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PubMed2004

Making sense of social capital, health and policy.

This paper summarizes current knowledge about social capital and its application to health policy. There is a consensus that social capital is a characteristic of social groups, rather than individuals, and is born of shared experience which fosters mutual trust and reciprocity. It is a collective resource that may accumulate over time and facilitates the accomplishment of objectives that would otherwise be unlikely. The theoretical articulation of social capital remains under-theorized, and its measurement is subject to considerable debate. Health researchers, searching for a pathway to explain the adverse health outcomes associated with income inequality, as well as to understand the results of multi-level analyses that demonstrate an independent etiological role for community of residence, may find social capital an attractive notion. Despite professions of interest, the utility of social capital for health policy formation remains problematic; however, as a theoretical paradigm for policy it may have particular appeal to exponents of the "Third Way".

Health Policy↗
PubMed2006

Social capital and administrative contextual determinants of lack of access to a regular doctor: a multilevel analysis in southern Sweden.

BACKGROUND: The aim of this study was to investigate the influence of contextual (social capital and administrative/neo-materialist) and individual factors on lack of access to a regular doctor. METHODS: The 2000 public health survey in Scania is a cross-sectional study. A total of 13,715 persons answered a postal questionnaire, which is 59% of the random sample. A multilevel logistic regression model, with individuals at the first level and municipalities at the second, was performed. The effect (intra-class correlations, cross-level modification and odds ratios) of individual and municipality (social capital and health care district) factors on lack of access to a regular doctor was analysed using simulation method. The Deviance Information Criterion (DIC) was used as information criterion for the models. RESULTS: The second level municipality variance in lack of access to a regular doctor is substantial even in the final models with all individual and contextual variables included. The model that results in the largest reduction in DIC is the model including age, sex and individual social participation (which is a network aspect of social capital), but the models which include administrative and social capital second level factors also reduced the DIC values. CONCLUSIONS: This study suggests that both administrative health care district and social capital may partly explain the individual's self reported lack of access to a regular doctor.

Adolescent↗
PubMed2006

Building social capital in first-time parents through a group-parenting program: a questionnaire survey.

BACKGROUND: Parents who are connected into strong family and community networks are said to have high social capital enabling them to provide a positive context where their children's social, emotional and educational needs are met. OBJECTIVES: To identify parent satisfaction with, strengths and weaknesses of, opportunities to build social capital, and the impact of a two-course pilot health and relationship focused Parenting Education Program-PEPE, designed for first-time parents, on the core work of the well-child nurse/health visitor. DESIGN: Retrospective descriptive survey using postal questionnaires. SETTING: Twelve pilot parenting courses facilitated across five regions of New Zealand. PARTICIPANTS: All parents (n = 105) and clinical nursing staff (n = 12) involved in the pilot parenting courses were invited to participate. Overall response rate was 82%. METHODS: Questionnaires developed by investigators were mailed to the eligible population. Numerical data was analysed using PC-SAS. Narrative data was subjected to thematic content analysis. RESULTS: Attendance at both parenting courses positively correlated with an increase in measures of social capital: development of strong social networks (82% Your New Baby course respondents: 95% CI, 75-89, and 98% Your Growing Baby course respondents: 95% CI, 96-100), and positive relationships with others (93% Your New Baby course respondents: 95% CI, 88-98, and 86% Your Growing Baby course respondents: 95% CI, 83-89). Increased confidence in respondent's parenting ability was also identified (96% Your New Baby course respondents: 95% CI, 92-100; 96% Your Growing Baby course respondents: 95% CI 93-99). CONCLUSIONS: The PEPE programme was well accepted by first-time parents leading to significant improvements in development of social capital and parenting confidence. Well-child health nurses are in a prime position to foster social capital and help rebuild communities within which they work to enhance parenting outcomes.

Adolescent↗
PubMed2005

Neighbourhood life and social capital: the implications for health.

