The relationship of community quality to the health of women and men
Introduction
In this study, we examine the relationship of community quality to the health status of women and men. Specifically, we expect that social networks and perceptions of community quality will contribute to better overall health status. We use two categories of community factors to assess community quality: measures of the quality of the social realities of community life, and measures of community quality that focus on the physical environment in order to explain and interpret gender differences. Lifestyle and environment, which can be viewed as dimensions of community, explain over half the variations in health status (Dever, 1991). Studies show that related factors such as smoking, drinking, nutrition, accidents, stress, violence, and other elements of our social and physical community impact health status (Berkman and Syme, 1979; Schoenbach et al., 1986; Dever, 1991; Coulton et al., 1995; Coulton et al., 1996). In addition, factors related to community quality including social support, social networks, socioeconomic characteristics, and neighborhood cohesion also influence health (House et al., 1988; Davidson and Cotter, 1991; Brooks-Gunn et al., 1993; Robinson and Wilkinson, 1995; Hendryx and Ahern, 1996). Few studies have been done regarding the impact of community factors on gender-specific health status.
Section snippets
Community quality, health, and gender: Selected literature review
House et al. (1988)review studies that show that the presence of positive social supports, usually operationalized as emotional or instrumental support from immediate friends and family, is strongly related to morbidity and mortality outcomes. Prospective community mortality studies (e.g. Berkman and Syme, 1979; Schoenbach et al., 1986) show that long term mortality rates are predicted by social network indices including ties of marriage, friends and kin, churches, and other formal and informal
Methods
We develop an empirical model based on two theoretical models of the determinants of health. Patrick and Wickizer (1995)conceptualize health outcomes as determined by the community's physical and social environment and by community responses as they are influenced by the environment. In this model, health is a function of the interaction of biological and environmental factors. Dever (1991)specifies that the social and physical environment, lifestyle, genetics, and health care are the major
Results
The logistic regression results, summarized in Table 2, Table 3, Table 4, Table 5, indicate that women's perceptions about the social quality of their community are associated with their perceived health status and functioning. Women who perceive more community problems have significantly worse general health status (see Table 2) and have poorer functioning in usual activities, including work, recreation, and self-care (see Table 3). Table 4, Table 5 show similar results for women's mental and
Discussion and conclusions
We find a significant relationship between perceived community problems and women's health across all four measures of health status. We also find a significant relationship between perceived environmental problems and men's health across three measures of health status: days of poor functioning, mental health, and physical health. These findings underscore the importance of the community's social and physical quality on the health status of women and men.
These results support the role of the
Acknowledgements
We want to thank Fran Martin from Whitman County Public Health District for generously providing access to the community assessment survey data. We also thank Evelyn Florio, Ph.D, and Rebecca Bohorques, M.A from Spokane Regional Health District for their helpful insights and comments.
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