Purpose: To investigate whether the communities where employees reside are associated with employee perception of overall physical health after adjusting for individual factors.
Design: Retrospective cross-sectional.
Setting: Active employees from a large manufacturing company representing 157 zip code tabulation areas (ZCTAs) in Michigan.
Participants: 22,012 active employees who completed at least one voluntary health risk appraisal (HRA) during 1999-2001.
Method: Community deprivation and racial segregation at the ZCTA level were obtained using indices created from 2000 U.S. Census data. Demographics and HRA-related data (health-related behaviors, medical history, and quality of life indicators) at the individual level were used as independent variables. A two-level logistic regression model (employees nested in ZCTA) was used to model the probability of better self-rated health perception (SRH) (better health: 89.1% versus poor health: 10.9%).
Results: Relative to those living in highly deprived communities, employees residing in less-deprived communities showed 2.06 (95% confidence interval [CI], 1.57-2.72) and those living in moderately deprived communities showed 1.83 (95% CI, 1.42-2.35) increased odds of better SRH. After adjusting for individual-level variables, employees living in less-deprived communities had increased odds (1.31 [95% CI, 1.07-1.60]) and those living in moderately deprived communities had increased odds (1.33 [95% CI, 1.11-1.59]) of better SRH compared with individuals from highly deprived communities. The association of racial segregation with employees' SRH was mediated after adjusting for other variables. Individual-level variables showed significant statistical associations with SRH.
Conclusion: Communities do have a modest association with SRH of the employees living there. After adjusting for individual-level and demographic variables, employees living in less/moderately deprived communities are more likely to perceive better physical health relative to those who live in highly deprived communities.
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| http://dx.doi.org/10.4278/ajhp.110316-QUAL-120 | DOI Listing |
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