Predictors of mental and physical health: individual and neighborhood levels of education, social well-being, and ethnicity.

This study examines how education benefits health through social well-being in Hawaii where the centrality of community life is underscored. The 2007 Hawaii Health Survey with linked zip-code information was used to investigate the effects of education at both individual and neighborhood levels using mixed-effects models. Geographic Information System was applied to map the geographical distributions of education, social well-being, and health. It was found that individual-level education benefits mental health and its effects are largely mediated by respondents' employment status and their social well-being (social integration, social contribution, social actualization, and social coherence). Both individual and neighborhood-level education promotes physical health and their effects are partially mediated by economic well-being and two indicators of social well-being (social integration and social coherence). Results of this study suggest the independent effects of two levels of education on physical health and the importance of education and social well-being to both mental and physical health in the State of Hawaii.

Education and self-rated health: An individual and neighborhood level analysis of Asian Americans, Hawaiians, and Caucasians in Hawaii.

Focusing on Asian Americans, Hawaiians, and Caucasians in Hawaii, this study contributes to the literature by examining (1) the geographical distributions of education in relation to self-rated general health at neighborhood levels, and (2) the individual variations in self-rated health by ethnicity and education at both individual and neighborhood levels. Using the 2007 Hawaii Health Survey with linked zip-code information, and applying GIS (Geographic Information System) and binary logistic regression models, this study found that (1) there are significant between ethnic differences in self-rated health in Hawaii, with Hawaiians being the most disadvantaged population compared to Japanese, Chinese, and Caucasians; (2) individual socioeconomic characteristics are all related to self-rated health, and education (in particular) mediates the Japanese vs. Hawaiian and Chinese vs. Hawaiian health differences; (3) the neighborhood level of education has an independent effect on self-rated health over and above individual characteristics for the whole sample and it partially mediates the between ethnic health differences; and (4) the relative importance of education to self-rated health is more significant and salient for Caucasians and Japanese/Chinese than for Filipinos and Hawaiians. In sum, this study not only demonstrates a geographical profile of health and education distributions in Hawaii, but also reveals significant mediating effects of education, at both individual and neighborhood levels, in explaining the between and within ethnic differentials in self-rated health.