Why do Swedish-speaking Finns have longer active life? An area for social capital research

We performed ecological and individual register studies to compare disability-free life expectancies and disability pensions among Swedish-speaking and Finnish-speaking Finns residing on the western coast of Finland. The study was conducted to establish our assumption that the Swedish-speaking ethnic minority has a longer active life than the Finnish-speaking majority and to show that this disparity can be seen in a limited geographical area with similar socio-economic and health service structures. We suggest that the observed disparities in active life and in mortality depend on differences in the extent of social capital. A detailed characterization of the social capital and its impact on the health of the Swedish-speaking individuals is in progress.     

Individual-level relationships between social capital and self-rated health in a bilingual community

BACKGROUND. Previous register studies have shown that mortality rates and disability pension statistics favor Swedish-speakers when compared to their Finnish-speaking neighbors in the same bilingual region in Finland. The purpose of the present questionnaire survey was to determine whether the Swedish-speaking community has more social capital and if the social capital is associated with health at the individual level. METHODS. The study population consisted of randomly selected samples of Finnish-speakers (N 1,000, response rate 66%) and Swedish-speakers (N 1,000, response rate 63%) representing all adults living in bilingual Ostrobothnian municipalities (75,000 Finnish-speakers and 78,000 Swedish-speakers). To inquire into social capital and health indicators, a bilingual questionnaire was composed to cover variables and indicators of sociodemography, health status, health behavior, and social capital (interpersonal trust and civic engagement). Data were analyzed with multiple logistic regression for two binary outcome variables: language group (Finnish vs Swedish) and self-rated health (good vs almost good/fair/poor/bad). RESULTS. When health-related variables (urban residence, migration, age, BMI, household income, smoking, singing in a choir, membership in any voluntary association, participation in community events, and long-term diseases) were controlled for, the Finnish-speakers were more often migrated (P = 0.0001) and mistrusting (P = 0.0001) and less active in community events (P = 0.0016) and in singing in a choir (P = 0.02) than the Swedish-speakers. After controlling for language and the above-mentioned health-related variables, the number of auxiliary (willing to help) friends (P = 0.001), mistrust (P = 0.037), and membership in any religious association (P = 0.0096) were significantly and independently associated with good self-rated health in the whole sample. CONCLUSIONS. The Swedish-speaking community seems to hold a fair quantity of social capital, which is associated with good health. Since the ecological and socioeconomic circumstances are equal for both language communities, a great deal of health inequality can be explained by differences in social capital.     

Minority status and perceived health: a comparative study of Finnish- and Swedish-speaking schoolchildren in Finland

Results of earlier studies suggest that the health of the Swedish-speaking minority in Finland is better than that of the sociodemographically similar Finnish-speaking population. The causes of differences are unknown. The main aim of the study referred was to investigate whether differences in perceived health according to linguistic group were present in a nation-wide representative sample (n=5,230) of schoolchildren aged 11, 13 and 15 years. A further aim was to determine whether differences could be attributed to socioeconomic background, social relationships or health behaviour. The study is part of the international Health Behaviour in School-aged children (HBSC) survey. The perceived health of Swedish-speaking children (n=1,699) proved to be better than that of Finnish-speaking children (n=3,531). In multivariate logistic regression models the differences could not be attributed to underlying associations with any variable studied. The health advantage of Swedish-speaking children essentially could not be related to known risk factors.     

The health of Swedish-speaking and Finnish-speaking schoolchildren in Finland

BACKGROUND: It is well known that Swedish-speaking adults in Finland have higher life expectancy and better health than their Finnish-speaking counterparts. Among young people, similar comparisons have been scarce. The present paper aims to compare the health of Swedish-speaking and Finnish-speaking schoolchildren. METHODS: Survey data from 1997, representing children at grades 8 and 9 of compulsory school in a bilingual region, are analysed with the help of logistic regression models. Self-rated health as well as objective measures of health are explored. RESULTS: We find that Swedish-speaking schoolchildren are healthier than Finnish-speaking ones in terms of objective measures of health, whereas there is no difference between language groups in terms of self-assessed health. Self-rated health seems to reflect well-being in a very broad context rather than objective health from a medical perspective. Risk factors and health behaviours being equal, both language groups consequently assess their health in a similar manner. CONCLUSIONS: Policy makers should be careful when advocating the health needs of schoolchildren based on survey results concerned with self-assessed health measures, particularly when they are concerned with targeting measures towards specific subgroups of the population. Self-rated health is obviously not well suited for reflecting overall and specific needs of medical assistance and expertise for schoolchildren.     

