Social capital and the miniaturization of community among daily and intermittent smokers: a population-based study

BACKGROUND: The impact of social participation, trust, and the miniaturization of community on daily and intermittent smoking was investigated. METHODS: The 2000 public health survey in Scania is a cross-sectional study. A total of 13,715 persons answered a postal questionnaire, which represents 59% of the random sample. A logistic regression model was used to investigate the association between the social capital variables and daily and intermittent smoking. The multivariate analysis was performed by using a logistic regression model to investigate the importance of possible confounders (age, country of origin, education, and snuff consumption) on the differences in daily and intermittent smoking between high versus low social participation, trust, and their four combination categories. The differences in the prevalences of the 13 social participation subitems between the high social capital and miniaturization of community categories were compared by t tests. RESULTS: Daily smoking is negatively associated with both social participation and trust, while intermittent smoking is positively associated with social participation and negatively associated with trust. This latter combination, named "the miniaturization of community," is an indirect measure of the ideologically and culturally increasingly narrow forms of social participation that excludes generalised trust to other people. Study circles, meetings of organisations, theatre/cinema, arts exhibition, and gathering of relatives are more prevalent in the high social capital category, while visit(s) to night club/entertainment is more prevalent in the miniaturization of community category. CONCLUSIONS: Low social capital is associated with daily smoking. "The miniaturization of community," i.e., high social participation and low trust, is significantly associated with intermittent smoking. The results have direct implications for smoking prevention strategies.     

Social capital, the miniaturization of community and cannabis smoking among young adults

OBJECTIVES: The impact of social participation, trust and the miniaturization of community, i.e. the combination of high social participation and low trust, on cannabis smoking was investigated. METHODS: The 2000 public health survey in Scania is a cross-sectional study. A total of 13,715 persons aged 18-80 years, of which 3,978 persons aged 18-34 years were included in this study, answered a postal questionnaire, which represents 59% of the random sample. A logistic regression model was used to investigate the association between the social capital variables and ever having experienced cannabis smoking. The multivariate analysis was performed to investigate the importance of possible confounders (age, country of origin and education) on the differences in having experienced cannabis smoking according to social participation, trust and their four combination categories. RESULTS: Cannabis smoking is not associated with social participation, but positively associated with low trust among both men and women, and the miniaturization of community, i.e. the combination of high social participation and low trust, among men. CONCLUSIONS: This study suggests that the miniaturization of community, i.e. the combination of high social participation and low levels of generalized trust of other people, may enhance the experience of cannabis smoking.     

Heavy alcohol consumption and associated factors: a population-based study

OBJECTIVE: To determine the prevalence of heavy alcohol consumption and factors associated with it in a Brazilian adult population. METHODS: Cross-sectional population-based study including 2,177 adults (aged 20 to 69), living in the urban area of the municipality of Pelotas, Rio Grande do Sul State, Brazil. The sample was selected in multiple stages. Heavy alcohol consumption was defined as above 30g/day. The adjusted analysis was conducted by logistic regression. RESULTS: The prevalence of heavy alcohol consumption was 14.3% (29.2% among men and 3.7% among women). The following groups presented higher prevalences of heavy alcohol consumption after adjusted analysis: men, elderly people, blacks or mulattoes, heavy smokers, and people who present some kind of chronic disease. Men with minor psychiatric disorders showed higher prevalences of heavy alcohol consumption than other men. Among women, association between age and heavy alcohol consumption was inversely related. Furthermore, the study indicates that among hypertensive subjects, those with heavy alcohol consumption presented worse disease management. CONCLUSIONS: Heavy alcohol consumption is high and results in countless negative consequences for the individual's health and quality of life. Our results highlight the high prevalence of heavy alcohol consumption and indicate subsections of the whole population more susceptible to alcoholism.     

