Connected Community Classification (C3): Development, Validation, and Geospatial Application for Population Health...

Area of Science:

• Public Health
• Social Epidemiology
• Community Health Assessment

Background:

• Social determinants of health (SDOH) significantly influence population health outcomes and health equity.
• A social infrastructure perspective highlights community strengths that can optimize health behaviors and outcomes.

Purpose of the Study:

• To develop, validate, and apply the Connected Community Classification (C3) as a measure of protective SDOH and structural factors.
• To assess C3's association with health behaviors and chronic disease prevalence in the Four Corners states region.

Main Methods:

• Developed C3 using principal component analysis of public SDOH data across five domains.
• Identified regional clustering of C3 scores using spatial autocorrelation methods.
• Analyzed associations between C3 and health outcomes using spatial autoregressive models.

Main Results:

• C3 demonstrated reliability and validity, with higher scores indicating greater social connection.
• Lower community connection (lower C3 scores) was linked to reduced fruit/vegetable intake, less physical activity, and increased obesity, smoking, coronary heart disease, and diabetes.
• Higher C3 scores were positively associated with heavy alcohol use.

Conclusions:

• Communities with stronger social infrastructure exhibit better population health.
• C3 effectively captures protective community attributes and can guide interventions to advance social connection and health equity.
• The C3 tool is valuable for researchers, practitioners, and policymakers in underserved regions.