A Multilevel Analysis of Key Forms of Community- and Individual-Level Social Capital as Predictors of Self-Rated Health in the United States

Communities may be rich or poor in a variety of stocks of social capital. Studies that have investigated relations among these forms and their simultaneous and combined health effects are sparse. Using data on a sample of 24,835 adults (more than half of whom resided in core urban areas) nested within 40 U.S. communities from the Social Capital Benchmark Survey, correlational and factor analyses were applied to determine appropriate groupings among eight key social capital indicators (social trust, informal social interactions, formal group involvement, religious group involvement, giving and volunteering, diversity of friendship networks, electoral political participation, and non-electoral political participation) at each of the community and individual levels. Multilevel logistic regression models were estimated to analyze the associations between the grouped social capital forms and individual self-rated health. Adjusting the three identified community-level social capital groupings/scales for one another and community- and individual-level sociodemographic and socioeconomic characteristics, each of the odds ratios of fair/poor health associated with living in a community one standard deviation higher in the respective social capital form was modestly below one. Being high on all three (vs. none of the) scales was significantly associated with 18% lower odds of fair/poor health (odds ratio = 0.82, 95% confidence interval = 0.69–0.98). Adding individual-level social capital variables to the model attenuated two of the three community-level social capital associations, with a few of the former characteristics appearing to be moderately significantly protective of health. We further observed several significant interactions between community-level social capital and one's proximity to core urban areas, individual-level race/ethnicity, gender, and social capital. Overall, our results suggest primarily beneficial yet modest health effects of key summary forms of community social capital, and heterogeneity in some of these effects by urban context and population subgroup.     

Social capital and social inequality in adolescents' health in 601 Flemish communities: a multilevel analysis

Although it is widely acknowledged that community social capital plays an important role in young people’s health, there is limited evidence on the effect of community social capital on the social gradient in child and adolescent health. Using data from the 2005–2006 Flemish (Belgium) Health Behavior among School-aged Children survey (601 communities, n = 10,915), this study investigated whether community social capital is an independent determinant of adolescents’ perceived health and well-being after taking account of individual compositional characteristics (e.g. the gender composition within a certain community). Multilevel statistical procedures were used to estimate neighborhood effects while controlling for individual level effects. Results show that individual level factors (such as family affluence and individual social capital) are positively related to perceived health and well-being and that community level social capital predicted health better than individual social capital. A significant complex interaction effect was found, such that the social gradient in perceived health and well-being (i.e. the slope of family affluence on health) was flattened in communities with a high level of community social capital. Furthermore it seems that socioeconomic status differences in perceived health and well-being substantially narrow in communities where a certain (average) level of community social capital is present. This should mean that individuals living in communities with a low level of community social capital especially benefit from an increase in community social capital. The paper substantiates the need to connect individual health to their meso socioeconomic context and this being intrinsically within a multilevel framework.     

Religious social capital: its measurement and utility in the study of the social determinants of health

As a social determinant of health, religiosity remains not well understood, despite the prevalence of religious activity and prominence of religious institutions in most societies. This paper introduces a working measure of Religious Social Capital and presents preliminary associations with neighborhood social capital and urban stressors. Religious social capital is defined as the social resources available to individuals and groups through their social connections with a religious community. Domains covered include group membership, social integration, values/norms, bonding/bridging trust as well as social support. Cross-sectional data come from a convenience sample of 104 community dwelling adults residing in a single urban neighborhood in a large US city, who also provided information on neighborhood social capital, and experiences of urban stressors. Results suggest that religious social capital is a valid construct that can be reliably measured. All indicators of religious social capital were higher among those who frequently attended religious services, with the exception of bridging trust (trust of people from different religious groups). A weak, inverse, association was also observed between religious and neighborhood social capital levels. Levels of religious social capital were correlated with higher levels of reported urban stressors, while neighborhood social capital was correlated with lower urban stressor levels. A significant percent of the sample was unaffiliated with a religious tradition and these individuals were more likely to be male, young and more highly educated. Social capital is a promising construct to help elucidate the influence of religion on population health.     

Building on leadership and social capital to create change in 2 urban communities

There has been an appeal to reduce health inequities by increasing community involvement and social capital. Poder es Salud/Power for Health is a community-based participatory prevention research project that seeks to address health disparities in the African American and Latino communities by enhancing community-level social capital. We provide specific examples of how this intervention uses community health workers and popular education to reduce language and cultural barriers and enhance community social capital. Although the communities share fundamental challenges related to health disparities, the ways in which the Latino and African American communities identify health concerns, create solutions, and think about social capital vary. Members of the project are working together to identify opportunities for cross-cultural collaboration.     

