Exploring the use of experimental small area estimates to examine the relationship between individual-level and area-level community belonging and self-rated health

Background

Small area estimation refers to statistical modelling procedures that leverage information or "borrow strength" from other sources or variables. This is done to enhance the reliability of estimates of characteristics or outcomes for areas that do not contain sufficient sample sizes to provide disaggregated estimates of adequate precision and reliability. There is growing interest in secondary research applications for small area estimates (SAEs). However, it is crucial to assess the analytic value of these estimates when used as proxies for individual-level characteristics or as distinct measures that offer insights at the area level. This study assessed novel area-level community belonging measures derived using small area estimation and examined associations with individual-level measures of community belonging and self-rated health.

Data and methods

SAEs of community belonging within census tracts produced from the 2016-2019 cycles of the Canadian Community Health Survey (CCHS) were merged with respondent data from the 2020 CCHS. Multinomial logistic regression models were run between area-level SAEs, individual-level sense of community belonging, and self-rated health on the study sample of people aged 18 years and older.

Results

Area-level community belonging was associated with individual-level community belonging, even after adjusting for individual-level sociodemographic characteristics, despite limited agreement between individual- and area-level measures. Living in a neighbourhood with low community belonging was associated with higher odds of reporting being in fair or poor health, versus being in very good or excellent health (odds ratio: 1.53; 95% confidence interval: 1.22, 1.91), even after adjusting for other factors such as individual-level sense of community belonging, which was also associated with self-rated health.

Interpretation

Area-level and individual-level sense of community belonging were independently associated with self-rated health. The novel SAEs of community belonging can be used as distinct measures of neighbourhood-level community belonging and should be understood as complementary to, rather than proxies for, individual-level measures of community belonging.

Perceived Community Belonging as a Moderator of the Association Between Sexual Orientation and Health and Well-Being

PURPOSE

This study examines the moderating role of perceived community belonging in the association between sexual orientation and various health and well-being outcomes.

DESIGN

A national cross-sectional survey.

SETTING

Confidential microdata from the 2021 Canadian Community Health Survey.

SUBJECTS

Individuals aged 15 and older, with a sample size ranging from 43,000 to 44,100.

MEASURES

Sexual orientation, health and well-being outcomes, and sense of community belonging were all self-reported. Outcomes included self-rated general and mental health, depressive symptoms, and life satisfaction.

ANALYSIS

A series of multiple linear regression models.

RESULTS

Compared to heterosexual individuals, bisexual individuals reported poorer self-rated general health (b = .402, P < .001 for men; b = .454, P < .001 for women) and mental health (b = .520, P < .001 for men; b = .643, P < .001 for women), higher depressive symptoms (b = 2.140, P < .001 for men; b = 2.685, P < .001 for women), and lower life satisfaction (b = .383, P < .05 for men; b = .842, P < .001 for women). Few disparities were observed among gay men and lesbians. Contrary to some recent findings, no disparities were observed among individuals uncertain about their sexual orientation or those who chose not to disclose it, even without controlling for covariates. A stronger sense of community belonging mitigated the disadvantages associated with self-rated general health (b = -.276, P < .01) and depressive symptoms (b = -.983, P < .01) for gay men, and life satisfaction (b = -.621, P < .01) for lesbians.

CONCLUSION

This study is among the first to highlight the stress-buffering role of community belonging in the association between sexual orientation and health and well-being outcomes.

Sense of Belonging, Meaningful Daily Life Participation, and Well-Being: Integrated Investigation

The association between well-being, sense of belonging, connectedness to community, and meaningful participation in daily life occupations was theoretically proved and demonstrated in several health conditions or specific age groups. This study aimed to investigate an interplay between well-being, sense of belonging, and connectedness, and meaningful participation in a range of daily life occupations among healthy adults of working age in Israel. Participants (N = 121; age: M = 30.8, SD = 10.1; women: N = 94, 77.7%) completed standard instruments to evaluate the main constructs through an internet survey. A variety of communities, that the participants reported to belong to, were not different in the sense of belonging and connectedness, participation dimensions, and well-being. An association was found between sense of belonging and connectedness, the participation subjective dimension, and well-being (0.18 < r_p < 0.47, p < 0.05). Sense of belonging explained in a significant way the variance in well-being (F(3) = 14.7, p < 0.001; R² = 0.274) and was found to be a mediator between participation and well-being (1.86 < Sobel test < 2.39, p < 0.05). The study provides empirical support to the interrelationship between meaningful participation, sense of belonging and connectedness, and well-being in a healthy population. Participation in a range of meaningful activities that contribute to the sense of belonging and connectedness as a universal concept could further promote well-being.

