The influence of environmental components of semi-outdoor spaces on the health of older adults in care facilities: Evidence from China

Population aging has become a major global issue, and the role of the built environment in promoting the health of older adults in elderly care facilities has received increasing attention. This study aims to investigate the mechanisms underlying the associations between environmental components of semi-outdoor activity spaces and older adults’ health status based on person–environment fit theory. Field environmental measurements, behavioral trajectory tracking, and questionnaire interviews were conducted in 12 semi-outdoor activity spaces across six care facilities in Shenzhen, resulting in 119 valid samples. Correlation analysis was performed to identify key environmental and activity-related factors associated with older adults’ health status, while regression analyses and mediation tests further examined the relationships between semi-outdoor activity space environmental components, older adults’ activity characteristics, and health statu s . The results indicate that environmental components of semi-outdoor activity spaces affect older adults’ health through multiple pathways. Spatial environmental factors exerted both direct effects and indirect effects mediated by activity frequency, activity needs evaluation, and walking speed on health status. These findings enhance the better understanding of the mechanisms between semi-outdoor activity space environments and older adults’ health and provide a scientific basis for optimizing semi-outdoor activity spaces in elderly care facilities to support healthy aging.