Effect of specific aspects of community social environment on the mortality of individuals diagnosed with serious illness

The purpose of this study was to examine the prospective and contextual effects of urban community environment on mortality among Medicare beneficiaries who were 67 years old or older in 1993, lived in the city of Chicago, and were hospitalized for one of 13 serious diseases. As expected, we found that advantageous socioeconomic context helps lower mortality risk among elderly patients over and above individual demographic and health background. We also found that collective efficacy was a health-enhancing social resource whereas criminal and violent activities in the community appeared to be deleterious. Inconsistent with our hypotheses, community social network density (measured by the size of social network and frequency of social interaction) was not protective but detrimental. Moreover, social support and the civic involvement of residents in the community do not seem to affect mortality. The complex relationship between community social environment and health found in this study may suggest that community-level social interventions based on social capital/social cohesion models are not likely to achieve fruitful results without concomitant effort in the economic and health care realm, at least in terms of influences on the health of older people once they are already ill.     

Place-specific constructs of social capital and their possible associations to health: a Japanese case study

The story of Roseto, Pennsylvania, USA, is one of the most widely cited studies of the putative influence of community social cohesion on population health. However, few contemporary studies of community-based "social capital" on health have addressed "communities" as unique places with unique histories outside of a Western context. In the present study, we focus on a specific region of Japan (which we call the M-region to preserve anonymity). Using survey data and qualitative interviews, we discuss the historical and contextual origins of the high social capital in the M-region that could account for its relatively good health profile. The analysis of survey data suggested that the residents of M-region have higher norms of reciprocity and participate more in horizontal organizations (including volunteer group, citizen or consumer group, sports group or club, and hobby group), and it also indicated better health status and behaviors in some outcomes among the residents of M-region. Based on qualitative interviews, the origins of social capital in the M-region appeared to be rooted in the strong sense of solidarity fostered by the fact that many of the residents were recruited into the region by the same local employer (a steel manufacturing company). Our study points to the need to ground studies of community-based "social capital" and health on detailed knowledge of the historical context of specific places.     

Individual-level analysis of social capital and health: a comparison of Arab and Jewish Israelis

Discrepancies exist in existing research regarding the association between social capital and self-rated health, most of which has been undertaken in the developed world. The aim of this study is first to assess the levels of the various variables describing individual social capital in Jews and Arab residing in Israel, and second to assess the association between individual social capital and self-rated health in these two population groups. The data were obtained from an Israeli health interview survey (knowledge, attitudes and practices (KAP)) conducted during 2004-2005, which is based on 3,365 interviews with adult Jews and 985 adult Arabs. Social capital measures included social trust, neighborhood safety, perceived helpfulness, trust in local and national authorities and social support. Data were also obtained on self-rated health and socioeconomic and demographic variables. Multivariate logistic regression revealed that Jews reported higher levels of social trust, perceived helpfulness, trust in authorities, and social support compared to Arabs, after adjusting for demographic and socioeconomic variables. Social contacts, however, were reported more frequently in the Arab population. Neighborhood safety was similar in the two population groups. Among Jews, those reporting higher levels of individual social capital reported better self-rated health after adjusting for demographic and socioeconomic variables. Among Arabs, only those reporting higher levels of social support reported better self-rated health. In Israel, individual levels of social capital seem to be lower in the Arab minority than in the Jewish majority. Individual social capital was associated with better self-rated health mainly in the Jewish population and less so in the Arab population. Social capital factors may be associated with health to a higher extent in affluent populations with relatively high social capital and less so in low social capital and more traditional communities. More research is needed to verify these differences.     

Racial and Ethnic Disparities in Personal Capital During Pregnancy: Findings from the 2007 Los Angeles Mommy and Baby (LAMB) Study

The objectives of this study were to determine if racial and ethnic differences in personal capital during pregnancy exist and to estimate the extent to which any identified racial and ethnic differences in personal capital are related to differences in maternal sociodemographic and acculturation characteristics. Data are from the 2007 Los Angeles Mommy and Baby study (n = 3,716). Personal capital comprised internal resources (self-esteem and mastery) and social resources (partner, social network, and neighborhood support) during pregnancy. The relationships between race/ethnicity and personal capital were assessed using multivariable generalized linear models, examining the impact of sociodemographic and acculturation factors on these relationships. Significant racial and ethnic disparities in personal capital during pregnancy exist. However, socioeconomic status (i.e., income and education) and marital status completely explained Black-White disparities and Hispanic-White disparities in personal capital, whereas acculturation factors, especially nativity and language spoken at home, partially mediated the disparities in personal capital between Asian/Pacific Islander women and White women. Findings suggest that the risks associated with low socioeconomic status, single motherhood, and low acculturation, rather than race or ethnicity, contribute to low personal capital for many pregnant women. As personal capital during pregnancy may influence subsequent maternal and child health outcomes, the development of interventions should consider addressing sociodemographic and acculturation factors in order to reduce racial and ethnic disparities in personal capital and ultimately in poor maternal and child health outcomes.     