Social capital, the miniaturisation of community and consumption of homemade liquor and smuggled liquor during the past year. A population-based study

BACKGROUND: To study the impact of social participation, trust and the miniaturisation of community, i.e. high social participation/low trust, on consumption of homemade liquor and smuggled liquor during the past year. METHODS: The Scania 2000 public health survey is a cross-sectional, postal questionnaire study. A total of 13,604 persons aged 18-80 years were included. A logistic regression model was used to investigate the association between the social capital variables and illegal alcohol consumption. The multivariate analyses analysed the importance of confounders (age, country of origin, education and economic stress) on the differences in consumption of homemade and smuggled liquor according to the social capital variables. RESULTS: A 28.2% proportion of all men and 14.9% of all women had consumed homemade liquor during the past year. The proportions who had consumed smuggled liquor during the past year were even higher, 40.1% among men and 21.4% among women. Both forms of illegal alcohol consumption were significantly positively associated with social participation and negatively associated with trust. The miniaturisation of community category, i.e. high social participation/low trust, had significantly higher risks of consumption during the past year of the consumption of both forms of illegally provided alcohol compared to the high social capital (high social participation/high trust) category, while the low social participation/high trust category had significantly lower risks. CONCLUSION: High social participation combined with low trust is positively associated with consumption of illegally provided alcohol. The results have implications for alcohol prevention programs, because structural/social factors that may hinder information and norms concerning illegal alcohol have been identified in this study.     

Social capital, anticipated ethnic discrimination and self-reported psychological health: a population-based study

This study investigates the association between anticipated ethnic discrimination and self-reported psychological health, taking generalized trust in other people into consideration. The 2004 Public Health Survey in Skåne, Sweden, is a cross-sectional postal questionnaire study including a total of 27,757 respondents aged 18–80 with a 59% response rate. Multivariate analyses of anticipated discrimination and self-reported psychological health were performed using logistic regressions in order to investigate the importance of possible confounders (age, country of origin, education and horizontal trust). Poor psychological health was reported by 13.0% of men and 18.9% of women, and 44.8% and 44.7%, respectively, reported that 50% or more of employers would discriminate according to race, colour of skin, religion, or cultural background. Respondents in younger age groups, born abroad, with high education, low trust and high levels of self-reported anticipated discrimination, had significantly higher levels of poor self-reported psychological health. There was a significant association between anticipated discrimination and low horizontal trust. After multiple adjustments for age, country of origin and education, the addition of trust in the model reduced the odds ratio of poor self-reported psychological health in the “most employers” category from 1.8 (1.4–2.1) to 1.5 (1.3–1.9) among men and from 2.2 (1.8–2.6) to 1.8 (1.5–2.2) among women. Generalized trust in other people may be a confounder of the association between anticipated discrimination and poor psychological health. Anticipated discrimination may have effects on the mental health of not only the affected minorities, but also on the mental health of the general population.     

Relationship of alcohol consumption to diet: a population-based study in Hawaii

The relationship of alcohol use to diet was examined in 2272 male and 2337 female adults aged 45 y and older who provided a quantitative diet history during 1977-1979. Mean values for each dietary variable, adjusted for smoking, ethnicity, income, and education, were compared in each sex between abstainers and drinkers and by tertile of ethanol intake. Linear relationships with extent of drinking were also sought. Drinkers were found to be less obese than abstainers. Consumption of carbohydrate, vitamins, calcium, fruits, fruit juices, and raw vegetables was greater among abstainers whereas consumption of fat (particularly polyunsaturated fatty acids), cholesterol, zinc, meat, pickled vegetables, and dried fish was greater among drinkers. Because validations of dietary questionnaires have shown that alcohol consumption is more accurately recalled than food intake, the possibility of a residual confounding effect for these dietary variables should be considered in epidemiologic studies of alcohol and health.     

