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Author ORCID Identifier



Open Access Dissertation

Document Type


Degree Name

Doctor of Philosophy (PhD)

Degree Program

Public Health

Year Degree Awarded


Month Degree Awarded


First Advisor

Michael E. Begay

Second Advisor

Cynthia Jacelon

Third Advisor

Kathryn Tracy

Subject Categories

Health Services Administration | Other Public Health


Accessory-Dwelling Units (ADUs) are one form of the built-environment in which the field of public health law can intervene to improve population aging. Modifying the built-environment to incorporate ADUs allows older adults to utilize a higher level of smart home technologies (SHT) to age-in-community. Under Massachusetts law MGL c. 40A, the state gives authority to cities and towns to adopt ordinances and bylaws to regulate the use of land, buildings and structures. A mixed-methods research design was used to examine the access and utilization of ADU and SHT among older adults. Of the 351 Massachusetts town and cities, 66.5% were categorized as having accessible ADU zoning bylaws. Educational attainment and housing density were significant predictor variables of ADU score in a regression analysis. The qualitative study sample (N=35) perceived ADU and SHT as strong alternatives to long-term care, but remained concerned about the financial and care planning aspects of aging well.