Perceived Community Integration on Older Women's Perceived Health Status: A Comparison between Rural and Urban Samples

Background: Social isolation is associated with poor health-related outcomes among older women. Differences between those living in rural versus urban settings may exist. This study examines the differences in perceived health status associated with perceived community integration (PCI) between a sample of older women (ages 50+) in Central Texas.

Methods: Women ages 50 and older were selected for specific analysis from a telephone-screened, mail-out community health assessment conducted in 2006. Descriptive statistics, ordinal logistic regression models and analysis of variance were utilized to estimate the effect of PCI (utilizing a six-item scale) on perceived health status, controlling for income, marital status, and education.

Results: 816 older women were included in the analysis. Mean age of the sample was 64.6 years. 67% were married; 29.6% had household incomes below 201% FPL. 27% were urban and 39% perceived their health status over the past year as very good or excellent. The six-item PCI scale demonstrated good internal consistency (Cronbach's alpha = 0.789); the overall mean score was 34.46 (std.dev. = 7.63, scores ranging 10 to 50). PCI scores were more influential in the urban model (increasing the odds of better health status by 7.3% for urban women vs. 4.5% for rural women). Analysis of variance demonstrated significant differences between rural and urban PCI scores (p<0.001).

Discussion: PCI was positively associated with perceived health status, with differences present between rural and urban residents in the sample. Further research should focus on improving PCI of older women, acknowledging the influence of geographic setting.