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Statistics Canada
RESEARCH DATA CENTRE
@
McMASTER UNIVERSITY
Sense of Community Belonging and Health in Canada:
A Regional Analysis
Peter Kitchen
Allison Williams
James Chowhan
RDC Research Paper No. 40
For further information about the McMaster RDC, see our web site:
http://socserv.mcmaster.ca/rdc
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Telephone: 905-525-9140 ext. 27967/27968 e-mail: rdc@mcmaster.ca
April 2012
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views expressed here.
Sense of Community Belonging and Health in Canada:
A Regional Analysis
Peter Kitchen
Allison Williams
James Chowhan
RDC Research Paper No. 40
Sense of Community Belonging and Health in Canada: A Regional Analysis
Peter Kitchen, Allison Williams, and James Chowhan
First published as:
Kitchen, P., A. Williams, and J. Chowhan. 2012. “Sense of Community Belonging and Health in Canada: A
Regional Analysis”. Social Indicators Research 107:103-126.
Copyright notice: © Springer Science+Business Media B.V. 2011
Link to online edition of the journal at:
doi: 10.1007/s11205-011-9830-9
Sense of Community Belonging and Health in Canada:
A Regional Analysis
Peter Kitchen •Allison Williams •James Chowhan
Accepted: 15 March 2011 / Published online: 26 March 2011
Springer Science+Business Media B.V. 2011
Abstract This article investigates the association between sense of community
belonging and health among settlements of different size and across the urban to rural
continuum in Canada. Using data from the recent 2007/08 Canadian Community Health
Survey (CCHS), the objective is to identify the major health, social and geographic
determinants of sense of community belonging and to consider policy options aimed at
improving sense of belonging among certain segments of the population. The research
found a significant and consistent association between sense of belonging and health,
particularly mental health, even when controlling for geography and socio-economic
status. At the same time, sense of community belonging improved progressively across the
urban to rural continuum with remarkably high levels of belonging evident in the outer
most regions of Canada. Despite the health deficit that exists in rural and small-town
Canada, the paper postulates that these communities are able to overcome health chal-
lenges to create conditions conducive to a positive sense of belonging. Overall, sense of
belonging was also found to be highest among seniors, people residing in single-detached
homes and among couples with children and was lowest among youth, residents of high-
rise apartments and among single-parents. Finally, in the context of addressing deficien-
cies in sense of belonging, the paper examines several recent policy developments aimed
at improving mental health services in Canada.
Keywords Sense of community belonging Mental health Urban to rural continuum
Social capital Public policy
P. Kitchen (&)A. Williams
School of Geography & Earth Sciences, McMaster University, 1280 Main Street West, Hamilton, ON
L8S 4K1, Canada
e-mail: kitchen@mcmaster.ca
J. Chowhan
DeGroote School of Business, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4M4,
Canada
123
Soc Indic Res (2012) 107:103–126
DOI 10.1007/s11205-011-9830-9
1 Introduction
A growing body of literature has identified differences in health outcomes between urban
and rural residents in Canada (DesMeules 2006; CIHI 2008; Pong et al. 2010; Kulig 2010).
Further, deep-rooted and sometimes historic social networks and social engagement within
rural communities have long been understood to be a substantial contributor to a sense of
community belonging (Turcotte 2005; Rothwell and Turcotte 2006). These two stylized-
facts lead to a type of paradox: how can regions with lower health outcomes have higher
sense of community belonging, particularly, when health has been found to be a con-
tributor to sense of community belonging?
Sense of community belonging is a concept related to levels of social attachment among
individuals and is indicative of social engagement and participation within communities.
Social isolation can adversely affect health while social engagement and attachment can
lead to positive health outcomes and significantly reduce mortality risk (Holt-Lunstad et al.
2010). As Shields (2008) proposes, feeling connected to one’s community can promote
health through the building of mutual respect and by increasing self-esteem. Recent
research has employed survey data to examine sense of community belonging and health in
Canada at a number of geographic scales, primarily urban and rural (Ross 2002; Shields
2008, Statistics Canada 2005,2009).
This paper examines sense of community belonging and discusses it in relation to social
capital. These two concepts are similar and can potentially influence one another. We
propose that sense of belonging is a psychological construct based on a person’s attach-
ment to and social comfort with their community, friends, family, workplace, or personal
interests (e.g. activities or hobbies). By comparison, social capital is a set of conditions
present in society, either organized or informal, which have the potential to tie people and
communities together socially. While much has been written on sense of belonging and
particularly social capital in recent years, relatively little attention has been paid to urban
and rural differences as related to health, although several Canadian studies have tan-
gentially dealt with the issue. The paper aims to address this lack of attention in the
research.
The objective is to examine the regional dynamics of sense of community belonging
and health in Canada in an effort to provide a more nuanced understanding of the
association between belonging and health issues. The following three research questions
are posed: (1) What are the major health, social and geographic determinants of sense
of community belonging? (2) How does this sentiment vary among settlements of
different sizes and across the urban to rural continuum? (3) Are there viable policy
options to address deficiencies in sense of belonging among certain segments of the
population?
The study employed data from the 2007/08 Canadian Community Health Survey
(CCHS). The CCHS includes a question on sense of belonging to local community, which
comprises the dependent variable in this study. The CCHS also contains questions relating
to geography, health and socio-economic status, a number of which are used as inde-
pendent variables in the analysis. This study is unique in that it investigates sense of
belonging and health among urban and rural residents of Canada. Two measures of rurality
are employed: Statistics Canada’s Census rural definition and the Metropolitan Influence
Zones (MIZ), both of which are defined below.
104 P. Kitchen et al.
123
2 Literature Review
2.1 Sense of Belonging and Mental Health
Interest in sense of belonging, particularly among psychologists, dates to the 1950s. In
early work, Maslow (1954) identified sense of belonging as a basic human need, ranking it
third in his hierarchy behind physiological needs (e.g. hunger, thirst) and the need for
safety and security. Anant (1966) proposed that sense of belonging is the missing con-
ceptual link in understanding mental health and mental illness from a relationship/inter-
actional approach (Hagerty et al. 1992). In recent years, sense of belonging has been
investigated from a number of perspectives including mental health (Sargent et al. 2002;
Choenarom et al. 2005), physical activity (Bailey and McLaren 2005), planning and design
(Pendola and Gen 2008; Rogers and Sukolratanametee 2009), mobility (Gustafson 2009),
neighbourhood characteristics (Jørgensen 2010), sports (Walseth 2006), participation in
community organizations (Neal and Walters 2008) and school attendance (Ma 2003).
