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Value of life and behavior toward health risks: an interpretation of social capital.

An individual assessing a risky job can be understood as a public good. He and each of his valued relationships place a demand for the preservation of his life and health for which he accepts a responsibility to preserve. Additional demands generally do not deplete his capacity for beneficial relationships, hence, they are nonrival. It follows that the more extensive are his relationships the greater is his social capital. Although a common metric to compare and aggregate such relationships is not practical, the paper demonstrates that the common social capital indicators can yield qualitative predictions on changes in risky behaviors in the context of conventional value of life models familiar within health economics. The individual will change his behavior toward risk upon experiencing an exogenous change in his social capital: when he marries, has children, acquires friends, or experiences a more socially active community. The empirical sections of the paper show this prediction to conform well to prior studies of micro data as well as to original empirical analysis of aggregate data.

Attitude to Health↗

Estimation of a human capital model of migration.

"The main deficiency of the current literature on the determinants of migration is the large gap between theoretical analyses and empirical applications. If no direct link is established between a theoretical model and its empirical specification, the empirical results cannot validate the model. This paper develops a version of the human capital model of migration which permits empirical specification. The human capital model presented incorporates two important concepts from migration theory: (1) an index of characteristics that uniquely define a specific location; and (2) location-specific human capital. The empirical model is estimated with a data set consisting of a number of cases from the Michigan [United States] Panel Study of Income Dynamics (PSID) survey."

Americas↗

[Dyamic screw fixation for slipped capital femoral epiphysis. Treatment results].

Slipped capital femoral epiphysis always requires surgical treatment. The operative technique depends on the degree of dislocation and the type of the slip. The goal of treatment is to achieve physeal stability until the epiphyseal plate closes without harming the further femoral growth. In situ fixation is generally recommended for slipped capital femoral epiphyses of a mild degree. For this purpose the technique of dynamic screw fixation (DSF) is applicable using a long cannulated screw with a short thread.DSF is easy to handle, provides sufficient long-term fixation of the epiphysis, does not promote premature closure of the epiphysis, and engenders few complications. Therefore, this technique is also applicable for the prophylactic treatment of the contralateral unaffected hip, which we always perform. Moreover, DSF can be used following gentle reduction of acute epiphysiolysis, if the amount of eventual residual dislocation does not exceed 30 degrees. We report our results with dynamic screw fixation of 29 slipped capital femoral epiphyses of a mild degree, and the prophylactic dynamic screw fixation of 34 unaffected hips. The fixation technique achieved a reliable stabilization with no visible growth disturbance of the femoral neck in all cases.

Adolescent↗

Risk-adjusted capitation funding models for chronic disease in Australia: alternatives to casemix funding.

Under Australian casemix funding arrangements that use Diagnosis-Related Groups (DRGs) the average price is policy based, not benchmarked. Cost weights are too low for State-wide chronic disease services. Risk-adjusted Capitation Funding Models (RACFM) are feasible alternatives. A RACFM was developed for public patients with cystic fibrosis treated by an Australian Health Maintenance Organization (AHMO). Adverse selection is of limited concern since patients pay solidarity contributions via Medicare levy with no premium contributions to the AHMO. Sponsors paying premium subsidies are the State of Victoria and the Federal Government. Cost per patient is the dependent variable in the multiple regression. Data on DRG 173 (cystic fibrosis) patients were assessed for heteroskedasticity, multicollinearity, structural stability and functional form. Stepwise linear regression excluded non-significant variables. Significant variables were 'emergency' (1276.9), 'outlier' (6377.1), 'complexity' (3043.5), 'procedures' (317.4) and the constant (4492.7) (R(2)=0.21, SE=3598.3, F=14.39, Prob<0.0001. Regression coefficients represent the additional per patient costs summed to the base payment (constant). The model explained 21% of the variance in cost per patient. The payment rate is adjusted by a best practice annual admission rate per patient. The model is a blended RACFM for in-patient, out-patient, Hospital In The Home, Fee-For-Service Federal payments for drugs and medical services; lump sum lung transplant payments and risk sharing through cost (loss) outlier payments. State and Federally funded home and palliative services are 'carved out'. The model, which has national application via Coordinated Care Trials and by Australian States for RACFMs may be instructive for Germany, which plans to use Australian DRGs for casemix funding. The capitation alternative for chronic disease can improve equity, allocative efficiency and distributional justice. The use of Diagnostic Cost Groups (DCGs) is a promising alternative classification system for capitation arrangements.

