Multilevel Analysis of the Physical Health Perception of Employees: Community and Individual Factors:

Abstract Purpose. To investigate whether the communities where employees reside are associated with employee perception of overall physical health after adjusting for individual factors. Design. Retrospective cross-sectional. Setting. Active employees from a large manufacturing company representing 157 zip code tabulation areas (ZCTAs) in Michigan. Participants. 22,012 active employees who completed at least one voluntary health risk appraisal (HRA) during 1999–2001. Method. Community deprivation and racial segregation at the ZCTA level were obtained using indices created from 2000 U.S. Census data. Demographics and HRA-related data (health-related behaviors, medical history, and quality of life indicators) at the individual level were used as independent variables. A two-level logistic regression model (employees nested in ZCTA) was used to model the probability of better self-rated health perception (SRH) (better health: 89.1% versus poor health: 10.9%). Results. Relative to those living in highly depri...