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Copyright ? 2006-2013 Scientific Research Publishing Inc. All rights reserved.
2013. Vol.3, No.3, 217-222
Published Online July 2013 in SciRes (http://www.scirp.org/journal/sm) http://dx.doi.org/10.4236/sm.2013.33029
Copyright © 2013 SciRes. 217
Sense of Community and Self-Rated Health: Mediating
Effect of Social Capital
Department of Public Relations and Advertising, Shih Hsin University, Taiwan
Received January 5th, 2013; revised April 17th, 2013; accepted May 6th, 2013
Copyright © 2013 Cheng-Neng Lai. This is an open access article distributed under the Creative Commons At-
tribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the
original work is properly cited.
Individuals expect to get better well-being through the community; however the formation of causal rela-
tions is rarely mentioned. This study was conducted to test a model by examining the relationship be-
tween Sense of Community and Self-rated Health, and took Social Capital as the mediating variable. So-
cial Capital was divided into two variables: Trust and Interaction. The method of Structural Equation
Modeling was used for evaluation. The result of the analysis verified the Sense of Community’s cause-
effect relationship on Self-rated Health, and the mediation effect of Social Capital existed between them.
The contribution of this research is to prove a positive health promotion path which is accepted by mem-
bers of a community. The collective attributes of the elements of social capital, including trust and inter-
action in a neighborhood network are the focus.
Keywords: Sense of Community; Social Capital; Self-Rated Health; Trust; Interaction
Sense of community is one of the most important areas of
community psychology that has been developing for a long
time (Sarason, 1974). A good environment and decent residents
help to create a more ideal and lively community, with a sense
of belongingness (Duffy et al., 1996). The establishment of a
sense of community motivates the health and happiness of the
community (Davidson & Cotter, 1993), whereas a collapse of a
sense of community not only reduces mental health index
(Caspi et al., 2000) and increases the perception of loneliness
(Prezza et al., 2001), but it also triggers a negative impact on
individual health hazards (Cutrona et al., 2000). According to
the research of Peterson et al. (2006), the aspect of sense of
community is more significantly correlated to mental health
than the physiological aspect is.
Specifically speaking, a sense of community is perceived by
the residents as a sense of belongingness about the community
as a whole, which motivates the residents to identify with the
community and to develop the willingness to take action (Mc-
Millan & Chavis, 1986; Wilson & Baldassare, 1996). The pur-
pose of a public community is to form an identity, with lively
local citizens and a community which supports its citizens. The
status of health is the end result (Mcknight, 2002). Pooley et al.
(2005) considered a sense of community as a better way to
understand the relationship and perception of the residents in a
community, in addition to serving as a proper and clear theo-
retical foundation for the development and planning of com-
munity health. Additionally, the issues related to an evaluation
of community health are not only confined to physical fitness or
to the improvement of individuals, but also to the mental fac-
tors and situations inside or outside the family and community,
and ought to be taken into consideration as well (WHO, 1981).
Though functional limitations may be evaluated through the
interaction among individuals and the environment, the records
of implicit private ailments, pains, emotions, satisfaction or
happiness still can’t be obtained. Consequently, measurement
of self-rated health is necessary (Patrick & Erickson, 1993). It
goes without saying that self-rated health, i.e., the perception of
daily living for the residents in a community, is the most nec-
essary thing to be understood (Sundquist & Yang, 2007).
In this paper, social capital means that an individual has a
chance or is qualified to obtain resources in the community
network as a member of the community. Social capital is dy-
namic, including the process and the mobile status of reciprocal
cause and effect embedded between an individual and the
community (Pooley et al., 2005; Protes, 1998), which is truly
helpful for a researcher to understand the community and to add
a supplement to relevant demonstrations. It should be noted that
the resources acquired are not personal assets, but public goods
contained in a relationship between an individual and the others.
These resources not only improve living standards, enhance the
quality of life in the community, but also help the physical and
mental health of the residents and even help residents to over-
come traumas and prevent diseases (Putnam, 2000). There are
two strategies of health maintenance or promotion for the gen-
eral public in the new era, in which the public is becoming
aware of, which involve the medical system and the public
It has also been found that interaction in a neighborhood and
the confidence of the residents are positive in promoting health
(McMillan & Chavis, 1986; Prezza et al., 2001). Neighborhood
activities and confidence of the residents are the core issues of
social capital (Putnam, 1993, 2001).
