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An examination of social capital and social disorganisation in neighbourhoods in the British household panel study.

Recent developments in social science research suggest that social environmental factors may be important for explaining community variations in health. We investigate the structural sources of two mechanisms that produce community variations in health. Using survey data collected from a representative cross-section of British households we examine variations in neighbourhood social capital and neighbourhood social disorganisation across a sample of British neighbourhoods. Adjusting for respondent's attributes, we assess the effects of neighbourhood characteristics measured by the 1991 census in Britain. The results show that concentrated affluence, residential instability and ethnic heterogeneity predict social capital for women. Population density is the only neighbourhood characteristic to predict social capital for men. For both men and women concentrated disadvantage and population density are associated with social disorganisation. Residential instability is additionally associated with social disorganisation for women. For women it was found that neighbourhood characteristics interact with individual social class in accounting for variations in social capital, the effects of neighbourhood characteristics being larger for those in professional and managerial and skilled non-manual occupations. The results show that neighbourhood structural characteristics influence social organisation processes. This helps establish a link between the structural characteristics of neighbourhoods and individual health outcomes.

Adult↗

Social capital, life expectancy and mortality: a cross-national examination.

This paper analyses the relationship between social capital and population health. The analysis is carried out within an econometric model of population health in 19 countries in the Organisation for Economic Co-operation and Development countries using panel data covering three different time periods. Social capital is measured by the proportion of people who say that that they generally trust other people and by membership in voluntary associations. The model performs well in explaining health outcomes. We find very little statistically significant evidence that the standard indicators of social capital have a positive effect on population health. By contrast, per capita income and the proportion of health expenditure financed by the government are both significantly and positively associated with better health outcomes. The paper casts doubt upon the widely accepted hypothesis that social capital has a positive effect on health and illustrates the importance of testing this kind of hypothesis in an extended model.

Cooperative Behavior↗

When being alone might be better: neighborhood poverty, social capital, and child mental health.

Public health researchers have provided a growing body of evidence on the salutary effects of social capital for individual well being. The importance of these findings for social epidemiology, however, may have precluded so far a full examination of the complex association between neighborhood social processes and the well being of individual residents, including the often acknowledged potential "downside" of social capital. In this study, we examine the association between attachment to community, an indicator of social capital, in a sample of African American parents, and the presence of behavior problems in their preschool children. Participants were recruited from a socioeconomically diverse set of neighborhoods. Attachment to community was assessed using a multi-item scale comprised of two subscales, general sense of community and how well one knew one's neighbors. Results indicated that the association between how well a parent knew her neighbors and the presence of child behavior problems differed depending on the degree of economic impoverishment of the neighborhood. In wealthy neighborhoods, children whose parent reported knowing few of the neighbors had higher levels of internalizing problems such as anxiety and depression compared to those who knew many of their neighbors. In contrast, in poor neighborhoods, children whose parent reported knowing few of the neighbors had lower levels of internalizing problems compared to those who knew many of their neighbors. These results are discussed in terms of furthering the study of the contextual nature of the social capital in explaining community inequalities in mental health among children.

Baltimore↗

Social capital and trust in providers.

Trust in providers has been in decline in recent decades. This study attempts to identify sources of trust in characteristics of health care systems and the wider community. The design is cross-sectional. Data are from (1) the 1996 Household Survey of the Community Tracking Study, drawn from 24 Metropolitan Statistical Areas; (2) a 1996 multi-city broadcast media marketing database including key social capital indicators; (3) Interstudy; (4) the American Hospital Association; and (5) the American Medical Association. Independent variables include individual socio-demographic variables, HMO enrollment, community-level health sector variables, and social capital. The dependent variable is self-reported trust in physicians. Data are merged from the various sources and analyzed using SUDAAN. Subjects include adults in the Household Survey who responded to the items on trust in physicians (N=17,653). Trust in physicians is independently predicted by community social capital (p<0.001). Trust is also negatively related to HMO enrollment and to many individual characteristics. The effect of HMOs is not uniform across all communities. Social capital plays a role in how health care is perceived by citizens, and how health care is delivered by providers. Efforts to build trust and collaboration in a community may improve trust in physicians, health care quality, access, and preserve local health care control.

Adolescent↗

Social capital and health: implications for public health and epidemiology.