Journal Article↗

Neighborhood poverty, social capital, and the cognitive development of African American preschoolers.

In this investigation, we examine the impact of the ecological context of the residential neighborhood on the cognitive development of children by considering social processes not only at the family-level but also at the neighborhood-level. In a socioeconomically diverse sample of 200 African American children living in 39 neighborhoods in Baltimore, we found that neighborhood poverty was associated with poorer problem-solving skills over and above the influence of family economic resources and level of positive parent involvement. Sampson has theorized that neighborhood poverty affects child well-being by altering levels of neighborhood social capital as well as family social capital. Although we found that indicators of neighborhood and family social capital were associated with cognitive skills, these factors did not explain the association between neighborhood poverty and problem-solving ability. Implications for future research in the area of neighborhoods and child development are discussed.

Black or African American↗

The willingness to pay for health changes, the human-capital approach and the external costs.

In this paper, the relationship between willingness to pay for health changes, the human-capital approach, and the costs that should be included in a cost-benefit analysis of a health care programme are analysed. The costs that should be included are defined as the change in consumption minus the change in production of the individual that receives a health care programme. The size of these external costs differs depending on the institutional arrangements in society. It is shown that the net production version of the human-capital approach is an estimation of the external costs. The human-capital approach can thus be given a theoretical foundation in cost-benefit analysis if it is used to estimate the external costs.

Attitude to Health↗

Capital intensive hospital technology and illness: an analysis of American state data.

This paper: describes the development of a 'hospital technology index' to measure the level of capital intensive medical technology in each of the 50 U.S. states and the District of Columbia, reports differences between states in scores on this index, and tests the hypothesis that there is a low but significant negative correlation between the level of capital intensive medical technology and the level of illness. The three subscales of the hospital technology index have high alpha coefficients of reliability, are reasonably orthogonal, and there is at least some evidence of construct and discriminant validity for each. The multiple regression analysis suggests that there is either no relation between capital intensive medical technology and the rate of illness or that there is a slight tendency for the illness rate to increase as the level of technology increases. Eight possible explanations for the findings are discussed.

Financing, Government↗

Is there a link between rates of common mental disorder and deficits in social capital in Gospel Oak, London? Results from a qualitative study.

Previous research in Gospel Oak indicates high-rates of common mental disorder. This paper explores how far deficits in social capital may be linked to these rates. Interviews, focus groups and participant observation were conducted to assess social capital in Gospel Oak from the phenomenological experience of residents. The data suggested that most residents perceived the neighbourhood to be rich in well-developed facilities, services and associational activity. Residents also generally expressed satisfaction with local trust and reciprocity. The results do not support the hypothesis that rates of common mental disorder in Gospel Oak are linked to deficits in social capital. Compositional factors may be more important in accounting for these rates.

Female↗

Social capital and health among the aged: comparisons between the United States and Germany.

Through a cross-national investigation of the United States and Germany, this study examines how individual level social capital relates to the health of the elderly. Data from two national telephone surveys conducted in Germany (N=682) and the United States (N=608) with probability samples of non-institutionalized persons aged 60 and older was used. Indicators of social capital including both norms (reciprocity and civic trust) and behaviors (participation) were tested with three self-reported health indicators-overall health, depression (CES-D) and functional limitations. Housing variables and social support were controlled for in the study. Lack of reciprocity was associated with poorer self-rated health in both countries. Civic mistrust was associated with poorer self-rated health in both countries as well as with depression and functional limitations in America. Lack of participation was, in Germany, associated with poorer self-rated health and depression. The cross-national results indicate that individual-level analysis of social capital along with marco-level determinants are important for understanding the health of the elderly.

