A Capabilities Approach to Unequal Trajectories of Healthy Aging: The Importance of the Environment.

Objectives: We aimed to examine the relationships of older people's standard of living and perceived quality of housing and neighborhoods, with different physical, mental, and social well-being trajectories over time. Method: Longitudinal data from 2,483 New Zealanders (55-70 years of age in 2006) surveyed biennially for 10 years were analyzed using latent profile growth analysis and MANOVA. Results: Five health trajectories were revealed: robust health, average good health, declining physical health, limitations in mental health and social well-being, or vulnerable health. Trajectory group membership was significantly related to economic standard of living, satisfaction with housing, quality of neighborhood, and social cohesion of neighborhood. Discussion: The findings support a focus on environmental resources to explain inequalities in health. Future research could focus on developing the basis of these associations. Policies to offset such inequalities would focus on social and physical environmental support for the maintenance of social, mental, and physical health in older age.