Public health and its "basic science", epidemiology, have become colonised by the individualistic ethic of medicine and economics. Despite a history in public health dating back to John Snow that underlined the importance of social systems for health, an imbalance has developed in the attention given to generating "social capital" compared to such things as modification of individual's risk factors. In an illustrative analysis comparing the potential of six progressively less individualised and more community-focused interventions to prevent deaths from heart disease, social support and measures to increase social cohesion faired well against more individual medical care approaches. In the face of such evidence public health professionals and epidemiologists have an ethical and strategic decision concerning the relative effort they give to increasing social cohesion in communities vs expanding access for individuals to traditional public health programs. Practitioners' relative efforts will be influenced by the kind of research that is being produced by epidemiologists and by the political climate of acceptability for voluntary individual "treatment" approaches vs universal policies to build "social capital". For epidemiologists to further our emerging understanding of the link between social capital and health they must confront issues in measurement, study design and analysis. For public health advocates to sensitise the political environment to the potential dividend from building social capital, they must confront the values that focus on individual-level causal models rather than models of social structure (dis)integration. The evolution of explanations for inequalities in health is used to illustrate the nature of the change in values.

Causality↗

Indirect costs of back pain in the Netherlands: a comparison of the human capital method with the friction cost method.

In this study we estimated the indirect costs of back pain in 1991 in The Netherlands on the basis of two approaches: the traditionally used human capital method and the more recently developed friction cost method. The indirect costs of illness were defined as the value of production losses of paid labour and related costs to society due to back pain. The results of this study in 1991 in The Netherlands show that the short-term indirect costs estimated by the human capital method were more than three times as high as the indirect costs estimated by the friction cost method (US$ 4.6 billion vs. USS 1.5 billion, respectively). The lower estimate of indirect costs when using the friction cost method is mainly due to the fact that in this method actual production losses are estimated during a relatively short friction period, which is defined as the period needed to restore the initial production level. In contrast with the human capital method, long-term absenteeism and disability do not induce additional costs when applying the friction cost method. Since the friction cost method takes into account that employees can be replaced, we believe that this method produces a more accurate estimate of indirect costs than the human capital method. Notwithstanding the resulting decrease in indirect costs of back pain, these costs are still impressive, representing 0.28% of the GNP in The Netherlands in 1991. As a consequence, but particularly stimulated by structural changes in the Dutch social security system, policies aimed at reducing indirect costs of back pain, increasingly concentrate on the development and evaluation of interventions early after the onset of disease. This is complemented, on the one hand, by the development of clinical guidelines for the management of back pain in primary care and, on the other hand, by governmental policies aimed at reintegration of chronically ill in the labour force.

Adult↗

Intraosseous blood supply of the capitate and its correlation with aseptic necrosis.

Isolated capitate fractures that result in the development of aseptic necrosis of the proximal pole are uncommon. Five patients were treated who developed aseptic necrosis of the proximal pole. Four had a history of trauma with radiographic evidence of nonunion. In vitro arterial injection studies were done to correlate clinical problem with intraosseous capitate vascularity. Palmar vessels were found to contribute the majority of the blood supply to the capitate. Three patterns of intraosseous blood supply were seen. In each pattern, the proximal pole received its blood supply exclusively in a retrograde fashion across the capitate waist analogous to the proximal scaphoid. Aseptic necrosis without collapse of the proximal pole was successfully managed with curettage and bone grafting in three patients. The remaining two patients, with collapse and pericapitate degenerative changes, were managed with intercarpal fusion.

Adult↗

Social capital: a guide to its measurement.

The primary aims of this paper are to review the concept of social capital and related constructs and to provide a brief guide to their operationalization and measurement. We focus on four existing constructs: collective efficacy, psychological sense of community, neighborhood cohesion and community competence. Each of these constructs taps into slightly different, yet overlapping, aspects of social capital. The existence of several instruments to measure each of these constructs calls for further study into their use as measures of social capital. Despite differences in the approach to measurement, there is general agreement that community characteristics, such as social capital, should be distinguished from individual characteristics and measured at the community level.

Humans↗

Religion as a resource for positive youth development: religion, social capital, and moral outcomes.

Although existing literature demonstrates that developmental benefits are associated with religion for adolescents, little is understood about the dynamics of this relationship. Drawing on social capital theory, this study tested a conceptual model exploring socially embedded religious influences on moral outcomes. A three-dimensional model of social capital demonstrated how social interaction, trust, and shared vision enable social ties associated with religiousness to influence moral behavior. Structural equation modeling was used with data gathered from 735 urban youths to test a proposed model of the effects of religiousness on moral outcomes. Results suggested that religiously active youths report higher levels of social capital resources and that the influence of adolescent religiousness on moral outcomes was mediated through social capital resources. Suggestions for further research and implications for faith-based youth development organizations are considered.