An important but under-studied theme in the literature is the relationship between sense
of belonging and mental health. Hagerty and colleagues have contributed to a better
understanding of the psychological aspects of this construct in a series of studies that
demonstrated that sense of belonging is negatively correlated with both stress and
depression (Hagerty et al. 1992,1996; Hagerty and Patusky 1995; Hagerty and Williams
1999). For example, in a study of 379 community college students in the United States,
Hagerty et al. (1996) examined sense of belonging in relation to social support, conflict,
involvement in community activities, attendance in religious services, loneliness, depres-
sion, anxiety and suicidality. The research indicated that sense of belonging is closely
related to indicators of both social and psychological functioning. Specifically, negative
social support and conflict were related to lower sense of belonging, particularly among
women. In another study, Hagerty and Williams (1999) examined people with major
depressive disorder and found that among a number of interpersonal phenomena including
social support, loneliness and conflict, sense of belonging was the strongest predictor of
depression. In a longitudinal study based in the U.S. Midwest, Choenarom et al. (2005)
examined the role of sense of belonging on the relationship between perceived stress and
symptoms of depression in 90 men and women. Of these participants 51 had a history of
depression and 39 did not. The study found that increased perceived stress and lower sense
of belonging had significant direct effects on the severity of depression that lasted over a
9-month period.
In a study of social relations and mortality risk, Holt-Lunstad et al. (2010) found that
individuals with adequate social relationships have a 50% greater likelihood of survival
compared to those with poor or insufficient social relationships. The authors point out that
the magnitude of this effect is comparable with quitting smoking and surpasses many other
risk factors for mortality such as obesity and physical inactivity (Holt-Lunstad et al. 2010,
p. 14). Given these relationships and in reference to the current paper we hypothesize the
following:
Hypothesis 1: Higher levels of self-perceived overall health (a), self-perceived mental
health (b), and physical activity (c) will be associated with higher levels of sense of
community belonging.
Hypothesis 2: Lower levels of self-perceived life-stress will be associated with higher
levels of sense of community belonging.
Sense of Community Belonging and Health in Canada 105
123
2.2 Sense of Community Belonging in Canada: Regional Analysis using Survey Data
Research by Statistics Canada has demonstrated the link between sense of community
belonging and health and socio-demographic outcomes. Using 2000/2001 CCHS data, Ross
(2002) found that just over half (56%) of Canadians reported a strong or somewhat strong
sense of community belonging. In addition, sense of community belonging was associated
with self-perceived health, even when controlling for socio-economic status, the presence of
chronic disease, health behaviors (such as smoking) and stress. In a follow-up study
employing 2005 CCHS data, Shields (2008) examined sense of community belonging in
Canada at the provincial and health region levels. The study found that nearly two-thirds of
Canadians (64%) reported a strong sense of community belonging with rates highest among
residents of Atlantic Canada and the territories and lowest among residents of Que
´bec.
People living in predominantly urban health regions (80–100% urban) tended to have lower
rates of community belonging compared to residents of rural health regions who had higher
rates. In support of Ross’ (2002) findings, Shields (2008) found that community belonging
was strongly related to self-perceived general and mental health even when controlling for
other factors such as SES, health behaviours and the presence of chronic conditions.
In a study of social engagement and civic participation, Turcotte (2005) used data from the
2003 General Social Survey (GSS) to examine sense of community belonging in larger urban
centres (with a population greater than 10,000) and in rural and small town areas (as measured
by two metropolitan influence zones). The analysis found that sense of community belonging
improved across the urban to rural gradient and was strongest in the most rural and remote
regions of Canada. Interestingly, Turcotte (2005, p. 17) found that the relationship between
place of residence and sense of belonging to the local community was strong even when
taking into account factors such as length of residence, education, place of birth and age. In
light of these findings and in reference to the current paper, we hypothesize the following:
Hypothesis 3: With regard to provincial regional differences, living in a rural area will
positively moderate the association with sense of community belonging.
Hypothesis 4: Across the urban to rural continuum, there will be a progressive increase
in positive sense of community belonging with communities farthest from a larger urban
area having the highest positive associations.
More recently, a report by Statistics Canada (2009) examined trends in sense of com-
munity belonging using data from five cycles of the CCHS (2000/01, 2003, 2005, 2007 and
2008). The study found that the age standardized percentage of Canadians reporting a ‘very
strong’ or ‘somewhat strong’ sense of community belonging rose sharply between 2000/01
and 2003 (57.3–63.0% for males and 57.6–67.3% for females). Between 2003 and 2008, the
proportion stabilized for both sexes. Furthermore, in 2007, females were more likely than
males to report a somewhat or very strong sense of community belonging while there was no
difference in the other years of reference included in the study. Finally, in 2008, a strong
sense of community belonging was more prevalent among Canadians aged 55 and over and
was lowest among males and females aged 18–34 (Statistics Canada 2009).
3 Data and Methods
This paper employed data from Statistics Canada’s 2007/08 Canadian Community Health
Survey (CCHS) Master file. The CCHS is released on an annual basis and includes a
question on sense of belonging to local community. Table 1shows the question as written
106 P. Kitchen et al.
123
in English and French as well as the coded responses and sample size. The population of
interest was all residents of Canada aged 18 or over (n =120,838), representing
approximately 25.5 million people.
1
As described, the objective of the paper is to assess the
health, geographic and socio-economic determinants of sense of belonging to local com-
munity. Table 2lists the 16 independent variables examined in the study, which capture a
range of factors that can influence sense of belonging. They include four health-related
indicators (self-perceived health, self-perceived mental health, self-perceived life stress
and physical activity), three geographic measures (province of residence, census rural and
metropolitan influence zone) and nine socio-economic variables (immigrant and Aborig-
inal status, sex, age, income, education, dwelling and household type and housing tenure).
One of the objectives of this research is to examine sense of belonging in the rural areas
of Canada. According to du Plessis et al. (2001) for national policy level analysis in
Canada there is a number of ways to define rural. As listed in Table 2, two derived
variables are employed to measure rural: (1) census rural and (2) metropolitan influence
zone (MIZ). The first is a dichotomized variable in which an urban area is defined as a
continuously built-up area having a population concentration of 1,000 or more and a
population density of 400 or more per square kilometre. As a result, a ‘rural’ person is
someone who does not live in an urban area according to that definition. The second is
MIZ, which refers to the population living outside the commuting zone of a larger urban
center: census metropolitan area (CMA) or census agglomeration (CA). A CMA must have
Table 1 Sense of belonging 2007/08 Canadian community health survey
Variable
name
GEN_10
Concept Sense of belonging to local community
Sentiment d’appartenance a
`la communaute
´locale
Question How would you describe your sense of belonging to your local community? Would you say it
is: (very strong, somewhat strong, somewhat weak, or very weak)?