Though previous studies have indicated that a higher sense of
community has resulted in better self-rated health and has
caused a positive correlation between them (Adams, 1992; Far-
rell et al., 2004), still, how a sense of community is exercised to
enhance the self-rated health of individuals has not yet been
explained clearly. It is certain that the source of the residents’
happiness is their feelings of belongingness to the community,
and that they may share their feelings or mitigate pressure dur-
ing the process of interaction with their neighbors to achieve
individual adaptation and health (Davidson & Cotter, 1993;
Hughey et al., 1999). Accordingly, an attempt to apply an ap-
proach that has a more comprehensive theoretical integration is
made, for the analysis of both sense of community and the pro-
motion of community health. In addition to testing and evalu-
ating the causal relationship regarding health, the mediating
role played by social capital is exercised for an understanding
of its impact on the self-rated health of the residents. A model
is thus established for reference of strategic planning for a heal-
thy community in the future.
Data Collection and Analysis
The sampling population in this research is the X community
located in Taiwan. In addition to considering the establishment
of a model, this research also provides strategies for developing
community health in the future. Consequently, it is also neces-
sary to conduct a small-scale regional study at the beginning of
model establishment so as to avoid confusion caused by the so-
cial capital theory and the analysis measurements (Yan, 2006).
The advantage of a small area of research is to focus on the
establishment of a model instead of on the generalization of the
whole area (Ullman, 2001). Interference of variables like geo-
graphical factors, environmental background, and crime rate in
each community can be prevented (Farrell et al., 2004). Fur-
thermore, to ensure the reliability and validity of this study, the
population is defined as the residents over 18 years of age in X
community. According to the statistical data, there were 1558
families, with 4539 people, in X community. Structural Equa-
tion Modeling (SEM) was adopted in this research for data
analysis and for an exploration of the causal relationship among
variables. SEM is a module analysis approach, and is suitable
for testing complicated theories, evaluating the appropriateness
of a model, analyzing the mediating effect, and comparing sam-
ples of groups (Ullman, 2001). Model operation has been con-
ducted with LISREL8.50, and the parameters have been esti-
mated by the Maximum Likelihood Estimation (MLE). As each
research model is over-identified, there won’t be any problem
with parameter estimation, and a suitable model can be located
more easily (Davis, 1993; Reilly, 1995; Rigdon, 1955). The
sample size must be between 100 and 150, at least for MLE
(Ding et al., 1995). The MLE results in a more sensitive model
when the sample size increases, therefore, the sample size
should not exceed 400 (Marsh et al., 1988; Tanaka, 1987). Pro-
portional sampling was conducted. One out of every seven
families was interviewed and residents over 18 were asked to
fill in the questionnaire in their presence. There were 220 cop-
ies of the questionnaire issued, 213 copies recalled, and 208
Research Framework and Q ue st ionnaire Design
The purpose of this research is to investigate the causal rela-
tionship between Sense of Community and Self-rated Health
under the mediating effect of Social Capital. As the definition
of social capital is diversified (Protes, 1998), two dimensions of
social capital are defined in this research. The first refers to the
social network (interaction among residents) and the other re-
fers to trust. The questionnaire has been divided into three parts:
Sense of Community, Social Capital and Self-rated Health. The
framework and hypotheses among dimensions are illustrated in
The Likert 5-point scale is adopted: 1—Strongly Disagree,
3—Neutral and 5—Strongly Agree. There are three questions
for the part related to Sense of Community in the questionnaire,
including recognition and understanding of the importance of
the community, willingness of introducing the community to
others, and knowing the location of each household in the com-
munity (McMillan & Chavis, 1986; Prezza & Costantini, 1998).
The part related to Social Capital is divided into two dimen-
sions, which are Trust and Interaction. There are three ques-
tions for Trust, including: friendly residents, mutual caring and
the sharing of resources (Putnam, 2001; Onyx & Bullen, 2000).
Three questions for the section related to Interaction are asked,
including: assistance in caring for the sick people in the com-
munity, active mediation against disputes among residents, and
invitation of festivities (Onyx & Bullen, 2000; Putnam, 1993).
