Abstract
Widespread recognition is given to the idea that an individual’s health is influenced by the ways an individual works, rests and plays as well as genetic endowments. More recently, some researchers have suggested that the relationships between individual ‘characteristics’ and health are influenced by the context or community of the individual. Although the notion of the community as a determinant of health is not new, the incorporation of the community in empirical research on the determinants of health has been based on simple statistical models that fail to reflect the complex nature of the individual-community interface. In this paper we use the methods developed in educational research to show how separate statistical models for variations in health between communities and between individuals can be combined to provide a multi-level model for the determinants of health of populations.
Résumé
L’idée que la santé d’un individu est influencée par son travail, ses loisirs et ses plaisirs, et par son bagage génétique, est généralement acceptée. Récemment, des chercheurs ont suggéré que la relation entre santé et caractéristiques des individus dépend du milieu de vie ou de la communauté de résidence. Depuis longtemps, on reconnaît en santé publique que la communauté est un déterminant de la santé. Dans les recherches empiriques, la communauté a été considérée comme toutes les autres variables individuelles dans des modèles statistiques qui ne traduisent pas la complexité de la relation individu-communauté. Les procédures statistiques développées dans les sciences de l’éducation proposent des modèles qui combinent les variations des états de santé dues aux caractéristiques des individus et à celles de la communauté. Un modèle multi-niveaux pour l’analyse des déterminants de la santé de population est décrit et proposé.
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Birch, S., Stoddart, G. & Béland, F. Modelling the Community as a Determinant of Health. Can J Public Health 89, 402–405 (1998). https://doi.org/10.1007/BF03404083
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DOI: https://doi.org/10.1007/BF03404083