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...75% of all visits to primary care physicians are for stress-related complaints and disorders. Stress has also been linked to health indicators such as obesity (measured through indices such as body mass index and percentage body fat), high systolic blood pressure, and elevated heart rates (Bell, Summerson, Spangler, Konen, 1998; Brand, Hanson, & Godaert, 2000). Stress is particularly problematic in the health of older adults, since aging is generally associated with changes in physical, psychological (e.g., cognitive, emotional), and social functions. A number of age-related changes (e.g., chronic disease, disability, loss of a loved one, care giving) can be viewed as potential stressors and have negative consequences for other aspects of personal health among older adults (Baltes & Baltes, 1990).
However, there are multiple definitions of stress. Stress can be conceptualized as both a positive (thought of as eustress) or a negative phenomenon (known as distress). For the purpose of this paper, stress will be considered as distress. While distress can be defined in a number of ways, one comprehensive definition suggests that it is a process in which people are unable to adapt to environmental demands (Cohen, Kessler & Gorgon, 1997). The instabilities within the human system create psychological and/or biological changes, which places individuals at an increased risk for poor health (Cohen et al., 1997). In particular, chronic (or daily) stressors can have a cumulative influence on psychological or physical health outcomes (Eckenrode & Bolger, 1997). Some scholars have argued that "everyday" stress or hassles have a greater impact on health and well-being than those life events which occur at relatively infrequent intervals (Folkman & Lazarus, 1988). As a result, a myriad of cognitive and behavioral strategies have been suggested to reduce or mitigate chronic stress and its health diminishing properties. Increasingly, scholars and social institutions are testing the efficacy of interventions designed to mitigate stress and, thus, improve the overall health of individuals and communities.
Physical activity has been investigated as a possible strategy for improving mental health, including stress. Physical activity (defined as any bodily movement) has been linked to improved health and decreased stress (Surgeon General's Report, 1996). Physical activity can be thought of as umbrella concept that encompasses exercise, household tasks, occupational or work related tasks, and leisure time activity (Casperson, Powell, & Christianson, 1985). Leisure activity is one type of physical activity purported to reduce chronic stress and improve health (Coleman & Iso-ahola, 1993; Iwaski & Manell, 2000; Kleiber, Hutchinson, & Williams, 2002).
Based on these relationships, there is a growing recognition that public park opportunities are an important part of the health care infrastructure (Crompton, 1999; Payne, 2002; Payne et al., 1999). However, there is currently a dearth of information concerning empirical relationships between leisure behavior in natural park settings, stress, and health.
Without such evidence, it will be difficult for park and recreation professionals to understand or quantify if and how their products/services reduce stress levels and improve the health of their constituents. Moreover, the small but growing body of leisure, stress, and health research has relied almost entirely on self-reported health data, rather than a comprehensive assessment of psychological and physiological health dimensions. That is, no studies have explored the relationships between park-based leisure activity, stress, and objective measures of physiological health (e.g., blood pressure, body mass index, and heart rates). To address this gap, we examined the relationships between park-based leisure activity, stress levels, and health among older adults. A review of existing research on stress and aging, stress coping and health, as well as the role of leisure activity on stress and health follows.
Literature Review
Stress and Aging
Later life is associated with a host of physical, psychological, and social changes (e.g., role loss, chronic disease, disability, death of significant others, care-giving, fixed incomes) that are potential stressors and can often negatively impact one's health and well-being. In addition, chronic stress can negatively affect older people's perceptions of their well-being. For example, role loss resulting from retirement or the death of a spouse can reduce perceived self-worth and personal control (Stephens, 1990).
Kahana & Kahana (1996) examined the relationship between acute and chronic stress and mental health. They found that acute and chronic stressors were significantly related to poorer perceptions of mental health. Specifically, illness, death, not having enough to eat, quarrelling, debt, and being denied a job promotion were inversely related to perceived mental health. A similar study explored the relationship of ego-centric (i.e., situations that impact directly upon the individual) and non-ego centric (i.e., situations that impact directly on family members) stressors on perceived health. Results indicated that both types of stressors were negatively related to psychological well-being.