Adolescent↗

Repair of femoral capital physeal fractures in 12 cattle.

OBJECTIVE: To document signalment, clinical signs, and long-term outcome of surgical treatment for femoral capital physeal fractures in cattle. STUDY DESIGN: Retrospective study. Animals-Twelve cattle with femoral capital physeal fractures. METHODS: Cases were identified by a search of radiographic records. Historical, diagnostic, surgical, and outcome data were collected from the medical records. Owners were contacted for follow-up information by telephone. RESULTS: Fractures were repaired by screws inserted in lag fashion in 4 animals and by use of multiple intramedullary pins in 8 animals. Six of 12 animals required repeat surgery to reposition screws or pins. Nine animals were considered successfully treated at discharge. Six months after surgery, 6 of 11 animals for which follow-up was obtained were still sound. At 12 months, 4 of 4 animals alive were still sound. Animals that bore weight earliest postoperatively were more likely to have a successful outcome. Animals <12 months of age had better outcomes than animals >12 months of age. CONCLUSIONS: Prognosis for serviceable soundness is good in cattle <12 months of age and fair in animals >12 months of age after surgical repair of femoral capital physeal fracture by stacking intramedullary pins or by screws inserted in lag fashion. CLINICAL RELEVANCE: Surgical repair of femoral capital physeal fracture is most successful in younger cattle and can result in productive animals.

Animals↗

The impact of a health campaign on health social capital.

Referring to literature in sociology, mass communication, and public health, we conceptualize and operationally define "health social capital" and "individual health social capital" and then posit and test a model for its development in response to a public health media campaign. The campaign evaluated here was designed to stimulate behaviors that would provide a more supportive social environment for children and youth, an environment which we consider to be richer in aggregate health social capital. The association model of advertising was employed to explain the development of individual health social capital measures of awareness, attitude, and behavior. With cross-sectional data (1998, n = 614; 1999, n = 1087; 2000, n = 1388), we examine the results for changes in awareness, attitude, and behavior over time and the significant links between these dependent variables and media campaign exposure. The results show significant increases in awareness and attitude, but not in behavior. Structural equation modeling revealed different patterns of influence for newspaper and TV campaign exposure.

Adolescent↗

Social capital, the miniaturization of community and assessment of patient satisfaction in primary healthcare: a population-based study.

AIMS: A study was undertaken to assess the impact of social participation, trust and the miniaturization of community, i.e. high social participation/low trust, on two measures of patient dissatisfaction in primary healthcare. METHODS: The Scania 2000 public-health survey is a cross-sectional, postal questionnaire study. A total of 3,456 persons aged 18-80 years who had a regular doctor within the primary healthcare system were included. A logistic regression model was used to investigate the association between the social capital variables and dissatisfaction. Multivariate analysis analysed the importance of confounders on the differences in lack of general openness and lack of information concerning treatment in accordance with social capital variables. RESULTS: Lack of openness is positively associated with low trust, the miniaturization of community and low social capital, while lack of information is not significantly associated with the miniaturization of community, but to a lesser extent with low trust and low social capital. CONCLUSIONS: Low levels of trust and the miniaturization of community may enhance non-specific patient dissatisfaction such as experience of lack of openness by the patient. In contrast, the miniaturization of community was not significantly associated with the more specific "lack of information". The results have implications for the evaluation of patient dissatisfaction.

Adolescent↗

Social capital and lack of belief in the possibility to influence one's own health: a population-based study.

OBJECTIVES: To study the impact of social capital (social participation and trust) on lack of belief in possibility to influence health. METHODS: The Scania 2000 public-health survey is a cross-sectional, postal questionnaire study including 13,604 persons aged 18-80 years which was conducted in 2000 by the regional healthcare authorities in Region Skåne, southern Sweden, to investigate health-related risk factors in the population. A logistic regression model was used to investigate the association between social capital and lack of belief in possibility to influence health. The multivariate analyses analysed the importance of confounders on the differences in lack of belief in possibility to influence health according to the social capital variables. RESULTS: In total, 31.0% of all men and 33.5% of all women lack belief in the possibility to influence their own health. Lack of belief in possibility to influence health was positively associated with both low social participation and low trust, although stronger for social participation than for trust. CONCLUSIONS: Low levels of social capital, particularly low social participation, is positively associated with lack of belief in the possibility to influence one's own health.

