DO COMMUNITIES DIFFER IN HEALTH BEHAVIORS

Communities differ in the prevalence of various health behaviors, but it is not known to what extent these differences are due to ''differen t types'' of people living in them. We used data from the evaluation o f the Henry J Kaiser Family Foundation Community Health Promotion Gran t Program to study individual-level and community-level variation in h ealth behaviors for 15 communities. Our results show (1) there was sig nificant variation among these communities in prevalences of smoking, consumption of alcohol and dietary fat, and use of seatbelts; (2) thes e differences persisted after control for demographic, health status, and other health behavioral characteristics of the people in the commu nities; (3) the community effect on a particular person's behavior, as represented by R2, was very small (less than 1 %); and (4) the adjust ed differences in prevalences among communities were potentially large (for example, a 7 percentage point difference in the probability of s moking). Unique features of communities may influence health behaviors . These findings affirm the potential importance of contextual effects on individual health behavior and thus support the theory that changi ng the community environment may offer effective ways to change indivi dual health behavior.