity (adjusted OR: 0.95, CI: 0.91 - 0.99). Those with crime exposure reported a higher number of chronic conditions (adjusted beta: 0.10, CI: 0.02 - 0.19). These associations were significantly more pronounced among those with ADL/IADL disabilities. Perceived neighborhood safety and crime exposure were significantly linked to chronic diseases and multimorbidity among older adults in India, particularly among those with functional disabilities. These findings underscore the need for targeted strategies to improve neighborhood safety and support among older Indians with functional disabilities.