Comment de
´cririez-vous votre sentiment d’appartenance a
`votre communaute
´locale? Diriez-
vous qu’il est: (tre
`s fort, pluto
ˆt fort, pluto
ˆt faible, ou tre
`s faible)?
Content Responses: population aged 18 and over
Code Sample Population Percent
Very strong 1 19,936 4,202,170 16.5
Somewhat strong 2 53,696 11,318,030 44.4
Somewhat weak 3 30,699 6,470,866 25.4
Very weak 4 11,898 2,507,811 9.8
Don’t know 7 1,718 362,072 1.4
Refusal 8 53 11,266 0.2
Not stated 9 2,837 598,066 2.3
Total 120,838 25,470,102 100
1
The target population of the CCHS includes household residents in all provinces and territories; with the
principal exclusion of populations on Indian Reserves, Canadian Forces Bases, and some remote areas.
Sense of Community Belonging and Health in Canada 107
123
a total population of 100,000 and a CA must have an urban core population of at least
10,000 (for complete definitions see Statistics Canada 2010). Statistics Canada classifies
four zones: Strong MIZ, Moderate MIZ, Weak MIZ and No MIZ.
2
In this measure, a
Table 2 Independent variables 2007/08 Canadian community health survey
Variable Survey question Coded responses
Self-perceived
health
In general, would you say your health is? Excellent/Very good–Good–Fair/poor
Self-perceived
mental health
In general, would you sat your mental health is? Excellent/Very good–Good–Fair/poor
Perceived life
stress
Thinking about the amount of stress in your life,
would you say that most days are?
Not at all/not very stressful–A bit
stressful–Quite a bit/extremely
stressful
Perceived work
stress
The next question is about your main job or
business in the past 12 months. Would you
say that most days were…?
Not at all/not very stressful–A bit
stressful–Quite a bit/extremely
stressful
Physical
activity index
Derived variable Active–Moderate–Inactive
Census rural Derived variable Urban–Rural
Province of
residence
– Newfoundland and Labrador–Prince
Edward Island–Nova Scotia–New
Brunswick–Que
´bec–Ontario–
Manitoba–Saskatchewan–Alberta–
British Columbia–Territories
Metropolitan
Influence
Zone (MIZ)
Derived variable
Statistical area classification type
CMA/CA–Strongly influenced–
Moderate influence–Weak or no
influence
Immigrant
status
Derived variable Yes–No
Aboriginal
status
Are you an Aboriginal person, that is, North
American Indian, Me
´tis or Inuit?
Aboriginal–Non-Aboriginal
Sex Is respondent male or female? Male–Female
Age What is your age? Age 18–24–Age 25–44—Age 45–64—
Age 65 and over
Household
income
What is your best estimate of the total income,
before taxes and deductions, of all household
members from all sources in the past
12 months?
Less than $20,000–$20,000 to $49,000–
$50,000 to $79,000–More than
$80,000
Education Derived variable Less than high school–High school–
Other post-secondary–College or
university
Dwelling type Derived variable Single detached–Double/row/duplex–
Low-rise–High-rise–Other
Household type Derived variable Unattached individual–Couple living
alone–Couple with children–Lone
parents
Housing tenure Is this dwelling owned by a member of this
household?
Yes (Owned)–No (Other)
2
Statistics Canada classifies the four zones as follows: Strong MIZ: at least 30% of the municipality’s
resident employed labour force commute to work in any CMA or CA; Moderate MIZ: at least 5%, but less
than 30% of the municipality’s resident employed labour force commute to work in any CMA or CA; Weak
108 P. Kitchen et al.
123
‘rural’ person is someone who does not live in a CMA or CA. In other words, they reside in
a town or municipality with a population under 10,000. Given these definitions, census
rural residents can reside in CMA/CAs. In fact, 7% of the population aged 18 and over are
rural residents who live within a CMA/CA and this group represents 39% of all rural
residents (i.e. 1.8 million people out of 4.6 million rural residents). For this reason,
emphasis is given to census rural in the conceptualization of rurality.
The CCHS does not include direct measures of social capital, such as trust, reciprocity
or knowing your neighbours. It does include one variable on participation in voluntary
organizations. However, most Canadians provinces elected not to collect this data and the
sample size (n =6,383) is too small for a meaningful analysis at the national level. As a
result of these limitations, the data analysis focuses only on sense of community belonging,
but as stated, the findings are interpreted in relation to factors influencing social capital.
The data analysis involved two steps. The first was the use of descriptive statistics by
way of bar charts and contingency tables to measure the relationship between sense of
belonging and a number of independent variables. The second step involved the use of
ordered logistic regression modeling. Compared to ordinary least squares (OLS), this
technique is more appropriate given the categorical nature (4 point Likert scale) of the
dependent variable: sense of belonging to local community. The ordered logistic regression
model more appropriately accounts for nuanced differences across the categorical scale
variable and controls for the constraints of the data; neither logistic or OLS address these
issues sufficiently. Further, the ordered logistic model allows for a more parsimonious
presentation of output given the proportional odds assumption (e.g. parallel regressions),
compared to more generalized models with few restrictions.
Underlying any scale variable is an assumed unobserved latent continuous construct (in
this case, sense of belonging). An ordered logistic regression is based on the following
latent structure:
y¼x0bþe;
where y
*
is the latent unobserved continuous construct. However, we do not observe the
continuous variable; we only observe the 4-point sense of belonging scale for each
individual:
y¼1ifyd1;
y¼2ifd1\yd2;
y¼3ifd2\yd3;and
y¼4ifd3\y:
The ds are unknown parameters that are estimated in conjunction with the parameter
estimates b. The ordered logistic model generates a common set of coefficients and cut-
points (or intercepts). The logistic distribution allows the output to be interpreted in terms
of log odds ratios, log [Pr(y[h)/Pr(yBh)] =x
i
b
h
,h=1,…,m -1,
3
where m=4 (e.g.
four point Likert scale), his a point at which the dependent variable can be dichotomized,
Footnote 2 continued
MIZ: more than 0%, but less than 5% of the municipality’s resident employed labour force commute to work
in any CMA or CA; No MIZ: fewer than 40 or none of the municipality’s resident employed labour force
commute to work in any CMA or CA.
3
The model uses the logistic distribution as the cumulative distribution and it can be written as:
Pr(y
i
[h) =F(XB
h
)=(exp(xib
h
)/(1 ?exp(x
i
b
h
))), h =1, 2,…,m-1.
Sense of Community Belonging and Health in Canada 109
123
and xis the amount of each explanatory characteristic for individual i. Odds ratios compare
the probability of events for two groups, where an odds ratio of 1 implies an event that is
equally likely to occur in one group as it is in the other group and an odds ratio greater than
1 implies the event is more likely to occur in the comparison group than the reference
group. Further, an odds ratio less than 1 means the event is less likely in the comparison
group than the reference group.