Cross-Sectional Studies↗

Capitate hairs on cotton textile wastes.

Bract and leaf samples from growing cotton plants and from cotton textile wastes were examined by scanning electron microscopy to determine if intact capitate hairs are important components fo raw cotton wastes. The density of capitate hairs on bract and leaf fragments in raw cotton was similar to that found on bracts and leaves from greenhouse and field collections. A bale of strict low middling raw cotton contains between 1.23 an 2.54 X 10(8) capitate hairs of bract origin alone. Capitate hairs could be important components of cotton textile wastes because of their abundance and because they contain chemicals that may be involved in the cause of respiratory disease in textile workers.

Gossypium↗

Does area-based social capital matter for the health of Australians? A multilevel analysis of self-rated health in Tasmania.

BACKGROUND: Material circumstances and collective psychosocial processes have been invoked as potential explanations for socioeconomic inequalities in health; and, linking social capital has been proposed as a way of reconciling these apparently opposing explanations. METHODS: We conducted multilevel logistic regression of self-rated health (fair or poor vs excellent, very good, or good) on 14 495 individuals living within 41 statistical local areas who were respondents to the 1998 Tasmanian Healthy Communities Study. We modelled the effects of area-level socioeconomic disadvantage and social capital (neighbourhood integration, neighbourhood alienation, neighbourhood safety, social trust, trust in public/private institutions, and political participation), and adjusted for the effects of individual characteristics. RESULTS: Area-level socioeconomic disadvantage was associated with poor self-rated health (beta = 0.0937, P < 0.001) an effect that was attenuated, but remained significant, after adjusting for individual characteristics (beta = 0.0419, P < 0.001). Social trust was associated with a reduction in poor self-rated health (beta = -0.0501, p = 0.008) and remained significant when individual characteristics (beta = -0.0398, P = 0.005) were included. Political participation was non-significant in the unadjusted model but became significant when adjusted for individual characteristics (beta = -0.2557, P = 0.045). The effects of social trust and political participation were attenuated and became non-significant when area-level socioeconomic disadvantage was included. CONCLUSION: Area-based socioeconomic disadvantage is a determinant of self-rated health in Tasmania, but we did not find an independent effect of area-level social capital. These findings suggest that in Tasmania investments in improving the material circumstances in which people live are likely to lead to greater improvements in population health than attempts to increase area-level social capital.

Adolescent↗

Physician social capital: its sources, configuration, and usefulness.

Specific characteristics of health care shape the social capital of physicians and, consequently, their behavior and the performance of organizations. In this article, propositions about how social capital is influenced by four characteristics of health care are developed. These propositions are analyzed with reference to the mechanisms through which social capital operates, to the contingencies that make it valuable, to the integrative power of a social capital framework in health care management, and to their practice implications.

Delivery of Health Care↗

Diagnosis and treatment of slipped capital femoral epiphysis.

Slipped capital femoral epiphysis remains a diagnostic problem despite numerous papers written on the subject. The most important factor in the diagnosis of slipped capital femoral epiphysis is suspicion by the practitioner. The history, physical examination, and radiographic imaging are important in the confirmation of the diagnosis. Imaging is the topic of 1998 with advances in the areas of ultrasound. Ultrasound may be better in experienced hands than plain radiography in the diagnosis of slipped capital femoral epiphysis. Magnetic resonance imaging is used for diagnosis of slipped capital femoral epiphysis and in the assessment of pre-slips. The magnetic resonance image can be oriented to a plane orthoganol to the plane of the physis to assess the width of the physis and to detect edema in the area of the physis.

Adolescent↗

Atypical slipped capital femoral epiphysis after radiotherapy and chemotherapy.

Atypical slipped capital femoral epiphysis after radiotherapy and chemotherapy is uncommon. Only 32 cases have been reported in the literature. Because patients may have slippage at atypical ages, we report two cases of slipped capital femoral epiphysis in children and review the 32 cases previously reported to heighten clinicians' awareness of this condition in patients who have received radiation and chemotherapy for pelvic tumors. The controversy over prophylactic pinning of the uninvolved hip in radiotherapy-associated slipped capital femoral epiphysis is unresolved. It may be justifiable to fix the nonslipped epiphysis if possible prodromal signs of abnormal radiographic findings are detected. Because radiotherapy and chemotherapy were used in the two children reported, it is not possible to state whether one or both forms of treatment were responsible for the atypical slipped capital femoral epiphysis.

Antineoplastic Agents↗