ArticleJournal of community health2009
County-level social environment determinants of health-related quality of life among US adults: a multilevel analysis.
Article in Journal of community health, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
23 citing papers in PubMed.
- Summary Measure of Health-Related Quality of Life and Its Related Factors Based on the Chinese Version of the Core Healthy Days Measures: Cross-Sectional Study.JMIR public health and surveillance · 2024Article
- County-level political group density, partisan polarization, and individual-level mortality among adults in the United States: A lagged multilevel study.SSM - population health · 2024Article
- Contextualizing Educational Disparities in Health: Variations by Race/Ethnicity, Nativity, and County-Level Characteristics.Demography · 2022Article
- The role of personality, social economic and prevention strategy effects on health-related quality of life among people living with HIV/AIDS.Infectious diseases of poverty · 2021Article
- A comparison of the four healthy days measures (HRQOL-4) with a single measure of self-rated general health in a population-based health survey in New York City.Health and quality of life outcomes · 2020Article
- Assessing county-level determinants of diabetes in the United States (2003-2012).Health & place · 2020Article
- Association of the Robert Wood Johnson Foundations' Social Determinants of Health and Medicare Ocular Hospitalizations: A Cross Sectional Data Analysis.Ophthalmology and therapy · 2019Article
- Predicting geographical variation in health-related quality of life.Preventive medicine · 2019Article
- Predictors of Quality of Life in Montreal, Canada: A Longitudinal Study.Community mental health journal · 2019Article
- A Spatial Regression Analysis on the Effect of Neighborhood-Level Trust on Cooperative Behaviors: Comparison With a Multilevel Regression Analysis.Frontiers in psychology · 2019Article
- Testing the Association Between Traditional and Novel Indicators of County-Level Structural Racism and Birth Outcomes among Black and White Women.Journal of racial and ethnic health disparities · 2018Article
- A Bold Goal: More Healthy Days Through Improved Community Health.Population health management · 2018Article
- Geotagged US Tweets as Predictors of County-Level Health Outcomes, 2015-2016.American journal of public health · 2017Article
- State socioeconomic indicators and self-reported hypertension among US adults, 2011 behavioral risk factor surveillance system.Preventing chronic disease · 2015Article
- Improving the Rank Precision of Population Health Measures for Small Areas with Longitudinal and Joint Outcome Models.PloS one · 2015Article
- Is Health Related Quality of Life (HRQoL) a valid indicator for health systems evaluation?SpringerPlus · 2013Review
- Displacement, county social cohesion, and depression after a large-scale traumatic event.Social psychiatry and psychiatric epidemiology · 2013Article
- Associations between community characteristics and psychiatric admissions in an urban area.Social psychiatry and psychiatric epidemiology · 2013Article
- Area variations in health: a spatial multilevel modeling approach.Health & place · 2012Article
- Health-related quality of life among central Appalachian residents in mountaintop mining counties.American journal of public health · 2011Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
To show that an individual's health-related quality of life (HRQOL) is not determined only by their personal-level characteristics, but also is socially determined by both physical and social environmental characteristics of their communities. This analysis examined the association of selected county-level indicators on respondents' unhealthy days and assessed the utility of mean unhealthy days for US counties as community health indicators. Data came from the 1999-2001 Behavioral Risk Factor Surveillance System. We used multilevel models to calculate the proportion of between-county variation in HRQOL that was explained by county-level contextual variables and examine the causal heterogeneity of some personal-level factors modified by these contextual variables. Counties with worse socioeconomic indicators, high mortality rate, and low life expectancy were associated with higher numbers of unhealthy days. These indicators explained 13-22% variance of county-level physically unhealthy days and 4.5-9.5% variance of county-level mentally unhealthy days. The GINI index, suicide rate, percent uninsured, primary care facilities-to-population ratio, and most county-level demographic and housing indicators also had significant but smaller impact on respondents' unhealthy days. Also, the counties with poorer socioeconomic scores had additional negative HRQOL impact on older persons. This study provides important new empirical information on whether various commonly-measured characteristics of the social environment, which are believed to be social determinants of health, are in fact associated with the perceived physical and mental health of its residents. Our findings provide additional support for the construct validity of county-level HRQOL as a community health indicator.
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