For all analysis, the CCHS individual sample weight was used to adjust for bias due to
the complex survey design and unequal probability of selection. Bootstrap techniques were
used to ensure appropriate inference by correcting for downward bias standard errors and
adjusting for intra-cluster correlation, again due to the survey’s complex design (Chowhan
and Buckley 2005). Using the sample survey weights implies that all estimates can be
considered representative of the Canadian survey population. All analysis was conducted
using the statistical software Stata 11 (www.stata.com).
4 Factors Influencing Sense of Community Belonging: Descriptive Statistics
4.1 Sense of Belonging and Health
There is a clear link between sense of belonging and health. Figure 1indicates that two-
thirds of the target population who reported ‘excellent or very good’ health said that they
had a ‘very strong or somewhat strong’ sense of belonging to their local community. Mental
health appears to be an important factor. Just 44% of people with ‘fair or poor’ mental health
reported a positive sense of belonging. As shown in Fig. 1, this point is highlighted by the
22% gap in positive sense of belonging between those reporting ‘excellent or very good’
mental health (66.5%) and those who said their mental health was ‘fair or poor’ (44%).
There is also an association between stress and sense of belonging, as depicted by the data in
Fig. 2. More than two-thirds (68.5%) of respondents who said that their daily lives were ‘not
at all or not very’ stressful revealed that they had a positive sense of belonging to their local
community. This figure drops more than 10% for people who said that their lives were ‘quite
a bit or extremely’ stressful (57%). Similar trends were apparent for perceived work stress.
There is a connection between physical activity and sense of belonging. As shown in Fig. 3,
physically active people were more likely to have a positive sense of belonging (69%)
compared to those that were physically inactive (59%).
66.0 66.5
61.5 57.0
43.7
54.5
0
10
20
30
40
50
60
70
(Canadian Community Health Survey 2007-08
respondent aged 18+)
% Very strong/somewhat
strong belonging
Excellent/very good Good Fair/poor
Self-perceived health Perceived mental health
Fig. 1 Sense of belonging to local community by health status
110 P. Kitchen et al.
123
4.2 Regional Variations
The results of the analysis suggest that place is an important determinant of sense of
belonging to local community. Figure 4illustrates variations in this sentiment among
residents of different regions of Canada. Overall, more than two-thirds (68%) of the target
68.5 66.3
62.6 62.7 58.6
56.7
0
10
20
30
40
50
60
70
80
Perceived life stress
(Canadian Community Health Survey 2007/08
respondents aged 18+)
% Very strong/somewhat
strong belonging
Not at all/not very A bit Quite a bit/extremely
Perceived work stress
Fig. 2 Sense of belonging to local community by level of stress
68.9 66.4
59.4
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
(Canadian Community Health Survey 2007/08
Respondents aged 18+)
% Strong/somewhat strong
belonging
Active Moderate Inactive
Fig. 3 Sense of belonging to local community by level of physical activity
81.8
74.0
72.1
68.8
59.7
68.5
71.5
73.2
64.1
68.6
73.7
68.0
0 20 40 60 80 100
NFLD/Labrador
PEI
Nova Scotia
New Brunswick
Quebec
Ontario
Manitoba
Saskatchewan
Alberta
BC
Territories
Canada
(Canadian Community Health Survey 2007/08
respondents aged 18+)
Fig. 4 Sense of belonging to
local community by province of
residence % Very strong/
somewhat strong belonging
Sense of Community Belonging and Health in Canada 111
123
population aged 18 and over described their sense of belonging as ‘very strong or some-
what strong’. Regional variations were apparent with smaller provinces and territories (in
terms of population) having higher proportions of residents expressing a positive sense of
belonging to their local community: Newfoundland and Labrador (82%), PEI (74%), the
Northern Territories (74%), Saskatchewan (73%) and Manitoba (71.5%). Interestingly,
residents of Alberta (64%) and Quebec (60%) were the least likely to express a positive
sense of belonging. Figure 5reveals that sense of belonging increased progressively across
the urban to rural continuum with 62% of residents in larger urban areas (CMA/CAs)
reporting a ‘very strong or somewhat strong’ sense of belonging compared to75% in the
‘weak or no MIZ’. In particular, as seen in Fig. 6, residents of small towns (population
between 1,000 and 30,000) had a stronger sense of belonging to their community (72%)
then residents of larger settlements or rural areas.
Table 3shows that in Canada as a whole, and in each province, larger proportions of
rural residents reported a ‘very strong’ sense of belonging compared to their urban
counterparts. This sentiment was strongest among rural residents of Newfoundland and
Labrador (36%), the Northern Territories (32%) and Saskatchewan (28%). The largest gap
between urban and rural residents was evident in Saskatchewan (11%). Quebec had the
smallest proportion of people reporting a ‘very strong’ sense of belonging, just 13% of
urban residents and 16% of rural residents.
61.8 63.7 69.8 75.6
0
20
40
60
80
100
Metropolitan Influence Zone (MIZ)
(Canadian Community Health Survey 2007/08
respondents aged 18+)
% Very strong/somewhat
strong belonging
CMA/CA Strong MIZ Moderate MIZ Weak or no MIZ
Fig. 5 Sense of belonging to local community by place of residence
59.4 64.2 64.7
72.0 68.5
0
10
20
30
40
50
60
70
80
(Canadian Community Health Survey 2007/08
respondents aged 18+)
% Very strong/somewhat
strong belonging
500K or more 100K to 500K 30K to 100K <30K Rural Area
Fig. 6 Sense of belonging to local community by population size
112 P. Kitchen et al.
123
4.3 Sense of Belonging and Socio-Economic Status
A number of socio-economic factors are associated with sense of belonging in Canada.
Figure 7demonstrates a clear and direct link to age, with each age group progressively
reporting a stronger sense of belonging. Nearly three-quarters (72%) of the target popu-
lation aged 65 and over said that they had a ‘very strong or somewhat strong’ sense of
belonging compared to just 57% of youth (age 18–24). Household type (or family com-
position) also had an influence with sense of belonging strongest among couples with
children (65%) and couples living alone (66%). By contrast, unattached individuals (58%)
and lone parents (56%) had a much lower sense of belonging (Fig. 8). Finally, higher
household incomes were associated with persons with a greater sense of belonging. Nearly
two-thirds (65%) of people living in households with an income of $80,000 or more had a
positive sense of belonging compared to 58% of those residing in households with an
income under $20,000 (Fig. 9). It should be noted, however, that the difference between
the three highest income categories (greater than $20,000) is slight.
