Elsevier

Social Science & Medicine

Volume 47, Issue 8, October 1998, Pages 1113-1120
Social Science & Medicine

The relationship of community quality to the health of women and men

https://doi.org/10.1016/S0277-9536(98)00114-2Get rights and content

Abstract

Using a 1996 community survey of behavioral risk factors, this cross-sectional study of 804 residents in a rural community examines the relationship of community quality to the health status of women and men. We use two categories of community factors to assess community quality: measures of the social quality of community life, and measures of community quality that focus on the physical environment. Health status is assessed by four measures that examine perceived health status and functioning. Regression results indicate that there is a significant relationship between the quality of the community and health status for both women and men. Specifically, women's perceptions about the social quality of their community are positively associated with their perceived health status and functioning; furthermore, these relationships are significantly different from those of men. Men's perceptions of their physical environment are significantly related to their reported functioning and health, to a limited extent these relationships are different from women. These relationships support our hypothesis that gender differentially affects the relationship between community quality and health.

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.

References (29)

  • C.J. Coulton et al.

    Community level factors and child maltreatment rates

    Child Development

    (1995)
  • W.B. Davidson et al.

    The relationship between sense of community and subjective well-being: A first look

    Journal of Community Psychology

    (1991)
  • L. Davies

    A closer look at gender and distress among the never married

    Women and Health

    (1995)
  • Dever, G. E. (1991) Community Health Analysis: Global Awareness at the Local Level, 2nd Edition. Aspen, Gaithersburg,...
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