For the part related to Self-rated Health, the three questions are:
satisfaction with the physical and mental conditions of indi-
viduals, satisfaction at the daily life, and the fulfillment of phy-
sical and mental requirements in the daily life (Kawachi et al.,
Profile of Res po ndents
There are 208 valid samples in this research and their profiles
are listed in Table 1. The number of females (55.8%) is greater
than that of males (44.2%), and most of them are married
(74.5%). For age group, people from 46 to 55 account for the
majority (42.3%) and people from 36 to 45 occupy 20.2%.
Most of them have lived in the community for over 15 years
(58.2%), only 2.4% of them have lived there less than a year,
and 9.1% of them have lived there for 1 to 5 years. As for their
educational background, most of them had graduated from
senior high schools or vocational schools (45.2%), and 38.9%
of them had received a college or university degree.
Variables of Reliability and Validity
The individual item of reliability in the questionnaire meas-
ures the factor loading of a latent variable for statistical signifi-
cance. As the factor loading of each individual item in this re-
search is between 0.66 and 0.85, the suggested value of above
0.5 is met (Hair et al., 1998). As for the composite reliability
Framework and hypotheses.
Copyright © 2013 SciRes.
Profile of respondents.
Demographics Category Sample
Male 92 44.2%
Female 116 55.8%
Single 41 19.7%
Cohabited 155 74.5%
Separated 7 3.4%
Widowed 5 2.4%
18 - 25 21 10.1%
26 - 35 34 16.3%
36 - 45 42 20.2%
46 - 55 88 42.3%
56 - 65 20 9.6%
Over 66 3 1.4%
Less than 1 year 5 2.4%
1 - 5 years 19 9.1%
6 - 10 years 22 10.6%
11 - 15 years 41 19.7%
Living in the
Over 15 years 121 58.2%
(Included) or Below 3 1.4%
Junior High School 19 9.1%
College 81 38.9%
(included) or Above 11 5.3%
(CR) of a latent variable, it is used to measure internal consis-
tency. The suggested value of above 0.6 is reached, since the
CR of latent variables in this study ranges from 0.75 to 0.81
(Fornell & Lacker, 1981). The variance extracted (VE) of latent
variables is used to calculate the average variance explanatory
power against each measurement of latent variables. As the VE
of this research ranges from 0.51 and 0.58, the requirement for
a suggested value of above 0.5 is met (Fornell & Lacker, 1981).
These three indices indicate that the reliability and validity of
this research are excellent. Refer to Table 2 for reliability and
The total number of valid samples in this study was identified
to be 208, and the Q-plot slope is in compliance with the nor-
mal hypothesis. Besides, the core of this research is to build a
Sense of Community/Social Capital/Self-rated Health model,
such that the demographic variables are analyzed, in which gen-
der, age and educational backgrounds are still correlated to
Sense of Community and Self-rated Health. To obtain the net
effects of the model, related demographic variables are under
controlled, so that the model may meet the hypothesis. The
Chi-square test shows that in the gender section, χ2 = 26.221, p
< 0.05 for males, χ2 = 37.233, p < 0.05 for females; in the age
section, χ2 = 49.503, p < 0.05 for under 45 years of age, χ2 =
21.943, p < 0.05 for over 46 years of age; in the education sec-
tion, χ2 = 37.162, p < 0.05 for the senior high school (and below)
level, χ2 = 33.653, p < 0.05 for the college (and above) level.
The different groups of the aforesaid variables are applicable to
the model in this research. Consequently, the measurement of
each latent variable will be transformed into a structural model
based on the research framework, to verify the goodness of fit
of the theoretical model. The researcher expects the null model
(H0), when using the SEM, to verify the goodness of fit. The
statistic χ2 will serve as one of the indicators for observing
whether or not the model fits the data. However, χ2 is easily
affected by the sample size. To eliminate the impact of sample
size upon SEM, the ratio of χ2 to the degree of freedom is usu-
ally used to measure the goodness of fit. A value below 3 is
required for strict research. In addition, the researcher also
needs to consider the important statistical indicators involved
provided by SEM (Hair et al., 1998; Jöreskog & Sörbom, 1996).
Seven indicators were selected in this research for evaluation of
the overall goodness of fit of the model. Refer to Table 3 for
the fit measurements of each indicator.