Network social capital, social participation, and physical inactivity in an urban adult population

Research on individual social capital and physical activity has tended to focus on the association among physical activity, generalized trust, and social participation. Less is known about the association between network social capital, i.e., the resources accessed through one's social connections, and physical inactivity. Using formal network measures of social capital, this study examined which specific dimension of network capital (i.e. diversity, reach and range) was associated with physical inactivity, and whether network social capital mediated the association between physical inactivity and social participation. Data came from the 2008 Montreal (Canada) Neighbourhood Networks and Healthy Aging survey, in which 2707 adults 25 years and older in 300 Montreal neighbourhoods were surveyed. Physical activity was self-reported using the International Physical Activity Questionnaire (IPAQ). IPAQ guidelines provided the basis for the physical inactivity cutoff. Network social capital was measured with a position generator instrument. Multilevel logistic methods were used to examine the association between physical inactivity and individual social capital dimensions, while adjusting for socio-demographic and -economic factors. Higher network diversity was associated with a decreased likelihood of physical inactivity. Consistent with previous findings, individuals who did not participate in any formal associations were more likely to be physically inactive compared to those with high levels of participation. Network diversity mediated the association between physical inactivity and participation. Generalized trust and the network components of reach and range were not shown associated with physical inactivity. Findings highlight the importance of social participation and network social capital and the added value of network measures in the study of social capital and physical inactivity. Population-based programs targeting physical inactivity among adults might consider ecological-level interventions that leverage associational involvement and interpersonal relationships to improve population-level physical activity.     

Social capital and collective efficacy in Hungary: cross sectional associations with middle aged female and male mortality rates

OBJECTIVES: Social capital, collective efficacy, and religious involvement have each been linked to population health. This study examined the relations between these measures and male/female mortality rates in Hungary. DESIGN: Cross sectional, ecological study. SETTING: 150 sub-regions of Hungary. PARTICIPANTS AND METHODS: 12643 people were interviewed in 2002 (the "Hungarostudy 2002" survey). Social capital was measured by lack of social trust, reciprocity between citizens, and membership in civil organisations. Collective efficacy was measured by survey items from the Project on Human Development in Chicago Neighborhoods. Religious involvement was measured by church attendance. MAIN OUTCOME MEASURE: Gender specific all cause mortality rates for the middle aged population (45-64 years) in the 150 sub-regions of Hungary, provided by the Central Statistical Office (CSO). RESULTS: Social capital, collective efficacy, as well as religious involvement were each significantly associated with middle age mortality. After education, collective efficacy showed the strongest association with mortality in both men and women. Among men, socioeconomic status, collective efficacy, social distrust, competitive attitude, reciprocity, and membership of civic organisations explained 68.0% of the sub-regional variations in mortality rates. Among women the same variables explained only 29.3% of the variance in mortality rates. Religious involvement was protective among women. CONCLUSION: Collective efficacy and social capital are significant predictors of mortality rates in both men and women across sub-regions of Hungary. Gender differences in the relative importance of social factors may help to explain the differential impact of economic transformation on mortality rates for men and women in Central-Eastern European countries.     

Social capital and self-rated health in Colombia: the good, the bad and the ugly

Although there is increasing evidence supporting the associations between social capital and health, less is known of potential effects in Latin American countries. Our objective was to examine associations of different components of social capital with self-rated health in Colombia. The study had a cross-sectional design, using data of a survey applied to a nationally representative sample of 3025 respondents, conducted in 2004-2005. Stratified random sampling was performed, based on town size, urban/rural origin, age, and sex. Examined indicators of social capital were interpersonal trust, reciprocity, associational membership, non-electoral political participation, civic activities and volunteering. Principal components analysis including different indicators of social capital distinguished three components: structural-formal (associational membership and non-electoral political participation), structural-informal (civic activities and volunteering) and cognitive (interpersonal trust and reciprocity). Multilevel analyses showed no significant variations of self-rated health at the regional level. After adjusting for sociodemographic covariates, interpersonal trust was statistically significantly associated with lower odds of poor/fair health, as well as the cognitive social capital component. Members of farmers/agricultural or gender-related groups had higher odds of poor/fair health, respectively. Excluding these groups, however, associational membership was associated with lower odds of poor/fair health. Likewise, in Colombians with educational attainment higher than high school, reciprocity was associated with lower odds of fair/poor health. Nevertheless, among rural respondents non-electoral political participation was associated with worse health. In conclusion, cognitive social capital and associational membership were related to better health, and could represent important notions for health promotion. Human rights violations related to political violence and gender based discrimination may explain adverse associations with health.     

