Michalski Camilla A, Diemert Lori M, Helliwell John F, Goel Vivek, Rosella Laura C
Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, M5T 3M7, Canada.
Vancouver School of Economics, University of British Columbia, 6000 Iona Drive, Vancouver, British Columbia, V6T 1L4, Canada.
SSM Popul Health. 2020 Oct 12;12:100676. doi: 10.1016/j.ssmph.2020.100676. eCollection 2020 Dec.
Health interventions aimed at facilitating connectedness among seniors have recently gained traction, seeing as social connectedness is increasingly being recognized as an important determinant of health. However, research examining the association between connectedness and health across all age groups is limited, and few studies have focused on community belonging as a tangible aspect of social connectedness. Using a population-based Canadian cohort, this study aims to investigate (1) the associations between community belonging with self-rated general health and self-rated mental health, and (2) how these associations differ across life stages.
Data from six cycles of a national population health survey (Canadian Community Health Survey) from 2003 to 2014 were combined. Multinomial logistic regressions were run for both outcomes on the overall study sample, as well as within three age strata: (1) 18-39, (2) 40-59, and (3) ≥ 60 years old.
Weaker community belonging exhibited an association with both poorer general and mental health, though a stronger association was observed with mental health. These associations were observed across all three age strata. In the fully adjusted model, among those reporting a very weak sense of community belonging, the odds of reporting the poorest versus best level of health were 3.21 (95% CI: 3.11, 3.31) times higher for general health, and 4.95 (95% CI: 4.75, 5.16) times higher for mental health, compared to those reporting a very strong sense of community belonging. The largest effects among those reporting very weak community belonging were observed among those aged between 40 and 59 years old.
This study contributed to the evidence base supporting life stage differences in the relationship between community belonging and self-perceived health. This is a starting point to identifying how age-graded differences in unmet social needs relate to population health interventions.
鉴于社会联系日益被视为健康的重要决定因素，旨在促进老年人之间联系的健康干预措施最近受到了关注。然而，针对所有年龄组研究联系与健康之间关联的研究有限，很少有研究关注社区归属感这一社会联系的具体方面。本研究利用加拿大一个基于人群的队列，旨在调查：（1）社区归属感与自我评定的总体健康和自我评定的心理健康之间的关联；（2）这些关联在不同生命阶段如何不同。
合并了2003年至2014年全国人口健康调查（加拿大社区健康调查）六个周期的数据。对总体研究样本以及三个年龄层（1）18 - 39岁、（2）40 - 59岁和（3）≥60岁的两个结果进行多项逻辑回归分析。
社区归属感较弱与总体健康和心理健康较差均有关联，不过与心理健康的关联更强。在所有三个年龄层均观察到了这些关联。在完全调整模型中，与社区归属感很强的人相比，在社区归属感非常弱的人中，报告健康最差与最佳水平的几率，总体健康方面高3.21倍（95%置信区间：3.11，3.31），心理健康方面高4.95倍（95%置信区间：4.75，5.16）。在社区归属感非常弱的人中，最大影响出现在40至59岁的人群中。
本研究为支持社区归属感与自我感知健康之间关系存在生命阶段差异的证据库做出了贡献。这是确定未满足的社会需求中年龄分级差异如何与人群健康干预措施相关的一个起点。