5 Multiple Factors Influencing Sense of Community Belonging
5.1 Ordinal Logit Regression
The next step was to carry out an ordinal logistic regression analysis to study the rela-
tionship between sense of belonging and a number of health, geographic and socio-
economic characteristics. Whereas the descriptive statistics examined the effect of indi-
vidual variables on sense of belonging, the regression analysis considered the influence of
multiple factors. The dependent variable is categorical and represents the four responses to
the sense of belonging question: ‘very strong’, ‘somewhat strong’, ‘somewhat weak’ and
‘very weak’. The variables listed in Table 2were entered as independent covariates in the
regression with the exception of perceived work stress.
4
The results are shown in Table 4,
which includes 3 models where groups of covariates were phased into the analysis. Model
1 tested the relationship between sense of belonging and health. Model 2 retained the
health variables and included geographic indicators as control variables. Model 3 added
socioeconomic measures as a second set of control variables. The independent variables
having significant odds ratios (*-p\0.10, **-p\0.05 and ***-p\0.01) are marked
with asterisks.
Model 1 indicates that each of the four health-related measures had a significant
influence on sense of belonging. For instance, people reporting ‘fair or poor’ health were
less likely to have a higher sense of belonging than those with ‘excellent or very good’
health (OR =0.888). Confirming the results of the descriptive statistics, mental health had
an even greater influence. Those reporting ‘fair or poor’ mental health were less likely to
have a higher sense of belonging than people with ‘excellent or very good’ perceived
mental health (OR =0.472). Stress was also an important factor. Those saying they had
‘quite a bit or extremely’ stressful lives were less likely to have a higher sense of belonging
than people having ‘not at all or not very’ stressful lives (OR =0.708). Finally, physically
active people were nearly 1.4 times more likely to have a greater sense of belonging than
4
Of the 17 variables listed in Table 2, perceived work stress was omitted from the ordinal logit regression
due to a large number of missing cases. This pertains to people who were not employed in a job at the time
the CCHS was conducted.
Sense of Community Belonging and Health in Canada 113
123
Table 3 Urban-rural differences in sense of belonging (Census rural definition)
Province Sense of belonging to local community
Very
strong (%)
Somewhat
strong (%)
Somewhat
weak (%)
Very weak (%)
Newfoundland
Urban 26.6 51.1 16.6 5.7
Rural 36.3 46.8 12.9 4.1
Rural difference 9.6 -4.3 -3.8 -1.6
PEI
Urban 19.1 50.1 22.2 8.7
Rural 25.5 51.0 16.6 6.9
Rural difference 6.5 0.9 -5.6 -1.8
Nova Scotia
Urban 19.7 50.3 21.4 8.6
Rural 20.6 50.9 21.6 7.0
Rural difference 0.9 0.6 0.2 -1.6
New Brunswick
Urban 18.8 47.6 24.1 9.5
Rural 22.1 48.6 19.9 9.4
Rural difference 3.3 1.0 -4.2 -0.1
Quebec
Urban 13.4 42.1 32.1 12.4
Rural 15.7 42.9 30.1 11.4
Rural difference 2.3 0.8 -2.0 -1.1
Ontario
Urban 17.6 46.5 24.8 11.2
Rural 22.5 48.8 21.2 7.5
Rural difference 5.0 2.3 -3.7 -3.6
Manitoba
Urban 16.6 48.6 24.6 10.3
Rural 24.7 49.3 19.6 6.5
Rural difference 8.1 0.7 -5.0 -3.8
Saskatchewan
Urban 16.9 49.5 25.2 8.4
Rural 28.3 49.9 16.5 5.3
Rural difference 11.4 0.4 -8.7 -3.1
Alberta
Urban 13.9 44.5 30.4 11.3
Rural 21.1 48.4 22.1 8.4
Rural difference 7.2 3.9 -8.3 -2.8
British Columbia
Urban 17.1 49.1 26.3 7.5
Rural 20.7 50.2 23.5 5.6
Rural difference 3.6 1.1 -2.9 -1.9
Territories
114 P. Kitchen et al.
123
the physically inactive (OR =1.366). The findings with respect to health, stress and
physical activity indicate that hypotheses 1 and 2, as outlined in Sect. 2of the paper, should
be accepted.
In Model 2, geographic variables were added to the analysis to test the effect of place of
residence on sense of belonging to local community. The results point to some important
regional variations. For instance, urban residents of Newfoundland and Labrador (OR =
2.280) and the Territories (OR =2.417) were more than twice as likely to have a higher
57.3 60.1 65.0 72.0
0
10
20
30
40
50
60
70
80
(Canadian Community Health Survey 2007/08
respondents aged 18+)
% Very strong/somewhat
strong belonging
18 to 24 25 to 44 45 to 64 65 and over
Fig. 7 Sense of belonging to local community by age group
58.5 64.5 66.0
56.0
0
10
20
30
40
50
60
70
(Canadian Community Health Survey 2007/08
respondents aged 18+)
% Very strong/somewhat
strong belonging
Unattached individual Couple alone
Couple with children Lone parent with child
Fig. 8 Sense of belonging to local community by household type
Table 3 continued
Province Sense of belonging to local community
Very
strong (%)
Somewhat
strong (%)
Somewhat
weak (%)
Very weak (%)
Urban 29.1 46.5 19.3 5.1
Rural 32.5 48.3 14.5 4.7
Rural difference 3.4 1.7 -4.8 -0.4
Canada
Urban 16.3 45.9 27.1 10.7
Rural 21.1 47.5 23.2 8.3
Rural difference 4.9 1.5 -4.0 -2.4
Sense of Community Belonging and Health in Canada 115
123
sense of belonging as urban residents of Que
´bec (the reference group). In fact, with the
exception of Alberta, urban residents of each province had a significantly higher sense of
belonging than their Que
´bec urban counterparts. In addition to Newfoundland and the
Territories, other provinces with significantly higher levels of sense of belonging among
their urban residents (compared to Que
´bec) included PEI (OR =1.697), Nova Scotia
(OR =1.657), Saskatchewan (OR =1.524) and British Columbia (OR =1.563).
Model 2 also includes Odds ratios calculated as a result of the statistical interaction
between the variables ‘Census rural’ and ‘Province of residence’ in an effort to account for
the rural effect on sense of belonging to local community. It is apparent that there is a
significant added effect on sense of belonging among the rural residents of PEI
(OR =1.303), Manitoba (OR =1.326) and Saskatchewan (OR =1.388). What this
means, for instance, is that the rural residents of PEI were 1.3 times more likely to report a
higher sense of belonging than urban residents of PEI. Finally, in Model 2, Odds ratios
were calculated for the variable denoting the four geographic zones (MIZ) to determine the
influence of distance from a larger urban centre on sense of belonging. Supporting the
findings of the descriptive statistics, sense of belonging was stronger in zones farthest from
a CMA/CA. People living in the ‘Moderate MIZ’ were 1.4 times more likely to report a
higher sense of belonging than residents of a larger urban center (OR =1.414) while
people residing in the ‘Weak or no influence MIZ’ were 1.7 times more likely to report a
higher sense of belonging (OR =1.694). The findings with respect to rural residency and
changes across the urban to rural continuum indicate that hypotheses 3 and 4 should be
accepted.
