Association of demographics, health behaviors, social factors, neighborhood perceptions, and quality of life among residents of a rural, new destination community in the Midwest

Health disparities of residents in rural communities are well documented, yet little is known about new destination rural communities for immigrants. New destination communities have emerged as Latinos and other immigrants move to these rural towns for work and life opportunities. The Prevention Research Center for Rural Health in Iowa, a community-based participatory research partnership, undertook a community assessment to explore determinants of health in a rural, new destination community in Iowa.

A Random Digit Dialed phone survey was conducted in 2013. The survey was conducted in English or Spanish. We asked about health and Quality of Life (QOL), demographics, health behaviors, social and neighborhood variables, and when possible questions were taken from national surveillance surveys to provide the opportunity to compare our findings with national and state indicators. QOL was defined as the number of unhealthy days and dichotomized 0-13 versus 14-30 days.  Bivariate analyses with categorical covariates were performed, and logistic regression models predicting good health (0-13 unhealthy days) were selected using model selection procedures. 

A total of 1101 community residents completed the survey.  The sample had a mean age of 56.91, 62.67% female, 7.0 % were Latino, 27.96 % of respondents lived at or below poverty, 73.10% reported good health, and 66.64 % met the PA guidelines. The following groups were significantly more likely to report greater numbers of unhealthy days (p< 0.01): females, those experiencing poverty, reporting lower levels of physical activity, consuming more sweetened drinks and fewer fruits and vegetables, and having higher BMIs. The total depression score was significantly associated with unhealthy days (p < 0.0001); with those with more unhealthy days experiencing more severe depression. Those who had more unhealthy days were less likely to attend at least one community meeting (p = 0.01).   Those who had more unhealthy days were less likely to experience all measures of social support (p < 0.0001).  Finally, perceived physical and social neighborhood measures were all significantly related to unhealthy days (p < 0.0001); with those with more unhealthy days holding more negative perceptions of their neighborhoods.

The findings from this study support previous evidence on the relationship of QOL and health. However, this study is one of the first that explore these associations among residents of a rural new destination community. We found that poor QOL respondents were associated with demographic, social and neighborhood- related variables, suggesting an inter-related association of these factors.