Scientific article
Open access

We are all in this together : Rurality, Social cohesion, and COVID-19 prevention behaviors

Published inThe journal of rural health, vol. 40, no. 1, p. 154-161
Publication date2023-07-10
First online date2023-07-10

Background: Social cohesion refers to an individual's sense of belonging to their community and correlates with health outcomes. Rural communities tend to have higher social cohesion than urban communities. Social cohesion is relatively understudied as a factor impacting COVID-19 prevention behaviors. This study explores the associations between social cohesion, rurality, and COVID-19 prevention behaviors.

Methods: Participants completed a questionnaire assessing rurality; social cohesion (subscales of (1) attraction to neighborhood, (2) acts of neighboring, and (3) sense of community); COVID-19 behaviors; and demographics. Chi-square tests were used to characterize participant demographics and COVID-19 behaviors. Bivariate and multivariable logistic regression models were used to analyze the relationship between COVID-19 outcomes and rurality, social cohesion, and demographics.

Results: Most participants (n = 2,926) were non-Hispanic White (78.2%) and married (60.4%); 36.9% were rural. Rural participants were less likely than urban participants to practice social distancing (78.7% vs 90.6%, P<.001) or stay home when sick (87.7% vs 93.5%, P<.001). Social distancing was more common among participants with higher "attraction to neighborhood" scores (adjusted odds ratio [aOR] = 2.09; 95% confidence interval [CI] = 1.26-3.47) but was less common among participants with higher "acts of neighboring" scores (aOR = 0.59; 95% CI = 0.40-0.88). Staying home when sick was also more common among participants with higher scores on "attraction to neighborhood" (aOR = 2.12; 95% CI = 1.15-3.91), and less common among participants with higher scores on "acts of neighboring" (aOR = 0.53; 95% CI = 0.33-0.86).

Conclusions: Efforts to maximize COVID-19 behavioral prevention, particularly among rural communities, should emphasize the importance of protecting the health of one's neighbors and how to support one's neighbors without face-to-face interactions.

  • COVID-19
  • Health behavior
  • Rural health
  • Social cohesion
Affiliation Not a UNIGE publication
Citation (ISO format)
SOOD, Radhika et al. We are all in this together : Rurality, Social cohesion, and COVID-19 prevention behaviors. In: The journal of rural health, 2023, vol. 40, n° 1, p. 154–161. doi: 10.1111/jrh.12781
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Article (Published version)
ISSN of the journal0890-765X

Technical informations

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