Aged↗

Area variation in mortality in Tasmania (Australia): the contributions of socioeconomic disadvantage, social capital and geographic remoteness.

This study investigated the association between socioeconomic disadvantage, social capital, geographic remoteness and mortality in the Australian state of Tasmania. The analysis is based on death rates among persons aged 25-74 years in 41 statistical local areas (SLA) for the period 1998-2000. Multilevel binomial regression indicated that death rates were significantly higher in disadvantaged areas. There was little support for an association between social capital and mortality, thereby contesting the often held notion that social capital is universally important for explaining variations in population health. Similarly, we found little evidence of a link between geographic remoteness and mortality, which contrasts with that found in other Australian states; this probably reflects the small size of Tasmania, and limited variation in the degree of remoteness amongst its SLA.

Adult↗

Social capital and neo-materialist contextual determinants of sense of insecurity in the neighbourhood: a multilevel analysis in Southern Sweden.

BACKGROUND: The aim of this study was to investigate the influence of contextual (social capital and neo-materialist) and individual factors on sense of insecurity in the neighbourhood. 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 (median odds ratios, intra-class correlation, cross-level modification and odds ratios) of individual and municipality/city quarter (social capital and police district) factors on sense of insecurity was analysed. RESULTS: The crude variance between municipalities/city quarters was not affected by individual factors. The introduction of administrative police district in the model reduced the municipality variance, although some of the significant variance between municipalities remained. The introduction of social capital did not affect the municipality variance. CONCLUSIONS: This study suggests that the neo-materialist factor administrative police district may partly explain the individual's sense of insecurity in the neighbourhood.

Adolescent↗

Community perspectives on the impact of policy change on linking social capital in a rural community.

Understanding what undermines or builds social capital is important when estimating the impact that changes in social capital have on people's lives. The aim of this paper is to illustrate how the consequences of neo-liberal policy initiatives have impacted on linking social capital in one small and vibrant rural community in Australia. Policy changes affecting all levels of government and various commercial agencies have undermined people's capability for a range of actions which bring personal and community-wide social and economic returns. Rationalisation and regionalisation of services and commercial agencies, including local government amalgamation, and increased workloads have undermined people's capabilities for community engagement. Policy outcomes are at odds with the stated policy agenda of building community capacity.

Adult↗

Social capital and farmer's willingness-to-join a newly established community-based health insurance in rural China.

In 2002, China announced a new funding strategy that would reestablish community-based health insurance (CHI) in rural areas, whereby the Chinese government will entice farmers' participation by providing each participant an annual subsidy of 10-20 Yuan (US 1.25-2.50 dollars). However, there is no evidence demonstrating how many farmers would be willing-to-join (WTJ) such newly developed government subsidized voluntary-based CHI scheme and what factors influence farmers' willingness-to-join. In this study, we examine the probability of farmers' willingness-to-join such CHI under the different scenarios of government subsidy and individual contribution, and also explore factors that influence farmers' willingness-to-join with the emphasis on social capital. The study is based on data collected from a 2002 household survey conducted in Fengsan Township, located in China's Guizhou Province. Logistic regression is used in the analysis. The findings from this study show that even with the government subsidy to the premium, the probability of WTJ the new voluntary-based CHI only reach 50%. The results also indicate that community level social capital, as measured by reciprocity index, and individual level social capital, as measured by trust index, are significantly and positively associated with the probability of farmers' WTJ newly developed government subsidized CHI. Policy recommendations have been made based on those findings.

Adult↗

Safety culture and accident analysis--a socio-management approach based on organizational safety social capital.

