Previous studies have linked social participation and community levels of trust with improved health status. We examined the associations between levels of community participation, self-reported community ratings (trust), and health within a public health surveillance survey conducted in Kansas (N=4601). Independent variables were individual ratings of their communities (excellent, very good, good/ fair, poor), and their involvement in community groups or organizations in the last 5 years (yes/no). Dependent variables were self-rated health status, depressive symptoms, physical activity, smoking, obesity, and binge drinking. After controlling for age, gender, race/ethnicity, education, and having a medical doctor, self-rated health status (p<0.001) and physical activity (PA) (p<0.001) were positively, and smoking (p<0.001) and depressive symptoms (p<0.001) were negatively associated with community ratings. Only PA (p<0.001) remained associated with community involvement in a multivariate analyses. Multilevel analysis using county-level data showed no significant interactions between population density and dependent variables. Individuals from rural areas had the highest community involvement but relatively low levels of community ratings. Our findings suggest that individuals in rural areas, especially in densely settled rural areas, may face increased risks of poor health.
Bibliographical noteFunding Information:
This study was supported by a Mentored-Clinician Scientist Career Development Award from the University of Kansas Research Institute and an American Cancer Society Career Development Award for Primary Care Clinicians, KAG, and a Robert Wood Johnson Foundation Generalist Physician Faculty Scholars Award, JSA.
- Health behaviors
- Population density
- Social capital
- Social participation