Degree Type


Date of Award


Degree Name

Doctor of Philosophy



First Advisor

Paul Lasley

Second Advisor

J. Gordon Arbuckle


This study links three streams of literature to explore the relationship between county-level European ancestry, civic structure and health outcomes. Research has shown that areas with high civic structure have better health outcomes compared to those areas low in civic structure. Studies also point out that some communities with higher population densities of certain ancestries have more civic structure than others. Researchers have also found some evidence that ethnic density is related to better mental or physical health. These mechanisms are tested on structural measures, such as county-level civic structure and ancestry (not race or ethnicity) to determine if they are associated with self-reported good health, obesity and diabetes diagnoses.

Data was extracted from several publically available sources such as the U.S. Census Bureau, Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System (BRFSS), the University of Wisconsin's County Health Rankings, Rupasingha and Goetz index, and the Economic Research Services' Environmental Food Atlas. The data were compared across two different periods in time; early and late 2000s.

This study finds that counties high in civic structure have higher self-reported good health, but it does not consistently show lower obesity and diabetes diagnoses. Further, civic structure added very little or in some cases no explained variance to the models. Norwegian and German ancestries were associated with higher civic structure, but they were not consistently related to better health outcomes. Ethnic density is associated with better health outcomes, but the results are not consistent. Further work should investigate the cultural activities of ancestries, such as food, holidays or celebrations and its potentially related health implications.


Copyright Owner

John Ferrell



File Format


File Size

173 pages