The p-value in this research model meets the suggested value
(χ2/df = 86.72/50, p = 0.00099). The other fit indices for the
adjusted goodness-of-fit index (AGFI) = 0.90, Goodness-of-fit
index (GFI) = 0.93, comparative fit index (CFI) = 0.96, normed
fit index (NFI) = 0.92, and non-normed fit index (NNFI) = 0.95
are greater than 0.90, and the root mean square error of ap-
proximation (RMSEA) = 0.06 is less than 0.08. This indicates
that the goodness of fit of this research model is excellent.
Mean Standard Deviation CR VE
Sense of Community3.54 0.69 0.780.54
Trust 3.64 0.55 0.750.51
Interaction 3.42 0.70 0.810.58
Self-Rated Health 3.85 0.61 0.780.55
Goodness-of-fit measures for SEM.
Fit Indices Critical Value Results
χ2/df (χ2/degrees of freedom) <3 1.73
Goodness of fit index (GFI) >0.9 0.93
Adjusted goodness of fit index
(AGFI) >0.9 0.90
Root mean square error of
approximation (RMSEA) <0.08 0.06
Normed fit index (NFI) >0.9 0.92
Non-normed fit index (NNFI) >0.9 0.95
Comparative fit index (CFI) >0.9 0.96
Copyright © 2013 SciRes. 219
Copyright © 2013 SciRes.
Result of SEM includes the establishment of a competing model and a satisfac-
tion of four groups of requirements. The four groups of re-
quirements refer to a significant relationship between independ-
ent variables and intervening variables, independent variables
and dependent variables and intervening variables and depend-
ent variables. Furthermore, a significant correlation between
intervening variables and dependent variables must exist with a
stronger effect than independent variables and dependent vari-
ables [shown as (a) thru (d) in Figure 3]. For the competing
model of the four groups of requirements in Figure 3, only an
insignificant relationship between Participation and Self-rated
Health in Group 3 exists. The other path requirements are met
and the competing model satisfies the requirements of Groups 1
and 2 completely. In Group 4, the original independent vari-
ables of Sense of Community vs. Self-rated Health are not sig-
nificant (path coefficient weakened from 0.62 to 0.11, com-
pared with the requirements of Group 2). For the original inter-
vening variables, only Participation does not affect Self-rated
Health significantly; however, Trust and Interaction are posi-
tively significant. As a result, it can be summed up that Social
Capital is a critical mediating dimension between Sense of
Community and Self-rated Health.
Figure 2 shows the relationship between Sense of Commu-
nity and Trust in Social Capital, with a standardized path coef-
ficient of 0.53, indicating a higher Sense of Community leading
to a higher level of Trust among residents in the community.
Accordingly, Hypothesis 1 is established. As for the relation-
ship between Sense of Community and Interaction in Social
Capital, the standardized path coefficient is 0.77, implying a
higher Sense of Community causing a higher level of Interac-
tion among the residents in a community. Therefore, Hypothe-
sis 2 is established. For the impact of Social Capital upon
Self-rated Health, the dimensions of Trust and Interaction result
in standardized path coefficients of 0.22 and 0.64, respectively,
showing a higher level of Trust and Interaction and resulting in
a greater level of Self-rated Health. As a result, Hypotheses 3
and 4 are established.
Testing of Mediating Effect
To verify the mediating effect of Social Capital on Sense of
Community and Self-rated Health, the method that Williams et
al. (2003) operated was adopted by using SEM. Verification
Result of SEM. Note: ( ) means t-value.
Competing model for sense of community, social capital and self-rated health. Note: *p < 0.05;
**p < 0.01
Discussion and Conclusion
According to the t-value of the model, all research hypothe-
ses in this study are within the level of significance as shown in
Figure 2, which explains how a significant causality between
Sense of Community and Social Capital exists in regards to the
two dimensions of Trust and Interaction; nevertheless, a causal-
ity is manifested between Social Capital and Self-rated Health
with respect to the two dimensions of Trust and Interaction.