In Model 3, nine socio-economic variables were added to the regression analysis. As
demonstrated by the significant Odds ratios across the three models, there is a remarkable
consistency in the influence of health on sense of belonging. This attests to the association
between healthy people and healthy communities even when controlling for geography and
socio-economic status. Among the socio-economic measures, it is interesting to note that
neither immigrant status nor Aboriginal identity had an influence on sense of belonging in
Canada. Females were more likely to have a higher sense of belonging to their local
community than males (OR =1.056), and seniors were 1.6 times more likely to have a
higher sense of belonging then people aged 45–64 years (OR =1.594). Contrary to the
findings of the descriptive statistics, those with a lower household income (less than
$20,000) were 1.2 times more likely to have a stronger sense of belonging than people with
a household income of $80,000 or higher (OR =1.124). With respect to dwelling type and
tenure, Model 3 shows that people residing in high-rise buildings were less likely to report
58.3 62.6 62.2 64.9
0
20
40
60
80
100
(Canadian Community Health Survey 2007/08
respondents aged 18+)
% Very strong/somewhat
strong belonging
Less than $20,000 $20,000 to $49,999
$50,000 to $79,999 $80,000 or more
Fig. 9 Sense of belonging to local community by household income
116 P. Kitchen et al.
123
Table 4 Results of ordinal logit regression analyses of sense of belonging to local community
Independent variables Model 1 Model 2 Model 3
Odds ratios Standard errors Odds ratios Standard errors Odds ratios Standard errors
Self-perceived health
Excellent/Very Good Reference
Good 0.935*** (0.021) 0.930*** (0.021) 0.878*** (0.021)
Fair/poor 0.888*** (0.033) 0.851*** (0.032) 0.714*** (0.028)
Self-perceived mental health
Excellent/Very Good Reference
Good 0.737*** (0.018) 0.721*** (0.018) 0.717*** (0.018)
Fair/poor 0.472*** (0.027) 0.455*** (0.025) 0.493*** (0.027)
Perceived life stress
Not at all/not very Reference
A bit 0.803*** (0.017) 0.802*** (0.017) 0.867*** (0.019)
Quite a bit/extremely 0.708*** (0.020) 0.740*** (0.022) 0.814*** (0.025)
Physical activity index
Active 1.366*** (0.032) 1.342*** (0.032) 1.389*** (0.033)
Moderate 1.262*** (0.029) 1.254*** (0.029) 1.262*** (0.030)
Inactive Reference
Census rural
Urban Reference
Rural 0.988 (0.050) 0.902** (0.047)
Province of residence
Urban Quebec Reference
Urban Nfld/Labrador 2.280*** (0.158) 2.200*** (0.151)
Urban PEI 1.697*** (0.138) 1.664*** (0.138)
Urban Nova Scotia 1.657*** (0.102) 1.636*** (0.102)
Sense of Community Belonging and Health in Canada 117
123
Table 4 continued
Independent variables Model 1 Model 2 Model 3
Odds ratios Standard errors Odds ratios Standard errors Odds ratios Standard errors
Urban New Brunswick 1.461*** (0.090) 1.418*** (0.089)
Urban Ontario 1.452*** (0.051) 1.427*** (0.053)
Urban Manitoba 1.401*** (0.078) 1.379*** (0.079)
Urban Saskatchewan 1.524*** (0.069) 1.515*** (0.070)
Urban Alberta 1.067 (0.050) 1.071 (0.052)
Urban British Columbia 1.563*** (0.058) 1.543*** (0.060)
Urban Territories 2.417*** (0.240) 2.719*** (0.256)
Census rural 9Province interaction
Rural 9Quebec Reference
Rural 9Nfld/Labrador 1.252** (0.137) 1.285** (0.140)
Rural 9PEI 1.303** (0.172) 1.294** (0.170)
Rural 9Nova Scotia 0.941 (0.090) 0.944 (0.089)
Rural 9New Brunswick 1.150 (0.112) 1.192* (0.115)
Rural 9Ontario 1.269*** (0.083) 1.265*** (0.084)
Rural 9Manitoba 1.251** (0.118) 1.286*** (0.123)
Rural 9Saskatchewan 1.326*** (0.117) 1.330*** (0.117)
Rural 9Alberta 1.388*** (0.120) 1.393*** (0.120)
Rural 9British Columbia 1.035 (0.082) 1.058 (0.085)
Rural 9Territories 1.041 (0.205) 1.085 (0.212)
Metropolitan influence zone
CMA/CA Reference
Strongly influenced MIZ 1.026 (0.056) 0.986 (0.054)
Moderately influenced MIZ 1.414*** (0.052) 1.343*** (0.052)
Weak or no influence MIZ 1.694*** (0.048) 1.631*** (0.049)
118 P. Kitchen et al.
123
Table 4 continued
Independent variables Model 1 Model 2 Model 3
Odds ratios Standard errors Odds ratios Standard errors Odds ratios Standard errors
Immigrant status
Immigrant 1.016 (0.031)
Non-immigrant Reference
Aboriginal status
Aboriginal 0.976 (0.048)
Non-Aboriginal Reference
Sex
Male Reference
Female 1.056*** (0.022)
Age
18–24 years 0.591*** (0.022)
25–44 years 0.737*** (0.018)
45–64 years Reference
65 years and over 1.594*** (0.050)
Household income
Less than $20,000 1.124** (0.053)
$20,000 to $49,999 1.074** (0.036)
$50,000 to $79,999 0.995 (0.027)
$80,000 or more Reference
Education
Less than high school 1.029 (0.032)
High school 0.969 (0.027)
Other post-secondary 1.003 (0.037)
Sense of Community Belonging and Health in Canada 119
123
Table 4 continued
Independent variables Model 1 Model 2 Model 3
Odds ratios Standard errors Odds ratios Standard errors Odds ratios Standard errors
College or university Reference
Dwelling type
Single detached Reference
Double/row/duplex 0.925** (0.030)
Low-rise 0.930 (0.041)
High-rise 0.778*** (0.058)
Other 0.959 (0.055)
Household type
Unattached individual Reference
Couple living alone 1.054* (0.030)
Couple with children 1.327*** (0.045)
Lone parents 1.105** (0.044)
Housing tenure
Owner Reference
Other (rent, lease, etc.) 0.840*** (0.029)
Cut 1 -2.394*** (0.028) -2.076*** (0.036) -2.113*** (0.050)
Cut 2 -0.709*** (0.023) -0.372*** (0.034) -0.381*** (0.051)
Cut 3 1.466*** (0.022) 1.842*** (0.034) 1.880*** (0.051)
Observations 97,186 97,186 97,186
Population size 20,397,137 20,397,137 20,397,137
Pseudo R2 0.0115 0.0206 0.0321
Wald chi2 844.91 (df =8) 2204.30 (df =32) 3137.23 (df =52)
The dependent variable is sense of belonging to local community using a 4 point likert scale: 1-very strong, 2-somewhat strong, 3- somewhat weak, 4-very weak. The model
used for estimation is Ordered Logit. Bootstrap standard errors in parentheses. (*) significant at 10%, (**) significant at 5%, (***) significant at 1%. Reference categories are
