JMIR Public Health Surveill. 2023 Mar 14. doi: 10.2196/45110. Online ahead of print.
ABSTRACT
BACKGROUND: Elderly people were regarded as the most impacted and most vulnerable social group during the COVID-19 epidemic. The community environment is vital for their health. The elderly people had to stay home during the implementation of the management and control of the COVID-19 epidemic. They lack resources and suffer from anxiety. Thus, determining environmental factors beneficial for their physical and mental health is very important.
OBJECTIVE: This study aims to assess the association between community cohesion and physical and mental health among elderly people and to identify the related community service and environmental factors that may promote community cohesion.
METHODS: This community-based cross-sectional study was designed during the COVID-19 epidemic. A multistage sampling method is applied to this study. A total of 2,036 participants aged ≥ 60 years were sampled from 27 locations in China. Data were collected through face-to-face interviews. The neighborhood cohesion instrument consisting of three-dimensional scales was used to assess community cohesion. Self-efficacy and life satisfaction, cognitive function and depression, and community service and environmental factors were also measured using standard instruments. Statistical analyses were restricted to 2,017 participants. Separate logistic regression analysis was conducted to assess the association between community cohesion and physical and mental health factors, as well as related community service and environmental factors, among elderly people.
RESULTS: The results showed that high levels of community cohesion were associated with good self-perceived health status and life satisfaction and high levels of self-efficacy and psychological resilience, and their odds ratios (ORs) were 1.27 (95% CI, 1.01-1.59) and 1.20 (95% CI, 1.15-1.27) and 1.09 (95% CI, 1.05-1.13) and 1.05 (95% CI, 1.03-1.06), respectively. The length of stay in the community and the level of physical activity were positively associated with community cohesion scores, whereas the educational level was negatively associated with the community cohesion scores (P < .05). Community cohesion was also associated with low level of depression and high level of cognitive function. The community cohesion was significantly associated with community services and environmental factors from four dimensions. High levels of community cohesion were associated with transportation service, rental of rehabilitation equipment, high levels of satisfaction for community doctors’ technical level and community waste disposal, and their ORs were 3.14 (95% CI, 1.87-5.28), 3.62 (95% CI, 2.38-5.52), 1.37 (95% CI, 1.08-1.73), and 1.23 (95% CI, 1.01-1.50), respectively.
CONCLUSIONS: Community cohesion was associated with the physical and mental health of elderly people. Our research suggests that enhancing community services and environmental management may be an effective strategy to increase community cohesion during the epidemic period of major infectious diseases.
PMID:36921236 | DOI:10.2196/45110
