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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