Associations between neighborhood environment and sense of community belonging in urban China: Examining mediation effects of neighborly interactions and community satisfaction

Introduction

Improving sense of community belonging (SCB) would help people live longer, happier lives. Although the importance of neighborhood environment on SCB is stressed in the literature, few studies have paid attention to perceived environment, as well as consider mediation effects such as neighborhood social interactions and place satisfaction.

Methods

Relied on a sample of 1051 respondents in Shanghai in 2018, this study investigates the associations between both objective and perceived neighborhood environment attributes and SCB in urban China, mediated by neighborly interactions and community satisfaction using structural equation modeling.

Results

The results suggest that the influence of perceived neighborhood environment on SCB is more prominent than that of objective neighborhood environment. In detail, perceived pedestrian facilities and perceived leisure facilities are vital to SCB, while among objective neighborhood environmental elements, the influence of land use entropy, park density and street greenery are significant. Then, neighborhood environmental attributes can influence SCB by affecting neighborly interactions and community satisfaction. We also identify gender differences in the effects of neighborhood environment upon SCB.

Discussion

Given increasing awareness of the connection, neighborhood environment may prove to be valuable assets to improve individuals' psychosocial constructs such as SCB.

Self-rated mental health, community belonging, life satisfaction and perceived change in mental health among adults during the second and third waves of the COVID-19 pandemic in Canada

Findings from the 2020 Survey on COVID-19 and Mental Health (SCMH) suggested that the positive mental health of adults in Canada was lower during the second wave of the pandemic (fall 2020) than in 2019. With 2021 SCMH data from winter/spring 2021, we find in the current study that average life satisfaction and the prevalence of high self-rated mental health, high community belonging and perceptions of stable/improved mental health were even lower during the third wave of the pandemic as compared to the second wave in the overall adult population and in most sociodemographic groups.

Positive mental health and perceived change in mental health among adults in Canada during the second wave of the COVID-19 pandemic

INTRODUCTION

Canadian surveys from spring/summer 2020 suggest the prevalence of some positive mental health (PMH) outcomes have declined compared to pre-pandemic levels. However, less is known about the state of PMH during the second wave of the COVID-19 pandemic.

METHODS

We compared adults' self-rated mental health (SRMH), community belonging and life satisfaction in Fall 2020 versus 2019 in the overall population and across sociodemographic characteristics using cross-sectional data from the Survey on COVID-19 and Mental Health (September-December, 2020) and the 2019 Canadian Community Health Survey. We also conducted regression analyses to examine which sociodemographic factors were associated with reporting in Fall 2020 that one's mental health was about the same or better compared to before the pandemic.

RESULTS

Fewer adults reported high SRMH in Fall 2020 (59.95%) than in 2019 (66.71%) and fewer reported high community belonging in Fall 2020 (63.64%) than in 2019 (68.42%). Rated from 0 (very dissatisfied) to 10 (very satisfied), average life satisfaction was lower in Fall 2020 (7.19) than in 2019 (8.08). Females, those aged under 65 years, those living in a population centre, and those absent from work due to COVID-19 had lower odds of reporting that their mental health was about the same or better in Fall 2020.

CONCLUSION

The PMH of adults was lower during the pandemic's second wave. However, the majority of individuals still reported high SRMH and community belonging. The findings identify certain sociodemographic groups whose mental health appears to have been more negatively impacted by the pandemic. Continued surveillance is important in ensuring mental health builds back better and stronger in Canada after the pandemic.

