The potential role of perceived neighborhood social cohesion on COVID-19 vaccination uptake among individuals aged 50 and older: Results from the Korean Community Health Survey

The COVID-19 pandemic highlighted the critical importance of vaccination in controlling infectious diseases. While previous research has identified social cohesion as a potential facilitator of health behaviors, empirical studies exploring its direct impact on COVID-19 vaccination rates, especially across different age groups, remain limited. This cross-sectional study utilized data from the 2021 Korean Community Health Survey, a nationally representative survey conducted in South Korea. The analysis focused on adults aged 50 and older, categorizing them into two age groups (50-64 and ≥65). We investigated the association between perceived neighborhood social cohesion and COVID-19 vaccination status, controlling for socio-economic status, health behaviors, and concerns related to COVID-19. Statistical analysis was conducted using complex sample multiple logistic regression to adjust for potential confounders. The study included 135,352 participants, with an analysis showing that in the age group ≥65, higher levels of perceived neighborhood social cohesion were significantly associated with increased vaccination uptake (aOR for trust between neighbors: 1.200, 95% CI: 1.058-1.362; aOR for mutual assistance among neighbors: 1.491, 95% CI: 1.312-1.695). Interestingly, these associations were not significant in the 50-64 age group. Additionally, satisfaction with healthcare services was associated with higher vaccination uptake in both age groups (aOR: 1.106, 95% CI: 1.004-1.219 for 50-64; aOR: 1.306, 95% CI: 1.160-1.471 for ≥65). Our findings suggest that perceived neighborhood social cohesion plays a crucial role in influencing COVID-19 vaccination uptake among older adults, particularly those aged 65 and above. These results indicate that health policies aimed at enhancing social cohesion may effectively improve vaccination rates, especially among the elderly. Future research should explore the impact of social cohesion on other age groups and assess the causal relationships in longitudinal studies.