Social capital and health and well-being in East Asia: a population-based study

How individual-level social capital relates to adult health and well-being was examined using data from a cross-sectional interview survey in East Asia (Japan, South Korea, Singapore, five areas in Mainland China, and Taiwan) in 2002-2004. The number of self-reported somatic symptoms, subjective health satisfaction, life satisfaction and social capital indicators, as well as socio-economic status (SES), were analyzed by a logistic regression model. Adjusting for SES, social capital measured by belonging to organizations and weakness in "norms of reciprocity" were related to a greater number of self-reported somatic symptoms (p<0.001 for both). Lack of trust in organizations (p<0.001) and of a person to consult (p=0.012) were related to poor health satisfaction. Lower "interpersonal trust" (p=0.016), weakness in "norms of reciprocity" (p<0.001) and lack of trust in organizations (p<0.001) were related to poor life satisfaction. Gender inequality was observed across countries, but the relationships varied according to the health indicator. Specifically, self-reported somatic symptoms were more numerous and health satisfaction was worse in women (p<0.001), but life satisfaction was worse in men (p=0.017). The analyses provide evidence that dimensions of social capital are positively associated with self-reported somatic symptoms and overall well-being in East Asian countries.     

Social capital, political trust and self rated-health: a population-based study in southern Sweden

AIM: To investigate the association between political trust (an aspect of institutional trust) and self-rated health, taking generalized (horizontal) trust in other people into account. METHODS: The 2004 public health survey in Sk?ne is a cross-sectional postal questionnaire study answered by 27,963 respondents aged 18-80 years, yielding a 59% response rate. A logistic regression model was used to investigate the associations between political trust in the Riksdag (national parliament) and self-rated health. Multivariate analyses of political trust and self-rated health were performed in order to investigate the importance of possible confounders. RESULTS: Poor health was reported by 28.7% of the men and 33.2% of the women. In total, 17.3% and 11.6% of the male and female respondents, respectively, reported that they had no trust at all in the Riksdag. The addition of generalized (horizontal) trust in the multivariate models reduced the odds ratios of poor self-rated health in the "no political trust at all' category as compared to the "very high political trust' category from 2.4 (1.8-3.1) to 2.1 (1.6-2.7) among men and from 1.9 (1.4-2.4) to 1.6 (1.3-2.1) among women. CONCLUSIONS: Low political trust in the Riksdag seems to be significantly associated with poor self-rated health, even after adjustments for plausible confounders, including generalized (horizontal) trust.     

Social capital,political trust and self-reported psychological health: A population-based study

This study investigates the association between political trust (an aspect of institutional trust) in the Riksdag (the national parliament in Sweden) and self-reported psychological health, taking generalized (horizontal) trust in other people into account. The 2004 public health survey in Skåne in Southern Sweden is a cross-sectional postal questionnaire study that was answered by 27,757 respondents aged 18–80 yielding a 59% response rate. A logistic regression model was used to investigate the associations between political trust and self-reported psychological health adjusting for possible confounders (age, country of origin, education, economic stress and generalized trust in other people i.e. horizontal trust). We found that 13.0% of the men and 18.9% of the women reported poor psychological health. A total of 17.3% and 11.6% of the male and female respondents, respectively, reported that they had no trust at all in the national parliament, and another 38.2% and 36.2%, respectively, reported that their political trust was not particularly high. Respondents in younger age groups, born abroad, with high education, high levels of economic stress, low horizontal trust and low political trust had significantly higher levels of self-reported poor psychological health. There was a significant association between low political trust and low horizontal trust. After adjustments for age, country of origin, education and economic stress, the inclusion of horizontal trust reduced the odds ratios of self-reported poor psychological health in the “no political trust at all” category compared to the “very high political trust” category from 1.6 to 1.4 among men and from 1.7 to 1.4 among women. It is concluded that low political trust in the Riksdag seems to be significantly and positively associated with poor mental health.     