Social capital has been linked to health outcomes, though there are some inconsistencies in the research and the link is dependent on the measures of social capital and health used. In this paper, we argue that social capital is multifaceted and its relationship with health is complex. We explore the relationship between a number of elements of neighbourhood life and neighbourhood-based social capital, and health, using both qualitative and quantitative methods. The paper reports on a study of the Western suburbs of Adelaide and the analysis of 2400 questionnaires and 40 in-depth interviews. A partial least-square path analysis was undertaken with the questionnaire data. It considered the impact of perceptions of the physical environment, neighbourhood connections, neighbourhood trust, reciprocity, perceived safety and local civic action, and a number of demographic variables, on physical and mental health as measured by the SF-12. Of the neighbourhood-related variables, only perceived neighbourhood safety was related to physical health, with neighbourhood safety and neighbourhood connections related to mental health. Of the demographic variables, higher-income level and educational achievement were related to better physical and mental health. In addition, physical health was lower and mental health higher within older age groups. The inter-relationships between the neighbourhood variables and demographic differences in experience of neighbourhood were also examined. The thematic analysis of the interviews linked a number of social aspects of neighbourhood, the physical neighbourhood environment, perceptions of safety, civic activities and availability of local services, to health outcomes. The paper concludes that there is a need for more complex measures of social capital and that socio-economic factors are of relatively greater importance in determining health.

Adolescent↗
PubMed2005

Social isolation, support, and capital and nutritional risk in an older sample: ethnic and gender differences.

This study examines the relationships that exist between social isolation, support, and capital and nutritional risk in older black and white women and men. The paper reports on 1000 community-dwelling older adults aged 65 and older enrolled in the University of Alabama at Birmingham (UAB) Study of Aging, a longitudinal observational study of mobility among older black and white participants in the USA. Black women were at greatest nutritional risk; and black women and men were the groups most likely to be socially isolated and to possess the least amounts of social support and social capital. For all ethnic-gender groups, greater restriction in independent life-space (an indicator of social isolation) was associated with increased nutritional risk. For black women and white men, not having adequate transportation (also an indicator of social isolation) was associated with increased nutritional risk. Additionally, for black and white women and white men, lower income was associated with increased nutritional risk. For white women only, the perception of a low level of social support was associated with increased nutritional risk. For black men, not being married (an indicator of social support) and not attending religious services regularly, restricting activities for fear of being attacked, and perceived discrimination (indicators of social capital) were associated with increased nutritional risk. Black females had the greatest risk of poor nutritional health, however more indicators of social isolation, support, and capital were associated with nutritional risk for black men. Additionally, the indicators of social support and capital adversely affecting nutritional risk for black men differed from those associated with nutritional risk in other ethnic-gender groups. This research has implications for nutritional policies directed towards older adults.

Aged↗
PubMed2006

Low-linking social capital as a predictor of mental disorders: a cohort study of 4.5 million Swedes.

Few previous studies have analyzed the association between different dimensions of social capital and mental disorders. This study examines whether there is an association between a relatively new theoretical concept describing the amount of trust between individuals and societal institutions, i.e. linking social capital, and hospitalization due to depression or psychosis. The entire Swedish population aged 25-64, a total of 4.5 million men and women, was followed from January 1, 1997, until the first hospital admission due to depression or psychosis during the study period, or the end of the study on December 31, 1999. Small area neighborhood units were used to define neighborhoods. The definition of linking social capital was based on mean voting participation in each neighborhood unit, categorized in tertiles. Multilevel logistic regression was used to estimate odds ratios and neighborhood-level variance in four different models. The results showed strong associations between linking social capital and hospitalization due to depression or psychosis. These associations decreased considerably in both men and women, but still remained significant, after adjustment for age, housing tenure, education, employment status, marital status, and country of birth. However, the results for depression (both men and women) no longer remained significant after adjustment for neighborhood deprivation. In contrast, the results for psychosis decreased considerably but remained significant after adjustment for neighborhood deprivation. The association between low levels of voting participation and hospitalization due to depression or psychosis might reflect neighborhood differences in linking social capital, which could affect vulnerable individuals negatively. Decision-makers should take into account the evidence of a neighborhood effect on mental health in decisions regarding the sites of psychiatric clinics and other kinds of community support for psychiatric patients.

Adult↗
PubMed2003

Children's health-related quality of life, neighbourhood socio-economic deprivation and social capital. A contextual analysis.

