Adolescent risk taking, neighborhood social capital, and health

PURPOSE: To assess the roles of a neighborhood measure of social capital, family affluence, and risk taking on adolescent self-rated health. METHODS: This study uses data from the 2384 Canadian students in Grades 9-10 (56.5% female) from the World Health Organization's Health Behavior in School-Aged Children Survey 2001/2002, a nationwide representative sample. RESULTS: Using binary logistic regression models, it is found that higher levels of risk taking and lower levels of neighborhood social capital and family affluence are independently associated with worse overall perceptions of health. These influences are not found to interact with each other. CONCLUSIONS: Neighborhood social capital, risk taking, and family affluence are important factors to consider when addressing the health of adolescents. Results are discussed in terms of possible health promoting interventions.     

Social capital,collective efficacy and the provision of social support services and amenities by municipalities in the Netherlands

Differential provision of local services and amenities has been proposed as a mechanism behind the relationship between social capital and health. The aim of this study was to investigate whether social capital and collective efficacy are related to the provision of social support services and amenities in Dutch municipalities, against a background of decentralisation of long‐term care to municipalities. We used data on neighbourhood social capital, collective efficacy (the extent to which people are willing to work for the common good), and the provision of services and amenities in 2012. We included the services municipalities provide to support informal caregivers (e.g. respite care), individual services and support (e.g. domiciliary help), and general and collective services and amenities (e.g. lending point for wheelchairs). Data for social capital were collected between May 2011 and September 2012. Social capital was measured by focusing on contacts between neighbours. A social capital measure was estimated for 414 municipalities with ecometric measurements. A measure of collective efficacy was constructed based on information about the experienced responsibility for the liveability of the neighbourhood by residents in 2012, average charity collection returns in municipalities in 2012, voter turnout at the municipal elections in 2010 and the percentage of blood donors in 2012. We conducted Poisson regression and negative binomial regression to test our hypotheses. We found no relationship between social capital and the provision of services and amenities in municipalities. We found an interaction effect (coefficient = 3.11, 95% CI = 0.72–5.51, P = 0.011) of social capital and collective efficacy on the provision of support services for informal caregivers in rural municipalities. To gain more insight in the relationship between social capital and health, it will be important to study the relationship between social capital and differential provision of services and amenities more extensively and in different contexts.     

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.     

Neighborhood social capital and individual health

Neighborhood social capital is increasingly considered to be an important determinant of an individual's health. Using data from the Netherlands we investigate the influence of neighborhood social capital on an individual's self-reported health, while accounting for other conditions of health on both the level of the neighborhood and the individual. We use national representative data ('The Housing and Living Survey', 2006) on the Netherlands with 61,235 respondents in 3273 neighborhoods. The cross-sectional data were combined with information provided by Statistics Netherlands on neighborhoods, i.e., the percentage of residents in the highest income quintile per neighborhood and the municipality's degree of urbanity. The association of neighborhood social capital with individual health was assessed by multilevel logistic regression analysis. Our results show that neighborhood social capital is positively associated with health. Interestingly, residents in urban neighborhoods benefit particularly from their neighborhood social capital.     

Mental health and social capital in Cali, Colombia

Mental ill health forms an increasingly significant part of the burden of disease in developing countries. The growing interest in social risk factors for mental health coincides with the development of social capital research which may further inform the social model of mental health. The objective of the study reported here was to discover if there is an independent association between social capital and mental health when taking into account an array of demographic and violence variables. A total of 1168 youth (15-25 years) in a low income community in Cali, Colombia were surveyed. Mental health was measured by a 20 item self-report questionnaire. The instrument used to measure social capital covered structural and cognitive social capital. Twenty-four per cent of the sample were probable cases of mental ill health. Females had a prevalence rate three times higher than males. Using a model which considered demographic and social capital measures as potential risk factors for mental ill health, the significant risk factors emerged as being female, having limited schooling, working in the informal sector, being a migrant, and having low trust in people. The 'classic' poverty type variables (poor education and employment) were more important than social capital, as was the commonly dominant risk factor for mental ill health-being a woman. When violence factors were added to the model, the 'trust' factor fell out and the most important risk factors became (in descending order of importance): being female; no schooling/incomplete primary; and being a victim of violence. The dominance of poverty related factors, as opposed to social capital, prompts renewed attention to the explanatory mechanisms that link income inequality and poor mental health.     

Making sense of social capital, health and policy

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

Reorienting health and social services

The global HIV/AIDS epidemic poses the particular challenge of how to concentrate resources and bring about results without provoking stigmatization against those groups who are highly vulnerable. AIDS-based discrimination is increasing around the world and is manifested in the unwillingness to fund programs claiming that the victims are at fault. This means that sexually transmitted diseases (STDs) and AIDS programs are responsible for promoting nondiscriminatory approaches. STD treatment programs generally provide pre- and post-test counseling, but broader antistigmatization efforts have been carried out by AIDS service organizations and nongovernmental organizations. A well-developed response to HIV/AIDS and STDs involves service and program providers, community health workers, traditional health practitioners, general and private practitioners, pharmacists, traditional birth attendants, and social workers. Outreach staff need to link with community workers and volunteers close to the client groups. HIV/STD diagnosis and treatment programs need to be coupled also with intensive community-led prevention and support activities in order to influence sexual behaviors. Programs conducted in this spirit share information more easily, provide authoritative roles for nonbiomedical workers, and have clear goals that are supported by the clients. These programs forge alliances between clients, service providers, and community leaders. The underlying concept of human rights embraces a broader perspective looking for the determinants and remedies for vulnerability to HIV/STD. HIV/AIDS/STDs must be fought to defeat both the virus and social backlash. This two-pronged struggle requires the reorientation of health and social services centering on partnerships and a conducive management style. Health and social services can be constrained by a trend toward reduced funding, but HIV-affected communities induce them to change whereby new partnerships could be forged.     