Social capital, political trust and experience of cannabis smoking: a population-based study in southern Sweden

OBJECTIVE: To investigate whether political mistrust in the Riksdag (the national parliament in Sweden) is an independent characteristic of cannabis smokers, or whether it reflects low confidence in people in general, and therefore low social capital. METHOD: The 2004 public health survey in Sk?ne is a cross-sectional postal questionnaire study answered by 27,757 respondents aged 18-80 with a 59% response rate providing data on political trust, cannabis smoking, and potential confounders. RESULTS: 13.9% of the men and 8.3% of the women had smoked cannabis; 17.3% of the male and 11.6% of the female respondents reported no trust at all in the Riksdag, and another 38.2% and 36.2%, respectively, reported a moderate political trust. Young age, high education, unemployment, low generalized trust in other people, and lower levels of political trust were associated with cannabis smoking, even after multiple adjustments. The groups men with no trust at all in the Riksdag, and women with high trust, not particularly high political trust and no political trust at all had significantly higher odds ratios of cannabis smoking than the very high trust reference category. The results thus somewhat differed between men and women. CONCLUSION: Low political trust is associated with cannabis smoking, independently of trust in people in general.     

Social capital, political trust and purchase of illegal liquor: a population-based study in southern Sweden

AimsTo investigate the association between political trust in the Riksdag (the national parliament in Sweden) and having purchased illegal liquor during the past 12 months.MethodsThe 2004 public health survey in Skåne is a cross-sectional postal questionnaire study answered by 27,757 respondents aged 18–80 with a 59% response rate. A logistic regression model was used to investigate the associations between political trust and having purchased illegal liquor during the past 12 months. Multivariate analyses of political trust and having purchased illegal liquor were performed in order to investigate the importance of possible confounders (including generalized/horizontal trust in other people).ResultsA 21.2% fraction of the men and 9.6% of the women had purchased illegal alcohol during the past 12 months. A total of 17.3% and 11.6% of the male and female respondents, respectively, reported that they had no trust at all in the national parliament, and another 38.2% and 36.2%, respectively, reported that their political trust was not particularly high. Respondents in younger age groups, with medium/low education, economic stress, low horizontal trust and not particularly high and no political trust at all and no opinion had significantly higher levels of having purchased illegal liquor. The significant odds ratios of having purchased illegal liquor in the not particularly high political trust and no political trust at all categories were somewhat reduced although still significant after multiple adjustments.ConclusionThe results suggest that political trust may have an independent effect on the propensity to purchase illegal liquor in Sweden.     

First-trimester maternal alcohol consumption and the risk of infant oral clefts in Norway: a population-based case-control study

Although alcohol is a recognized teratogen, evidence is limited on alcohol intake and oral cleft risk. The authors examined the association between maternal alcohol consumption and oral clefts in a national, population-based case-control study of infants born in 1996-2001 in Norway. Participants were 377 infants with cleft lip with or without cleft palate, 196 with cleft palate only, and 763 controls. Mothers reported first-trimester alcohol consumption in self-administered questionnaires completed within a few months after delivery. Logistic regression was used to calculate odds ratios and 95% confidence intervals, adjusting for confounders. Compared with nondrinkers, women who reported binge-level drinking (>or=5 drinks per sitting) were more likely to have an infant with cleft lip with or without cleft palate (odds ratio = 2.2, 95% confidence interval: 1.1, 4.2) and cleft palate only (odds ratio = 2.6, 95% confidence interval: 1.2, 5.6). Odds ratios were higher among women who binged on three or more occasions: odds ratio = 3.2 for cleft lip with or without cleft palate (95% confidence interval: 1.0, 10.2) and odds ratio = 3.0 for cleft palate only (95% confidence interval: 0.7, 13.0). Maternal binge-level drinking may increase the risk of infant clefts.     

Social capital and the neighborhood alcohol environment

We examine whether neighborhood alcohol outlet density is associated with reduced social capital and whether this relationship is mediated by perceived neighborhood safety. Hierarchical models from a random sample of Los Angeles, CA, and Louisiana residents (N=2,881) from 217 census tracts were utilized. Substantial proportions of the variance in collective efficacy (intraclass correlation coefficient, ICC=16.3%) and organizational participation (ICC=13.8%, median odds ratio=1.99) were attributable to differences between neighborhoods-suggesting that these factors may be influenced by neighborhood-level characteristics. Neighborhood alcohol outlet density was strongly associated with reduced indicators of social capital, and the relationship between collective efficacy and outlet density appears to be mediated by perceived neighborhood safety. Findings support the concept that off-premise alcohol outlets in the neighborhood environment may hinder the development of social capital, possibly through decreased positive social network expansion.     