Neighbourhood objective socio-economic indicators and community-reported subjective measures of social capital were examined in relation to children's health-related quality of life in the Netherlands. Three different data-sources were used: (1) objective neighbourhood socio-economic indicators, (2) subjective neighbourhood data on social capital, and (3) individual data of a family cohort study, including questions on children's health-related quality of life, and family socio-economic status. Multilevel analyses were conducted using both neighbourhood level and individual level data. Neighbourhood socio-economic status and social capital were associated. Measures of socio-economic deprivation and social capital were both non-specifically associated with children's general health and satisfaction, independent of possible individual-level confounders. However, children's mental health and behaviour were specifically associated with one aspect of social capital, the degree of informal social control in the neighbourhood.

Child↗
PubMed1998

Social capital, income inequality, and firearm violent crime.

Studies have shown that poverty and income are powerful predictors of homicide and violent crime. We hypothesized that the effect of the growing gap between the rich and poor is mediated through an undermining of social cohesion, or social capital, and that decreased social capital is in turn associated with increased firearm homicide and violent crime. Social capital was measured by the weighted responses to two items from the U.S. General Social Survey: the per capita density of membership in voluntary groups in each state; and the level of social trust, as gauged by the proportion of residents in each state who believed that "most people would take advantage of you if they got the chance". Age-standardized firearm homicide rates for the years 1987-1991 and firearm robbery and assault incidence rates for years 1991-1994 were obtained for each of the 50 U.S. states. Income inequality was strongly correlated with firearm violent crime (firearm homicide, r = 0.76) as well as the measures of social capital: per capita group membership (r = -0.40) and lack of social trust (r = 0.73). In turn, both social trust (firearm homicide, r = 0.83) and group membership (firearm homicide, r = -0.49) were associated with firearm violent crime. These relationships held when controlling for poverty and a proxy variable for access to firearms. The profound effects of income inequality and social capital, when controlling for other factors such as poverty and firearm availability, on firearm violent crime indicate that policies that address these broader, macro-social forces warrant serious consideration.

Homicide↗
PubMed2000

Social capital, SES and health: an individual-level analysis.

Stimulated by the finding (Kawachi et al., 1997) that social capital in communities may mediate the relationship between income inequality and health status, this article describes relationships between individual-level elements of social capital--trust, commitment and identity in the social-psychological dimension; participation in clubs and associations and civic participation in the action dimension--and self-rated health status, before and after controlling for human capital (socioeconomic status measured by income and education), using survey data collected in Saskatchewan, Canada (n = 534, 40% response rate). Income (P = 0.001) and education (P < 0.001) were related to health in the expected directions. Both income (P = 0.002) and education (P = 0.004) were related to health among the elderly; education (P = 0.035) to health among the middle-aged; and neither among the youthful respondents. Frequency of socialization with work-mates (P = 0.019) and attendance at religious services (P = 0.034) had the strongest (and positive) relationships with health of the social engagement questions, even after controlling for human capital, and participation in clubs and associations was positively related to health among the elderly (P = 0.009). But for commitment to one's own personal happiness (P = 0.039), trust, commitment and identification of various kinds were not significantly related to health. Civic participation was also unrelated to health. The main conclusion is that little evidence was found for compositional effects of social capital on health. Secondary findings are that the relationship between SES and health was the same for men and women and strongest among the elderly; that socialization with colleagues from work is relevant and that attendance at religious services and participation in clubs are related to health for the elderly.

Female↗
PubMed2003

Neighborhood differences in social capital: a compositional artifact or a contextual construct?

Assessment of social capital at the neighborhood level is often based on aggregating individual perceptions of trust and reciprocity. Individual perceptions, meanwhile, are influenced through a range of individual attributes. This paper examines the socioeconomic and demographic attributes that systematically correlate with individual perception of social capital and determines the extent to which such attributes account for neighborhood differences in social capital. Using improved multilevel modeling procedures, we ascertain the extent to which differences in social capital perception can be ascribed to true neighborhood-level variations. The analysis is based on the 1994-95 Community Survey of the Project on Human Development in Chicago Neighborhoods (PHDCN). The response measure is based on survey respondent's perceptions of whether people in their neighborhood can be trusted. The results suggest that even after accounting for individual demographic (age, sex, race, marital status) and socioeconomic characteristics (income, education), significant neighborhood differences remain in individual perceptions of trust, substantiating the notion of social capital as a true contextual construct.

