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.

Correlates of employees' perceptions of a healthy work environment.

PURPOSE: This study analyzed correlates of workers' perceptions of the extent to which their work environment is healthy and how these perceptions influence job satisfaction, employee commitment, workplace morale, absenteeism, and intent to quit. DESIGN: One-time cross-sectional telephone survey. SETTING: Canadian employees in 2000. SUBJECTS: A randomly chosen, nationally representative sample of 2500 employed respondents, using a household sampling frame. The response rate was 39.2%. Self-employed individuals were excluded, leaving a subsample of 2112 respondents. MEASURES: The dependent variable was the response to the item, "The work environment is healthy" (5-point strongly agree-strongly disagree Likert scale). Independent variables used in bivariate and ordinary least-squares regression analyses included sociodemographic characteristics, employment status, organizational characteristics, and scales that measured job demands, intrinsic rewards, extrinsic rewards, communication/social support, employee influence, and job resources. Perceptions of a healthy work environment were related to job satisfaction, commitment, morale (measured on a 5-point scale), number of self-reported absenteeism days in the past 12 months, and whether or not the respondent had looked for a job with another employer in the past 12 months. RESULTS: The strongest correlate of a healthy work environment was a scale of good communication and social support (beta = .27). The next strongest was a job demands scale (beta = -.15.) Employees in self-rated healthier work environments had significantly (p < 0.01) higher job satisfaction, commitment and morale, and lower absenteeism and intent to quit. CONCLUSIONS: The study supports a comprehensive model of workplace health that targets working conditions, work relationships, and workplace organization for health promotion interventions.