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 Sk?ne, 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.     

A community case-control study of alcohol consumption in stroke

This study examines the hypothesis that there may be a clinically important association between alcohol intake and stroke. Alcohol consumption and the haematological and biochemical markers of alcohol intake were studied in hospital admissions for stroke and compared with community based control subjects from an occupational screening survey. In males, moderate to heavy alcohol consumption (greater than 30 units per week) was associated with an increased relative risk of stroke. Light drinking (less than 30 units per week) was associated with reduced relative risk when compared to teetotallers. The relative risk of stroke in moderate and heavy consumers of alcohol compared with teetotallers was elevated 1.8 times. Similar patterns of risk were present for increasing levels of aspartate transaminase and uric acid. Relative risk was increased for all levels of gamma-glutamyl transferase above the lowest. There was a decrease in relative risk associated with increasing levels of mean erythrocyte cell volume though this did not achieve statistical significance. There were few heavy drinkers among the female cases or controls. We conclude that high alcohol intake may be a significant preventable risk factor particularly among male strokes.     

Social roles and alcohol consumption: A study of 10 industrialised countries

The empirical evidence as regards the precise associations between alcohol use and social roles, and these associations across genders and cultures is heterogeneous. The literature tends to focus on two central but conflicting theories. The first – classic role theory – assumes that a higher number of social roles is associated with a more structured life and thus fewer opportunities to drink heavily. The second – the multiple burden hypothesis – posits that the increasing complexity of multiple social roles leads to higher stress levels, and thus to increased alcohol use. Survey data on 25–54-year olds in 10 western industrialised countries which participate in the Gender, Alcohol and Culture: An International Study (GenACIS) project were used to test whether holding the three main social roles – partnership, parenthood, and paid labour – had a more protective or a more detrimental association with problematic alcohol use than holding fewer roles. Age and education were included as possible confounders, while the outcome variables were risky single occasion drinking (RSOD) and heavy-volume drinking. For both men and women and in almost all countries, the study found that those who had all three roles were least likely to drink heavily or engage in RSOD, thus supporting the assumptions of classic role theory. It also found that the protective effect of multiple roles was more consistent for RSOD. There were a few countries where a two-role model gave a better fit. Results for Germany (RSOD), Switzerland, and the Unites States (heavy-volume drinking) indicate that the role of paid labour appears to be particularly relevant for risky alcohol use among women. Despite some variability in the association between paid labour and heavy drinking or RSOD among women, in almost all countries the greater the number of roles a person held, the lower their risk of this type of alcohol use was.     

Social capital, community size and utilization of health services: a lagged analysis

Objectives

We examine the relationship between social capital, community size and GP visits, and conceptualize social capital as a stock variable measured at a prior point in time.

Methods

Data from the 2002 Canadian Community Health Survey and the 2001 Canadian Census are merged with GP visit data from the Ontario Health Ministry. Negative binomial regression is used to measure the impact of community-level (CSC) and individual-level social capital (ISC) on GP visits. CSC is measured with the Petris Index using employment levels in religious and community-based organizations, and ISC is measured along multiple dimensions.

Results

The effect of social capital varies by community size. A one standard deviation increase in the Petris Index in larger communities (population > 100,000) leads to a 2.6% decrease in GP visits with an annual offset in public spending of $66.4M. Tangible social support—a measure of ISC—also exhibited large effects on GP visits. In smaller communities (population 10,000-100,000), only increased ISC exhibited an impact on GP visits. Age had no effect on the association between social capital and GP visits.

Conclusions

Each form of social capital likely operates through different mechanisms and impact differs by community size. Stronger CSC likely obviates some physician visits in larger communities that involve counseling/caring services while some forms of ISC may act similarly in smaller communities.