Community lives of adolescents across multiple special needs: Discrimination, community belonging, trusted people, leisure activities, and friends

We sought to gain insights into the community lives, experiences, and activities of adolescents across multiple categories of special needs. Specifically, we: explored the particular aspects of their lives adolescents felt elicited discrimination; determined whether adolescents feel a sense of community belongingness, as well as the categories of people whom adolescents approach when help is needed; and detailed the leisure activities respondents undertake and with which frequency, in addition to the quantity of friendships they have. We performed assorted descriptive analyses of the McCreary Centre Society's 2013 British Columbia Adolescent Health Survey (BCAHS) database. We found tremendous variation in the survey responses of adolescents, both within and between special needs categories, highlighting the importance of such exploratory analyses. This paper provides inductive population-based evidence to inform theories about the community lives of adolescents with special needs, as well as to guide programs and policies targeting such youth.

Reduced Risk of Hospitalization With Stronger Community Belonging Among Aging Canadians Living With Diabetes: Findings From Linked Survey and Administrative Data

Background: Social isolation has been identified as a substantial health concern in aging populations, associated with adverse chronic disease outcomes and health inequalities; however, little is known about the interconnections between social capital, diabetes management, and hospital burdens. This study aimed to assess the role of community belonging with the risk of potentially avoidable hospitalization among aging adults living with diabetes in Canada. Methods: The study leveraged a novel resource available through Statistics Canada's Social Data Linkage Environment: the Canadian Community Health Survey linked to administrative health records from the hospital Discharge Abstract Database. A population-representative sample of 13,580 community-dwelling adults aged 45 and over with diabetes was identified. Multiple logistic regression was used to assess the association of individuals' sense of community belonging with the risk of diabetes-related hospitalization over the period 2006-2012. Results: Most (69.9%) adults with diabetes reported a strong sense of belonging to their local community. Those who reported weak community belonging were significantly more likely to have been hospitalized for diabetes (χ2 = 13.82; p < 0.05). The association between weak community attachment and increased risk of diabetes hospitalization remained significant [adjusted OR: 1.80 (95%CI: 1.12-2.90)] after controlling for age, education, and other sociodemographic and behavioral factors. Conclusion: The COVID-19 pandemic has resurfaced attention to the need to better address social capital and diabetes care in public health strategies. While the causal pathways are unclear, this national study highlighted that deficits in social attachments may place adults with diabetes at greater risk of acute complications leading to hospitalization.

A PLS-Neural Network Analysis of Motivational Orientations Leading to Facebook Engagement and the Moderating Roles of Flow and Age

Despite engagement being a criterion for the success of initiatives on Facebook, there is a lack of conclusive evidence about its connections with the psychological and motivational orientations that lead one to use Facebook. Built upon the uses and gratifications theory, we develop an integrative and context-specific model that links engagement with enjoyment, self-presentation, and community belonging-identified as motivational orientations underlying Facebookers' behaviors. We also draw on current flow accounts and socioemotional selectivity theory to examine the potential moderating roles of both flow experiences and age differences. We validate the survey instrument and test the model on a sample of active Facebook users. Model testing and sensitive analysis is performed with a two-stage method that combines partial least squares (PLS) and artificial neural network analysis. The results provide strong support for the validity of the hypothesized causal, mediating and moderating relationships embodied in the model. The research also provides insights into practitioners seeking to enhance Facebookers' engagements and promote continued use of Facebook.

Family networks and health among Métis aged 45 or older

BACKGROUND

Social networks are important for promoting and maintaining health and well-being. Social networks, including family and friendship ties, are sources of emotional, practical and other support that enhance social participation and help combat isolation and loneliness. Aboriginal seniors have been identified as a population at risk of social isolation.

DATA AND METHODS

The data are from the 2012 Aboriginal Peoples Survey, a national survey of First Nations people living off reserve, Métis, and Inuit. Frequencies, cross-tabulations, and logistic regression models were used to look at family networks and self-perceived general and mental health among Métis aged 45 or older.

RESULTS

An estimated 48% of Métis men and 60% of Métis women aged 45 or older had strong family networks. Older age, lower education, and non-participation in the labour force were associated with strong networks. Métis men and women with strong family networks had higher odds than did those with weak networks of reporting positive mental health, even when potential confounders were taken into account. Among Métis men, a relationship between strong family networks and positive general health was also observed.

DISCUSSION

Strong family networks are associated with positive self-perceived general and mental health among Métis adults. In addition to individual behaviours, family well-being is important for general health promotion.