One of the biggest challenges for organizations in today's competitive business environment is to create and preserve a self-sustaining safety culture. Typically, the key drivers of safety culture in many organizations are regulation, audits, safety training, various types of employee exhortations to comply with safety norms, etc. However, less evident factors like networking relationships and social trust amongst employees, as also extended networking relationships and social trust of organizations with external stakeholders like government, suppliers, regulators, etc., which constitute the safety social capital in the Organization--seem to also influence the sustenance of organizational safety culture. Can erosion in safety social capital cause deterioration in safety culture and contribute to accidents? If so, how does it contribute? As existing accident analysis models do not provide answers to these questions, CAMSoC (Curtailing Accidents by Managing Social Capital), an accident analysis model, is proposed. As an illustration, five accidents: Bhopal (India), Hyatt Regency (USA), Tenerife (Canary Islands), Westray (Canada) and Exxon Valdez (USA) have been analyzed using CAMSoC. This limited cross-industry analysis provides two key socio-management insights: the biggest source of motivation that causes deviant behavior leading to accidents is 'Faulty Value Systems'. The second biggest source is 'Enforceable Trust'. From a management control perspective, deterioration in safety culture and resultant accidents is more due to the 'action controls' rather than explicit 'cultural controls'. Future research directions to enhance the model's utility through layering are addressed briefly.

Accidents, Occupational↗

[Fenton's syndrome or scapho-capitate fracture (a case report)].

INTRODUCTION: Scapho-capitate fracture is a rare lesion and its mechanism is controversial. Forced extension seems to be the most frequent cause as this movement of the wrist induces scaphoid fracture by compression. Hyperextension of the wrist as a result of the scaphoid lesion, allows contact between the posterior margin of the radius and the neck of the capitate inducing a capitate fracture. MATERIALS AND METHODS: We report a case of Fenton's Syndrome, the patient was operated as an emergency by pining and immobilization of the carpus and thumb until bone consolidation had occurred. RESULTS: Consolidation was noted at 8 weeks with a good mobility of the wrist. DISCUSSION: Fenton's Syndrome is a rare lesion of the wrist. Analysis of our own case and a review of literature demonstrated extension as a causative mechanism, and the frequency of delayed diagnosis. Because of the presence of instability, scaphoid reduction and osteosynthesis is necessary. Immobilization of the carpus and thumb is essential until bony consolidation is obtained.

Adult↗

Health and social context: social capital's utility as a construct for nursing and health promotion.

Social capital is a health-related construct that is a way for pediatric nurse practitioners (PNPs) to conceptualize the interconnectedness between health and social relations. Applying the concept of "social capital" to child and family health has the capacity to help PNPs reframe persistent questions and explore health issues in new and creative ways. A health-enabling environment must be built using a bottom-up approach, with participatory health promotion programs and internally driven community health projects. PNPs must create opportunities for networking and diffusing knowledge about community-related health issues. PNPs also must build their own social capital and practice "vision therapy" to develop new interventions to enhance child and family health.

Community Networks↗

Location, location, location: contextual and compositional health effects of social capital in British Columbia, Canada.

After decades of epidemiological exploration into individual-level risk factors for ill health, a recent surge of interest in the health effects of socially patterned attributes of geographically defined 'places' has given the structural side of the agency-structure debate new prominence in population health research. Utilizing two original data sets, one pertaining to features of communities in British Columbia, Canada and the other to characteristics of individuals living in them, this article distinguishes the health effects of socially patterned attributes of communities, including the social capital of communities, from the health effects of characteristics of residents that contribute to social capital, e.g., trust and participation in voluntary associations. Results from multilevel analysis demonstrated that, of three different individual-level measures of health and well-being (and including measures of long-term limiting illness and self-rated health), only a measure of depressive symptoms had variability that could be reasonably attributed to the level of the community. The social capital of communities in the form of the availability of public spaces explained some of this variability, but in the direction contrary to expectations. Overall, location (community of residence) did little to explicate health inequalities in this context. The strongest predictors of health in multivariate and multilevel models were characteristics of individual survey respondents, namely, income, trust in politicians and governments, and trust in other members of the community. Breadth of participation in networks of voluntary association was not significantly related to health in multivariate models.

Adult↗

Social capital and substance use among Swedish adolescents--an explorative study.

Cross-sectional survey data on Swedish adolescents aged 12-18 was used to estimate the link between individual social capital and smoking, illicit drug use and binge drinking. Major conclusions drawn were (1) that social capital, indicated by measures of social participation and trust, was negatively correlated with the probability of smoking and illicit drug use, but (2) that social capital showed no statistically significant correlation with the probability of binge drinking.

Adolescent↗