Reduced Risk of Hospitalization With Stronger Community Belonging Among Aging Canadians Living With Diabetes: Findings From Linked Survey and Administrative Data

Abstract

Background: Social isolation has been identified as a substantial health concern in aging populations, associated with adverse chronic disease outcomes and health inequalities; however, little is known about the interconnections between social capital, diabetes management, and hospital burdens. This study aimed to assess the role of community belonging with the risk of potentially avoidable hospitalization among aging adults living with diabetes in Canada.Methods: The study leveraged a novel resource available through Statistics Canada's Social Data Linkage Environment: the Canadian Community Health Survey linked to administrative health records from the hospital Discharge Abstract Database. A population-representative sample of 13,580 community-dwelling adults aged 45 and over with diabetes was identified. Multiple logistic regression was used to assess the association of individuals' sense of community belonging with the risk of diabetes-related hospitalization over the period 2006–2012.Results: Most (69.9%) adults with diabetes reported a strong sense of belonging to their local community. Those who reported weak community belonging were significantly more likely to have been hospitalized for diabetes (χ2 = 13.82; p < 0.05). The association between weak community attachment and increased risk of diabetes hospitalization remained significant [adjusted OR: 1.80 (95%CI: 1.12–2.90)] after controlling for age, education, and other sociodemographic and behavioral factors.Conclusion: The COVID-19 pandemic has resurfaced attention to the need to better address social capital and diabetes care in public health strategies. While the causal pathways are unclear, this national study highlighted that deficits in social attachments may place adults with diabetes at greater risk of acute complications leading to hospitalization.

Factors associated with community commitment among older adults: a stratified analysis of community group leaders and members

“…From the above, we decided that it was appropriate to dichotomize the groups in subsequent multiple logistic analysis. The mean ± SD (range) of CCS scores was 17.2 ± 3.7 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) for the total participants, 18.4 ± 3.2 (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) for leaders, and 17.2 ± 3.8 (7-24) for members. We set a cutoff of 17/18 for the overall analysis, 18/19 for the analysis of leaders, and 17/18 for the analysis of members, based on the mean CCS scores: 17.2 (total; n = 926), 18.4 (leaders; n = 54), and 17.2 (members; n = 872) among study participants (Table 3).…”

“…When this need goes unmet, it can not only serve as the basis for problems such as social isolation [7], crime, and accidents in the community [8][9][10][11], but serious impacts on the internal lives of older individuals, which are not visible from the outside, can occur, such as effects on their dignity. Additionally, a low sense of belonging together with low community commitment can result in declining health [12][13][14][15] and may even result in early death [16][17][18].…”

Social Support, Sense of Belonging, and Communication Technology Use Among Paid and Unpaid Caregivers of Middle-Aged and Older Adults

“…Sense of belonging is described as a “component of connecting one's self into the fabric of surrounding people, places, and things” ( 12 ). While feelings of belonging have been investigated among various populations (e.g., young adults, older adults, and patients) ( 9 , 13 , 14 ), limited studies have examined the sense of belonging felt by caregivers. Furthermore, paid and unpaid caregivers may have different needs, preferences, and barriers related to connecting with their community and interpersonal groups; however, limited studies have examined or compared feelings of social support or sense of belonging among paid and unpaid caregivers ( 15 ).…”

Perceived Community Belonging as a Moderator of the Association Between Sexual Orientation and Health and Well-Being

“…46(p1394) Studies have shown that community belonging can act as a proxy indicator for social support 47 and thereby enhance various health outcomes. [47][48][49][50][51] Furthermore, multiple studies have confirmed the stress-buffering role of community belonging among immigrants and racial/ethnic minority populations. [52][53][54][55][56] Applied to the present scenario, a strong sense of community connectedness could provide a less stigmatized living environment for sexual minority individuals, facilitating more positive identity development.…”