Date of Award
Doctor of Philosophy
Using United States Behavioral Risk Factor Surveillance Survey (BRFSS) and Census data, this study replicated and extended previous research conducted using the Canadian Community Health Survey (CCHS) by Statistics Canada. It examines the associations among both lifestyle and social determinants predictors and a criterion of perceived health. Results were also compared cross-culturally (United States and Canada). The study used secondary data analysis of 2000 and 2001 United States and Census data. In particular, multiple linear regression (MLR) and hierarchical linear modeling (HLM) were used to analyze state and individual-level data. Unlike data at the aggregate level (Canadian health regions and states of the United States), results at the individual-level were consistent across the United States and Canada. Social determinants of health (socioeconomics) were better predictors of health than lifestyle (behaviors). Individual-level socioeconomic characteristics and lifestyle were better predictors than higher level contexts (i.e., characteristics of a state or health regions). The findings of this study suggest that health educators should further research, and increase the focus in teaching and service on, social determinants of health in addition to efforts emphasizing lifestyles (health behaviors). This recommendation aligns with the soon to be released Healthy People 2020 that will add social determinants of health as a priority area for public health.
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