Is social capital the key to inequalities in health?

There has been vigorous debate between the "social capital" and "neomaterialist" interpretations of the epidemiological evidence regarding socioeconomic determinants of health. We argue that levels of income inequality, social capital, and health in a community may all be consequences of more macrolevel social and economic processes that influence health across the life course. We discuss the many reasons for the prominence of social capital theory, and the potential drawbacks to making social capital a major focus of social policy. Intervening in communities to increase their levels of social capital may be ineffective, create resentment, and overload community resources, and to take such an approach may be to "blame the victim" at the community level while ignoring the health effects of macrolevel social and economic policies.     

Bonding versus bridging social capital and their associations with self rated health: a multilevel analysis of 40 US communities

STUDY OBJECTIVE: Few studies have distinguished between the effects of different forms of social capital on health. This study distinguished between the health effects of summary measures tapping into the constructs of community bonding and community bridging social capital. DESIGN: A multilevel logistic regression analysis of community bonding and community bridging social capital in relation to individual self rated fair/poor health. SETTING: 40 US communities. PARTICIPANTS: Within community samples of adults (n = 24 835), surveyed by telephone in 2000-2001. MAIN RESULTS: Adjusting for community sociodemographic and socioeconomic composition and community level income and age, the odds ratio of reporting fair or poor health was lower for each 1-standard deviation (SD) higher community bonding social capital (OR = 0.86; 95% = 0.80 to 0.92) and each 1-SD higher community bridging social capital (OR = 0.95; 95% CI = 0.88 to 1.02). The addition of indicators for individual level bonding and bridging social capital and social trust slightly attenuated the associations for community bonding social capital (OR = 0.90, 95% CI = 0.84 to 0.97) and community bridging social capital (OR = 0.96, 95% CI = 0.89 to 1.03). Individual level high formal bonding social capital, trust in members of one's race/ethnicity, and generalised social trust were each significantly and inversely related to fair/poor health. Furthermore, significant cross level interactions of community social capital with individual race/ethnicity were seen, including weaker inverse associations between community bonding social capital and fair/poor health among black persons compared with white persons. CONCLUSIONS: These results suggest modest protective effects of community bonding and community bridging social capital on health. Interventions and policies that leverage community bonding and bridging social capital might serve as means of population health improvement.     

Social capital and young adolescents' perceived health in different sociocultural settings

We conducted a cross-national study to examine the association between neighbourhood socioeconomic deprivation, social capital and child health in two countries and multiple ethnic groups. For our analysis we used data from (1) the Project on Human Development in Chicago Neighborhoods (PHDCN), USA and (2) the Maastricht Quality of Life study (MQoL), the Netherlands. Both the PHDCN and the MQoL collected data on objective neighbourhood socioeconomic deprivation, subjective neighbourhood social capital (i.e. informal social control, ISC, social cohesion and trust, SC&T), and children's perceived health. For the present analyses, 11- and 12-year olds were selected. Multilevel analyses were conducted using both neighbourhood level and individual-level data. Lower socioeconomic deprivation scores and higher levels of ISC as well as SC&T were associated with higher levels of children's perceived health, in both Maastricht and the Chicago Hispanic subsample, but not in the Chicago non-Hispanic samples. The results suggest that associations between the wider social environment and health outcomes vary across different populations and cross-national contexts.     

Spatial path models with multiple indicators and multiple causes: mental health in US counties

This paper considers a structural model for the impact on area mental health outcomes (poor mental health, suicide) of spatially structured latent constructs: deprivation, social capital, social fragmentation and rurality. These constructs are measured by multiple observed effect indicators, with the constructs allowed to be correlated both between and within areas. However, in the scheme developed here, particular latent constructs may also be influenced by known variables, or, via path sequences, by other constructs, possibly nonlinearly. For example, area social capital may be measured by effect indicators (e.g. associational density, charitable activity), but influenced as causes by other constructs (e.g. area deprivation), and by observed features of the socio-ethnic structure of areas. A model incorporating these features is applied to suicide mortality and the prevalence of poor mental health in 3141 US counties, which are related to the latent spatial constructs and to observed variables (e.g. county ethnic mix).