Adult↗
PubMed2005

Flow of natural versus economic capital in industrial supply networks and its implications to sustainability.

Appreciating the reliance of industrial networks on natural capital is a necessary step toward their sustainable design and operation. However, most contemporary accounting techniques, including engineering economics, life cycle assessment, and full cost accounting, fail in this regard, as they take natural capital for granted and concentrate mainly on the economic aspects and emissions. The recently developed "thermodynamic input-output analysis" (TIOA) includes the contribution of ecological goods, ecosystem services, human resources, and impact of emissions in an economic input-output model. This paper uses TIOA to determine the throughputs of natural and economic capitals along industrial supply networks. The ratios of natural to economic capitals of economic sectors reveals a hierarchical organization of the U.S. economy wherein basic infrastructure industries are at the bottom and specialized value-added industries constitute the top. These results provide novel insight into the reliance of specific industrial sectors and supply chains on natural capital and the corresponding economic throughput. Such insight is useful for understanding the implications of corporate restructuring on industrial sustainability metrics and of outsourcing of business activities on outsourcer, outsourcee, and global sustainability. These implications are discussed from the standpoints of weak and strong sustainability paradigms. The calculated ratios can also be used for hybrid thermodynamic life cycle assessment.

Costs and Cost Analysis↗
PubMed2005

Depressive symptomatology, exposure to violence, and the role of social capital among African American adolescents.

Focusing on the role of capital as both personal and social resources for adolescents, the authors examined depressive symptomatology among a sample of 10- to 18-year-old African American youths (N=1,538). In addition to gender and age differences, adolescents exposed to threatening environments (school, neighborhood, home) reported more depressive symptoms. Social capital had a significant inverse relationship with adolescent depression; self-esteem and a social capital index were negatively related to depressive symptomatology. Furthermore, the interaction effects of gender with social capital, age with self-esteem, and age with grades were significant, indicating the presence of a buffering effect. These findings suggest the importance of interrelationships among violence exposure, capital, and well-being for adolescents.

Adolescent↗
PubMed2006

Health, economy and social capital in Nordic children and their families: a comparison between 1984 and 1996.

OBJECTIVE: The aim of the study was to analyse the development in the health of children that occurred in the five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) between 1984 and 1996 and relate it to the changes in economic growth and social capital in these countries during the same period. METHODS: Two cross-sectional studies covered a representative sample of children, aged 2-17 years in each country, a total of 10,291 in 1984 and 10,317 in 1996. The data were collected by mailed questionnaires. Statistical associations between a health indicator (the absence of psychosomatic complaints), economic indicators (social class, housing and disposable income) and social capital indicators (parents' and children's organized group activities, parents playing with their children and the absence of bullying) within samples and between corresponding values in different samples across subgroups (defined by country and area of residence) were evaluated using multiple linear regression. RESULTS: In both surveys, there was a statistically highly significant association between the health indicator and the social capital indicators, whereas the economy indicators were not related to either of the other two types of measure. Change in health was associated positively with change in social capital and negatively with change in economy. CONCLUSION: The study provides strong support for the concept of social capital as an important determinant of children's health.

Adolescent↗
PubMed2006

Social capital, rural nursing and rural nursing theory.

The notion of social capital focuses attention on social connectedness within communities and the ways that this connectedness may affect health and well-being. There are many competing definitions of social capital but most suggest that it involves trust, social networks and reciprocity within communities, not necessarily geographically defined. The usefulness of social capital and related theories that help in understanding the function of nurses in rural communities are explored in this paper. Nurses and health service planners are becoming increasingly aware of the potential contribution of community nurses in rural and/or remote areas, as evidenced in the development of nurse practitioners. Through their interrelational role and status in rural communities, nurses are often 'immersed' or 'embedded' in the social networks that make up the fabric of rural life and may therefore be important contributors to social capital. For a concept such as social capital to be useful in nursing research, it must have distinct attributes, delineated boundaries, and well-described preconditions and outcomes in multiple contexts.

Communication↗
PubMed1999

Social capital and community development: practitioner emptor.

