Shin Sang Soo, Shin Young-Jeon
Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea.
Epidemiol Health. 2016 Apr 8;38:e2016012. doi: 10.4178/epih.e2016012. eCollection 2016.
With an increasing number of studies highlighting regional social capital (SC) as a determinant of health, many studies are using multi-level analysis with merged and averaged scores of community residents' survey responses calculated from community SC data. Sufficient examination is required to validate if the merged and averaged data can represent the community. Therefore, this study analyzes the validity of the selected indicators and their applicability in multi-level analysis.
Within and between analysis (WABA) was performed after creating community variables using merged and averaged data of community residents' responses from the 2013 Community Health Survey in Korea, using subjective self-rated health assessment as a dependent variable. Further analysis was performed following the model suggested by WABA result.
Both E-test results (1) and WABA results (2) revealed that single-level analysis needs to be performed using qualitative SC variable with cluster mean centering. Through single-level multivariate regression analysis, qualitative SC with cluster mean centering showed positive effect on self-rated health (0.054, p<0.001), although there was no substantial difference in comparison to analysis using SC variables without cluster mean centering or multi-level analysis.
As modification in qualitative SC was larger within the community than between communities, we validate that relational analysis of individual self-rated health can be performed within the group, using cluster mean centering. Other tests besides the WABA can be performed in the future to confirm the validity of using community variables and their applicability in multi-level analysis.
随着越来越多的研究强调区域社会资本(SC)是健康的一个决定因素,许多研究正在使用多层次分析,该分析采用根据社区SC数据计算得出的社区居民调查答复的合并和平均分数。需要进行充分的检验,以验证合并和平均后的数据是否能够代表社区。因此,本研究分析了所选指标的有效性及其在多层次分析中的适用性。
利用韩国2013年社区健康调查中社区居民答复的合并和平均数据创建社区变量后,以主观自评健康评估作为因变量,进行了组内和组间分析(WABA)。根据WABA结果所建议的模型进行了进一步分析。
E检验结果(1)和WABA结果(2)均显示,需要使用具有聚类均值中心化的定性SC变量进行单层次分析。通过单层次多元回归分析,具有聚类均值中心化的定性SC对自评健康显示出积极影响(0.054,p<0.001),尽管与使用无聚类均值中心化的SC变量进行的分析或多层次分析相比,没有实质性差异。
由于定性SC在社区内部的变化大于社区之间的变化,我们验证了可以在组内使用聚类均值中心化对个体自评健康进行关系分析。未来可以进行WABA以外的其他检验,以确认使用社区变量的有效性及其在多层次分析中的适用性。