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This chapter assesses the effects of two rural community residential advantages – economic growth and availability of health services – upon residents’ health and emotional well-being.

A de facto experimental design divided communities into four analytical types based on their economic growth and health services. Household survey data were gathered via a drop-off/pickup procedure and 400 randomly selected households were surveyed in each location. Physical health was measured with a subset of items from the Medical Outcomes Study’s 36-item short form. A 10-item emotional well-being index was used. Beyond sociodemographic items, questions concerned household assets, medical problems, social supports, and community ties. Nested regression analyses were used to assess the effects of residential advantage upon health, net of potentially confounding factors.

Contrary to expectations, both residential advantages were necessary for improved health. The most important negative net effect on health was aging. Beyond household assets and community economic expansion, miles commuted to work was the next most important factor enhancing physical health. In all types of communities, residents’ emotional well-being scores were independent of age, but positively related to household income and religious involvement.

Obviously the study is limited by geography and by the small number of communities in each residential type. While we could measure the effects of household members not being able to address all health needs, we could not assess the effects of such problems on anyone else in the households beyond the respondents. Our survey approach is also unable to address the effects of rural residents being unable to meet their health needs over time.

Ours is the first study that we know of applying a de facto natural experimental design to assess community residential effects. The interrelated effects of residential community resources for residents’ health suggests that more studies like this one should be done.

Information gathered from a sample of residents in four rural Pennsylvania communities is used to test the net effects of household resources (financial assets, supports, and community ties) upon respondents’ physical health and emotional well-being. Size and composition of households, types, and extent of insurance coverage, age, and aspects of household liquidity had major net effects upon physical health. Some measures of liquidity, a range of supports, and community ties had net impacts upon emotional well-being. The importance of considering the collective health needs of rural households in relation to their affordability and sustainability is stressed. The public policy implications of our results are discussed.

A random sample of insured adults (n=134) tests the effects of insurance on respondents’ emotional and physical health. Results showed that being married and being widowed improved physical health while having no religious identification heralded less emotional distress. Preferred Provider Organization services satisfaction was related to better physical health. Respondents in households that restructured themselves to acquire or maintain health coverage also reported more emotional distress than those in households without such problems. Implications of our results regarding improving insurance programs and the effects of marital status and the lack of religious affiliation upon adults’ health are discussed.

This paper uses social network principles to explain the sources of and variations in relationships among health care providers and patients. General principles of social networks applied are global structure, structural equivalence, structural conduciveness, and the duality of network linkages. Specific principles employed to understand structural variability in provider interrelationships are structural encapsulation and structural excludability, centrality and integration, subgroups and structural holes, close ties versus weak ties, and the virtual ties created by computersupported social networks (CSSNs). Various ways that social network principles help explain the evolving complexities of interconnectedness among health care providers and patients are demonstrated. Practical advantages of using social network principles to organize and to manage interrelationships among health care providers and patients are discussed.

In this study we used community health survey data to test an adapted version of Lin's (2001a, b) theoretical model for explaining health differences in terms of the differential generation of social capital. There was considerable support for the model's explanatory components with regard to differences in physical health. Variation in physical health was related to resources generated by education and avoidance of cost barriers in paying for care, embeddedness in the form of household composition, and accessibility of interpersonal health resources. However, life satisfaction differences were more related to employment experience and to being female than to health resources generation or utilization. Cost barriers had a considerable positive effect upon stress levels, as did being female. Overall, findings show that life orientations were largely independent of health-related resources, and that differences in stress reflected problems in paying for health care and gender-related experiences. The importance of gender in our results suggested the need for considering gender-specific models of the generation of health resources. The reciprocal relationship found between households' mobilization of provider services and their involvement in community health activities suggested the collateral generation of resources at the individual and community levels stressed by network theorists such as Burt (1992), Granovetter (1985), and Wellman (1983). Implications of our results for policy issues regarding inequalities in health and for the future study of health-related social capital are discussed.

Community household survey data tested the intervening role (between education and reported health outcomes) of adaptations of Antonovsky’s (1987) tripartite sense of coherence (SOC). Comprehensibility was indexed by clarity and responsiveness of insurance representatives, manageability was measured by problems reported with physician office visits, and meaningfulness was assessed with household members’ community health activities. SOC measures did not link education to either impairments or to health lifestyle scores. Comprehensibility and manageability linked education with self-reported well-being. Education and manageability each reduced impairments, while education, manageability, and meaningfulness increased lifestyle totals. Results help elucidate the influence of education on health.

The objective of this chapter was to advance the medical sociology theoretical literature on health lifestyle behaviors. This study investigated the influence of mid-life adult statuses (gender, marital status, parenthood, presence of children in the home, and employment status) and functional health status (general physical health, general mental health, vitality, and social functioning) on selected health-related behaviors. These behaviors included preventive medicine behaviors (routine physical exams, cholesterol checks, and blood pressure checks), risk-taking behaviors (driving above the speed limit, smoking, and consuming alcohol), health promoting behaviors (exercising, sleeping well, and relaxing), and medication usage (using prescribed medicines, over-the-counter medicines, and herbal supplements). The data were gathered through the Warren County Health Survey, a telephone survey of a randomly selected sample of residents from a county in Kentucky. Logistic regression was used to analyze the data. Results indicated that having children at home, being married, being fifty years old or older, and possessing better mental health and social functioning statuses were associated with a greater likelihood of practicing better health-related behaviors. In contrast, being both male and aged 49 and younger were correlated with a greater likelihood of engaging in poorer health-related behaviors. Based on these results, the authors offered several testable, theoretical propositions for future research to test the relationships between mid-life adult health statuses, functional health statuses, and health-related behaviors in other community-based samples.