Social capital has become the latest 'flavour of the month'. There is considerable disagreement over what the term means, and calls for theorising and measurement of the construct. Health promoters, among others, are being challenged to re-construct their efforts around this still contested idea. Social capital doesn't exist, but is being created by those aspects of social relations particular theorists or researchers choose to study in its name. The choice of these relations is directed by ideology. To those aligned more with neoliberal, market-driven ideology, social capital is a means to the end of economic growth, something that can pick up the slack of privatised or reduced public services. To those aligned more with social justice and communitarian ideology, social capital is an end in itself, requiring the defence of strong, egalitarian state intervention into market practices that create inequalities. Community development is one of many state interventions used to buffer market-generated inequalities. Social capital may be a useful concept for practitioners, researchers and policy makers in bring the missing 'social' into economic and fiscal policy debates. But its use should be approached cautiously as a construct of potential strategic value. It should not confuse all of the previous 'good' work undertaken in the name of empowerment and community capacity.

Australia↗
PubMed2001

Social disadvantage and variation in the incidence of end-stage renal disease in Australian capital cities.

OBJECTIVE: To evaluate variation in the incidence of end-stage renal disease (ESRD) within Australian capital cities. To explore the relation between the incidence of ESRD and socioeconomic disadvantage. METHODS: We obtained data from the Australian and New Zealand Dialysis and Transplant Registry (ANZDATA) regarding 5,013 patients from capital cities who started ESRD treatment between 1 April 1993 and 31 December 1998. We used the postcode at the start of treatment to calculate the average annual incidence of ESRD for each of 51 capital city regions using 1996 Census counts based on place of usual residence. We calculated standardised incidence ratios with 95% confidence intervals for each region. The standardised incidence ratios were examined in relation to the SEIFA Index of Relative Socio-economic Disadvantage (IRSD), derived from the 1996 Census. Low IRSD values indicate more disadvantaged areas. RESULTS: There is significant variation in the standardised incidence of ESRD within capital cities. There was a significant correlation (r=-0.41, p=0.003) between the standardised incidence ratio for ESRD and the SEIFA IRSD. CONCLUSIONS AND IMPLICATIONS: Capital city areas that are more disadvantaged have a higher incidence of ESRD. Socioeconomic factors may be important determinants of the risk of developing ESRD.

Australia↗
PubMed2003

Social norms, social behaviours and health: an empirical examination of a model of social capital.

OBJECTIVE: To explore a model of social capital, specifically the association between socially oriented norms and behaviours and the effect that these factors have on the gradient between income and self-rated health across three different welfare states. METHOD: We used data from the 1995-97 World Values Survey, a cross-sectional study conducted in a variety of countries including Australia, United States, Sweden and Norway (n = 5,096). RESULTS: We found variation in the level of social capital measures across the three different welfare states. Socially oriented norms are not strongly correlated with each other, or with socially oriented behaviours. The presence of socially oriented norms or behaviours did not reduce the likelihood of lower income groups reporting poor self-rated health, relative to the highest income groups. CONCLUSIONS AND IMPLICATIONS: Many questions still exist regarding the relationship between social capital and health, including how to measure the social capital concept and whether and how social capital affects health, independent of material and economic conditions.

Altruism↗
PubMed2005

Gender, home and family in cultural capital theory.

The paper argues that Bourdieu's stress on early familiarization for the highest value of cultural capital is closely linked to his idea, strongly emphasized in Distinction, about the role of family and domestic life for individual development and social positions. The role of women, as mothers and homemakers, is crucial in this process. Yet, Bourdieu defines social origin as deriving from the father. The centrality to Bourdieu's thinking of a resilient traditional pattern of masculine domination and feminine submission constitutive of the Western gender habitus explains both his stress on 'normalcy' for the production of legitimate dispositions, and his resistance to incorporating into his thinking the implications of recent transformations in home family living, which have destabilized the gender order. It is thus important to consider contemporary feminist analyses of the family and home life and their significance for a renewed theory of cultural capital. The paper considers two sets of literature. Firstly, it addresses the manners in which home and family are conceptualized in Bourdieu's key texts where these issues were prominent in the development of his thinking on cultural capital. The second set of literature includes texts by feminist academics in the fields of family, gender and the body, which analyse the destabilizing of the gender order and everyday family living in contemporary society. Two questions are addressed on the basis of these reflections: (1) Is cultural capital an individual or a household resource? (2) How does cultural capital relate to personal interdependencies at the level of family and households?

Anthropology, Cultural↗