Overall, the literature suggests that older adults are subjected to stressful events (e.g., death, chronic illness), more frequently than younger adults. Despite the prevalence of stressful events in later life, life experiences can arm older people with numerous resources for coping with stress. For example, older people can utilize the experience, knowledge, and wisdom gained over their life time in order to cope with stress (Aldwin, Sutton, Chiara, & Spiro, 1996). Additionally, studies of coping across the life span reveal that, as we age, neurotic or maladaptive coping strategies (e.g., avoidance, hostility) are replaced by more mature coping styles (e.g., cognitive reappraisal, problem solving) (Aldwin, et al, 1996; Blanchard-Fields, Sulsky, & Robinson-Whelan, 1991). Moreover, there is evidence that effective social support networks are a useful strategy to restore feelings of personal control and self esteem, thereby buffering the effects of stress on health (Krause & Shaw, 2000; Krause, 1987).
The stress-theory-based model of successful aging developed by Kahana and Kahana (1996) is a useful framework from which to propose that park-based leisure opportunities are specific assets that adults can utilize to ameliorate stress and its negative effects on their health and well-being. According to Rowe and Kahn (1997), successful aging results from the intersection of three major factors: 1) avoiding disease and disability, 2) high cognitive and physical function, and 3) engagement in life. Baltes (1997) and Kahana & Kahana, (1996) have an expanded view of successful aging by incorporating adaptation and compensation into the concept of successful aging. Specifically, they posited that older adults can use cognitive and behavioral resources and strategies to adapt and/or compensate for age related changes, in a way that optimizes health and well-being.
Numerous studies support these assertions. For example, it is well known that biological systems decline with age (e.g., bone density, cardiac output, muscle mass). However, research indicates that with resistance training (e.g., weight training, weight bearing exercise) older people can significantly slow the decline of bone loss and improve cardiac output (Hagberg, Yerg, & Seals, 1988; Kohrt et al., 1991). Similarly, studies reveal that with training older people can improve working memory, perceptual speed and reasoning (Baltes, 1997). Other studies indicate that older people selectively invest in social relationships that offer the highest personal rewards (Carstensen, Hanson, & Freund, 1995). These are all examples how older people successfully adapt to age related change in a way that maintains and/or optimizes their health. Leisure experiences are becoming recognized as important to successful aging. For example, Lenartsson & Silverstein (2001) examined several factors associated with higher risk of mortality in an oldest old sample. They examined age, functional status, education, smoking and participation in physical, social and sedentary activities. While controlling for health and demographics, they found that an increase in solitary activities (e.g., reading, crossword puzzles) was associated with a significant decrease in risk of mortality. Similarly, Glass and colleagues (1999) demonstrated that social (e.g., group recreation, church attendance), productive (e.g., gardening, shopping), and fitness (e.g., walking, exercise) activities were associated with survival, even after controlling for health status and functional ability. These studies are important because they affirm the connection between leisure and successful aging. However, we know less about specific strategies and mechanisms that older people utilize to enhance their well-being. We propose that leisure activity within park settings is an effective stress coping mechanism that is positively related to both perceived physical and mental health as well as physiological health indicators (e.g., blood pressure, body mass index). We view the stress-based model of successful aging as an appropriate framework to understand how park based leisure experiences are associated with stress and stress coping strategies. Thus, literature that examines the role of leisure in stress coping and health warrants further consideration.
Stress Coping and Health
The role of leisure in stress coping and health has been examined from two perspectives: 1) stress coping as a buffer or moderator (Caltabiano, 1995; Coleman & Iso-Ahola, 1993; Coleman, 1993; Iso-Ahola & Park, 1995) and 2) stress coping as a mediator or process oriented construct in the relationship between leisure and health (Iwasaki & Mannell, 2000). Caltabiano studied the main and buffering effects of leisure participation on illness symptoms. She found that outdoor physical activity (i.e., sports) had the strongest positive effect on health, regardless of stressful life events. Hobbies and social leisure were also found to significantly buffer the effect of stressful life events on perceived physical health. Coleman & Iso-Ahola (1993) also purported that leisure-based social support was important in reducing the impact of stress on health. Coleman (1993) tested this relationship based on a random...
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