included in the table
120 P. Kitchen et al.
123
a higher sense of belonging than those living in single detached homes (OR =0.778) and
residents who don’t own (e.g. renters) were less likely to have a higher sense of belonging
than owners (R =0.840). Finally, household type (or family composition) was an
important factor. Not surprisingly, couples with children were 1.3 times more likely to
have a greater sense of belonging than unattached individuals (OR =1.327). While the
descriptive statistics showed that lone-parents had the lowest sense of belonging, the
regression modeling indicates that these families had a slightly better sense of belonging
than unattached individuals or couples living alone.
5.2 Three-Way Contingency Table
The last step in the data analysis was to measure the relationship among three factors: sense
of belonging, health and place of residence. A three-way contingency table was created to
determine if a strong sense of belonging is associated with positive self-perceived health
across the urban to rural continuum. Research has consistently shown that there is a gap
between urban and rural Canadians with respect to both health status and access to health
services (DesMeules 2006; CIHI 2008; Pong et al. 2010). Indeed, analysis of the most
recent CCHS showed that self-perceived health declined across the urban to rural con-
tinuum. In 2007/08, 59% of respondents living in a CMA/CA reported ‘excellent/very
good’ health compared to 54% of those residing in the ‘weak/no MIZ’. At the same time,
12% of CMA/CA respondents reported ‘fair/poor’ health compared to 15% of ‘weak/no
MIZ’ respondents. Figure 10 reveals that residents of urban areas have a health advantage
over rural and small town residents when factoring changes in sense of belonging. For
instance, 64% of CMA/CA respondents who reported a ‘very strong’ sense of community
belonging said they had ‘excellent/very good’ health compared to 59% of ‘weak/no MIZ’
respondents who expressed the same sentiment. Even urban residents with a ‘very weak’
sense of community belonging enjoyed a health advantage over their rural/small town
counterparts -49 to 41%. Of course, these trends are occurring under the backdrop of a
much stronger overall sense of community belonging in rural Canada. These findings
suggest that while health is an important determinant of sense of belonging in all regions of
Canada, rural areas and small towns possess additional qualities or characteristics which
enable them to overcome a relative health deficit to produce stronger feelings of sense of
belonging among many of their residents. These issues will be discussed in the next
section.
64 62 58
49
56
49
41
59
0
10
20
30
40
50
60
70
80
Very strong Somewhat
Strong
Somewhat weak Very weak
Sene of belonging to local community
% Reporting Excellent/Very
Good Self-rated health
CMA/CA Strong MIZ Moderate MIZ Weak or no MIZ
Fig. 10 Sense of belonging to
local community by place of
residence and self-rated health
Sense of Community Belonging and Health in Canada 121
123
6 Summary of Findings
The objective of this paper was to examine the regional dynamics of sense of community
belonging in Canada and to acquire a more nuanced understanding of the association
between belonging and health. The research employed the most recent data from the
Canadian Community Health Survey (CCHS). A number of the major findings from this
paper confirm earlier work by Statistics Canada on this topic (Ross 2002; Turcotte 2005;
Shields 2008). In 2007/08, more than two-thirds (68%) of Canadians aged 18 and over
reported that they had a ‘strong or somewhat strong’ sense of belonging to their local
community. This sentiment has been increasing over the last decade. The paper found that
there was a strong and consistent association between health and sense of belonging even
when controlling for geography and socio-economic status. In particular, mental health and
life stress were strong determinants.
Important regional variations were evident. Several smaller provinces (in terms of
population) had high levels of community belonging especially Newfoundland and Lab-
rador, Prince Edward Island, the Northern Territories, Manitoba and Saskatchewan.
Overall, this sentiment was strongest in the rural areas of Canada and particularly among
the rural residents of Newfoundland and Labrador, the Northern Territories and Sas-
katchewan. Interestingly, sense of belonging was lowest in Que
´bec and Alberta, especially
among urban residents. This finding, particularly as related to Que
´bec is somewhat per-
plexing and requires additional study. The paper also demonstrated that sense of belonging
increased progressively across the urban to rural continuum with residents of the outer
most areas of Canada (weak/no MIZ) having exceptionally positive feelings of belonging
(75% of respondents). In terms of socio-economic status, sense of community belonging
was highest among seniors, couples with children, people who own a dwelling and those
living in a single-detached home. Conversely, sense of belonging was lower among youth,
people living in high-rise apartments and among single parents and unattached individuals.
Interestingly, there was only a slight difference between men and women and no significant
difference between immigrants and Canadian-born people and between Aboriginal and
Non-Aboriginal Canadians.
7 Discussion: Sense of Belonging and Social Capital
In the context of health as a strong determinant of sense of belonging, the paper revealed
that despite the health deficit that exists between urban and rural residents, belonging is
much stronger in rural and small town Canada. In other words, additional social factors are
likely overcoming the health challenges in these areas to create a strong sense of com-
munity belonging. In part, this development can be interpreted with respect to the idea of
social capital. Social capital is a concept related to sense of belonging that has received
considerable attention over the past 20 years. As mentioned, due to data limitations, this
paper was unable to directly measure the concept. Ross (2002) succinctly describes what is
meant by social capital:
At its most basic level, the term refers to the notion that relationships with others
have important implications for well-being. Individuals can possess social capital by
having a large network of friends and acquaintances, but social capital can also be
thought of a type of social savvy (Ross 2002, p. 34).
122 P. Kitchen et al.
123
Ross observes that social capital can refer to the properties of a community, which are
indirectly associated with health. For instance, communities with high levels of social
capital ‘‘might be those that offer opportunities for interaction and that have well-devel-
oped resources such as parks, libraries and recreational facilities’’ (Ross 2002, p. 35).