The objectives of total community development being pro-
moted in Taiwan currently are to improve interpersonal rela-
tionships, to agglomerate a sense of community, and to estab-
lish a concept of a living community, which is a movement of
creating social capital. A case of X community in Taiwan is
studied in this research to prove that sense of community in-
deed affects self-rated health under the mediating effects of
The Role of S oci al C a pi tal as Media ti ng Factor
As was mentioned previously, social capital means that an
individual has a chance or is qualified to obtain resources in the
community network as a member of the community, and that
the resources acquired are not personal assets, but public goods
contained in a relationship between an individual and others.
Putnam (1993) particularly stressed that a social network devel-
oped firm principles for general communication and promoted
social trust. This type of network helps coordination and com-
munication, enhances identity and belongingness of residents
and favors in dealing with predicaments of the community.
Hypotheses 1 and 2 in this research consider that a high level
of Sense of Community will result in a high level of Trust and
Interaction in Social Capital. A high level of significance is
manifested in the model (with t-values of 6.55 and 9.46 respec-
tively). A close causal relationship between Sense of Commu-
nity and Social Capital is verified once again.
Social capital has been previously defined as those public
goods which enhance the living standards of life, including the
medical and public operations, to improve the health and live-
lihood of the community. Ostrom and Ahn (2003) also deemed
that the fundamental source of health came from active citizens
and a vigorous community, and that social capital may make
important contributions to health. In this research, Social Capi-
tal has been divided into two parts: Interaction and Trust. A
significant causality was manifested for Interaction and Trust in
relation to Self-rated Health (t-values of 6.56 and 2.69 respec-
tively) and Interaction was even more significant in particular.
Interaction as a Means to Improve Health
In addition to families, the interaction formed within a neigh-
borhood is the most basic interpersonal network. Interaction
forms in the community are constructed through different di-
mensions, including the invitation of festivities, caring for sick
neighbors and the sharing of resources. The reason why inter-
action plays the most important role in self-rated health is be-
cause a high level of interaction symbolizes a close social net-
work during the process, implying that good interpersonal rela-
tionships may efficiently increase cognition of self-rated health
Trust as a Means t o Im pro ve Health
Trust is one of the issues that have been discussed most
among studies on social capital (Fukuyama, 1995). For the cor-
relation between social capital and community health, trust es-
tablished between community health promoters and local resi-
dents helps the latter accept suggestions for health promotion
more easily. The community network of trust also provides op-
portunities of obtaining health education or information for re-
sidents (Sundquist & Yang, 2007). The interactive network is
established by community health promoters, organizations, and
by the willingness and active participation of residents. It was
found in this study that the items in the Trust dimension with a
score of more than 3 on average (no distrust in the community)
account for 78.4%, which shows a high level of Trust in the
community. A significant correlation between Trust and Self-
rated Health also adequately proves the critical influence of
Trust on Self-rated Health in the neighborhood. In other words,
social capital—firstly through trust, and secondly through so-
cial networking—is tremendously beneficial to promote a heal-
thy lifestyle, conduct and practice (Veenstra, 2000).
The contribution of this research is to present individual in-
teraction by exercising social capital from the aspect of a com-
munity. A positive health promotion path is also accepted in a
network or members of a community. How to use social re-
sources for more action results for individuals is emphasized,
and the collective attributes of the elements of social capital,
including trust and interaction in a neighborhood network are
For an analysis of the application of social capital, the pre-
dicaments of a logical circular argument and repetitive meaning
are avoided, since Putnam (2001) and Coleman (1990) started
social capital with results, in which causes are also the results,
if only stock of social capital is used as a characteristic of a
community. In addition, this research may serve as a reference
of future research designs on specific issues of healthy behavior
or habits (e.g. smoking, cancer prevention and exercise, etc.) by
applying the basic self-health cognitive appraisals made by the
residents at the beginning of developing a community-health
Limitations and Suggestions for Further Research
Finally, there are certain limitations to the design of this re-
search. Although the researcher referred to the research designs
of related literature for a Self-rated Health assessment; however,
the correlation of mortality rate was also incorporated upon
Sundquist and Yang’s (2007) advice, to prevent the errors de-
rived from the subjective statements of the respondents. Fur-
thermore, Hill suggested that a long-term observational study
on a specified area should be conducted for a true understand-
ing of the impact of Sense of Community upon the happiness
perceived by individuals (Hill, 1996). It goes without saying
that the testing of an urban- and rural-based operation mode
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