Political scientist Robert Putnam’s (2000,2001, 2004) views on social capital are well
known. Referring to American society, he contends that people have become increasingly
disconnected from friends, families, neighbours and from democratic structures such as
community organizations and voting. Putnam states that this situation has led to the
impoverishment of people’s lives and the communities in which they live. The literature
proposes four principal overlapping theoretical approaches to social capital. These are
collective efficacy, social trust/reciprocity, participation in voluntary organizations and
social integration for mutual benefit (McKenzie et al. 2002).
During the last decade, a large body of research has been devoted to social capital and
health (Kiwachi et al. 2008). Kim et al. (2008) and Almedom and Glandon (2008) con-
ducted extensive reviews of the literature and found evidence that community social capital
has an influence on physical and mental health. For instance, research indicates that there is
an association between community social cohesion and lower rates of all causes of mor-
tality and higher self-rated health. It is interesting to note, that in Kim et al. (2008) and
Almedom and Glandon’s (2008) review of dozens of academic papers and research reports,
there are very few references to social capital and health in rural areas or differences across
the urban to rural continuum. A recent exception is a study of South Australia by Ziersch
et al. (2009), which found higher levels of social capital were significantly associated with
better mental health for both urban and rural residents. There is clearly a need to expand
this line of research to better understand the association between health and social capital
and sense of belonging in rural areas. Interestingly, in a recent study of 918 middle-aged
people in Victoria, Canada, Chappell and Funk (2010) examined the relationship between
advantage, social capital and health status and found no support for a direct relationship
between measures of social capital and health.
While not dealing with health, several researchers have studied social capital in rural
and small town Canada and their findings are instructive for the interpretation of the
findings of this paper. For instance, Turcotte (2005) examined social engagement and civic
participation and uncovered mixed evidence to support the notion that social capital is
stronger in rural and small-towns. The study found that rural residents are more likely to
know all or most of their neighbours and are more likely to trust them. However, there was
little difference between rural and urban residents in providing or receiving help from a
neighbour. Rural residents are more likely to provide unpaid volunteer work for an
organization but they are just as likely as their urban counterparts to provide unpaid help to
people that they know (relative, neighbours, friends). In another study, Rothwell and
Turcotte (2006) measured the influence of education on civic engagement across Canada’s
urban–rural spectrum. The authors found that individuals of all levels of education are
more likely to volunteer if they live in rural areas than urban areas. In addition, rural
university degree holders are more likely to be active politically than those from urban
areas. Furthermore, rural residents are more likely to attend public meetings regardless of
their level of education.
To a certain degree, these findings suggest that rural areas and small towns benefit from
higher levels of civic engagement, participation in community activities and voluntarism as
well as more neighbourliness. In short, they have enhanced social capital, which in turn,
likely results in a greater sense of belonging among residents. This situation may explain
why rural areas in general and provinces with higher rural populations such as
Sense of Community Belonging and Health in Canada 123
123
Newfoundland and Labrador (42% in 2006), Prince Edward Island (55%), Saskatchewan
(35%) and the Northern Territories (46%), have much greater levels of community
belonging.
5
8 Policy Issues and Further Research
For the most part, research on sense of community belonging in Canada has not ventured
into the realm of policy prescriptions. This is likely due to the complex nature of the issue,
which touches on numerous societal factors. One area where it is clear that more policy
attention is needed is mental health in Canada. However, a detailed discussion is beyond
the scope of this paper. Nonetheless, in the context of sense of belonging, a brief review of
several mental health issues is warranted. An analysis of the 2007/08 CCHS revealed that
more than 1.2 million Canadians aged 18 or over reported that they had ‘fair or poor’
mental health, representing about 5% of adults. And while this proportion is remarkably
even across the urban to rural continuum (about 5% in each of the 4 zones), more than 1
million of these respondents live in urban areas (CMA/CA) where sense of belonging is
lowest.
Like most other health services in Canada, the care and treatment of people with mental
health problems is primarily a provincial or territorial responsibility. A landmark 2006
Canadian Senate Report titled ‘Out of the Shadows at Last’ observed that the social
determinants of mental health have been overlooked despite their importance in preventing
and treating mental illness. At the community level, the report identified affordable
housing, employment, education and adequate income supports as crucial life-sustaining
factors for people living with mental illness and addiction. It also emphasized the
importance of creating supportive environments and strengthening community action (The
Senate of Canada 2006, p. 413). The Senate Report included more than 100 recommen-
dations several of which are relevant to the issue of enhancing sense of community
belonging. Chief among these recommendations is that the federal government set up a
Mental Health Transition Fund to support community-based mental health services. This
would permit people suffering from mental illness to be eligible for funding as part of the
‘Basket of Community Services’ component of the transition fund. These services would
include adequate access to community-based treatment and prevention programs. Another
recommendation is the creation of a Mental Health Housing Initiative that would provide
funds both for the development of new affordable housing units. It would also cover rent
supplement programs that subsidize people living with mental illness who would otherwise
not be able to rent vacant apartments at current market rates. More recently, in August
2010, the Legislative Assembly of Ontario released a report on mental health and addic-
tions. It called for a more coordinated approach to the treatment and prevention of mental
illness in the province and for the development of a core basket of services and support.
Similar to the Senate’s recommendations, the Ontario report emphasized the creation of
affordable and safe housing as a way to facilitate access to treatment and community
services.
Several avenues for further research can be pursued to enhance our understanding of
sense of community belonging and health in Canada. The current research was limited to
the study of provincial and urban–rural trends. However, a more detailed analysis at the
inter and intra-urban levels may yield important clues into local factors that influence sense
5
According to the 2006 Census, Canada’s rural population is 6,262,154 or 20% of the total.
124 P. Kitchen et al.
123
of belonging and health such as access to local services and programs as well as com-
munity design features. This paper found that sense of community belonging was lowest
among unattached people, lone-parent families and residents of high-rise apartments. A
dual quantitative–qualitative study of one or all these segments of the population and
possibly tied to mental health issues may reveal the key individual factors impacting sense
of belonging and how low levels of belonging can be remedied through planning and
community initiatives. On-going research has pointed to the fact that sense of belonging is
much higher in rural and small-town Canada despite the presence of a health deficit. These
communities are clearly benefitting from a number of social and organizational factors
leading to enhanced social capital. However, our understanding of what exactly these
factors are is limited. Additional research could involve an ethnographic study of a small-
town, for instance, in a rural region of Canada to uncover the social, cultural and political
dynamics at play in creating a strong sense of belonging as related to issues such as trust
and reciprocity. Such a study could also serve as a platform to re-examine the notion of a
health gap between urban and rural residents by broadening the definition of health to
include sentiments such as belonging.
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