Cultural capital and social inequality in health

Economic and social resources are known to contribute to the unequal distribution of health outcomes. Culture-related factors such as normative beliefs, knowledge and behaviours have also been shown to be associated with health status. The role and function of cultural resources in the unequal distribution of health is addressed. Drawing on the work of French Sociologist Pierre Bourdieu, the concept of cultural capital for its contribution to the current understanding of social inequalities in health is explored. It is suggested that class related cultural resources interact with economic and social capital in the social structuring of people's health chances and choices. It is concluded that cultural capital is a key element in the behavioural transformation of social inequality into health inequality. New directions for empirical research on the interplay between economic, social and cultural capital are outlined.     

Associations between health communication behaviors,neighborhood social capital,vaccine knowledge,and parents’ H1N1 vaccination of their children

During the H1N1 pandemic in 2009–10, the vaccination behavior of parents played a critical role in preventing and containing the spread of the disease and the subsequent health outcomes among children. Several studies have examined the relationship between parents’ health communication behaviors and vaccinations for children in general. Little is known, however, about the link between parents’ health communication behaviors and the vaccination of their children against the H1N1 virus, and their level of vaccine-related knowledge. We drew on a national survey among parents with at least one child less than 18 years of age (n = 639) to investigate Parents’ H1N1-related health communication behaviors including sources of information, media exposure, information-seeking behaviors, H1N1-related knowledge, and neighborhood social capital, as well as the H1N1 vaccination rates of their children. Findings showed that there is a significant association between the degree at which parents obtained H1N1 vaccination for their children and health communication variables: watching the national television news and actively seeking H1N1 information. And this association was moderated by the extent of the parents’ H1N1-related knowledge. In addition, the parents’ degree of neighborhood social capital mediated the association between H1N1 knowledge of the parents and H1N1 vaccination acceptance for their children. We found, compared to those with a low-level of neighborhood social capital, parents who have a high-level of neighborhood social capital are more likely to vaccinate their children. These findings suggest that it is necessary to design a strategic health communication campaign segmented by parent health communication behaviors.     

Individual social capital, neighbourhood deprivation, and self-rated health in England

Individual social capital is increasingly considered to be an important determinant of an individual's health. This study examines the extent to which individual social capital is associated with self-rated health and the extent to which individual social capital mediates t.he relationship between neighbourhood deprivation and self-rated health in an English sample. Individual social capital was conceptualized and operationalized in both the social cohesion- and network resource tradition, using measures of generalized trust, social participation and social network resources. Network resources were measured with the position generator. Multilevel analyses were applied to wave 2 and 3 of the Taking Part Surveys of England, which consist of face-to-face interviews among the adult population in England (N(i) = 25,366 respondents, N(j) = 12,388 neighbourhoods). The results indicate that generalized trust, participation with friends and relatives and having network members from the salariat class are positively associated with self-rated health. Having network members from the working class is, however, negatively related to self-rated health. Moreover, these social capital elements are partly mediating the negative relationship between neighbourhood deprivation and self-rated health.     

The privatization of human services: myths, social capital and civil society

It is fashionable to point to privatization and the involvement of for-profits as the parties responsible for many, if not most, of the ills that plague the social welfare system today. This article takes a contrary point of view. Three arguments are made. First, private sector human service delivery and the use of for-profits in the United States predate privatization as a defined public policy. Second, the privatization of the human services is a world wide phenomenon that transcends politics and ideology. Third, the privatization of human services helps to promote civil society and generate social capital.     

Health promotion, social epidemiology, and social capital: associations and perspectives for public health

The idea of health promotion predates the use of the actual term. However, the incorporation of this idea and the practice of health promotion were influenced by the Canadian health reform movement, which echoed the voices of many others who were concerned with the influence of the physical and social environment on health. This provided the basis for the World Health Organization to launch a series of conferences beginning with the Alma Ata Conference in 1977 and followed by the Ottawa Conference, from which resulted the first international document on health promotion, known as the Ottawa Charter. Although health promotion has been the subject of a wide range of studies, the concept is still not well understood and its explicit practice is limited. Health conferences have been important for keeping the notion of equity in health alive, while the gap between the rhetoric of these conferences and practice remains to be bridged. However, the rise of social epidemiology and the development of the concept of social capital for health could bring new insights into traditional epidemiology in order to narrow this gap. The purpose of this paper is to elucidate these concepts and to describe the roles they play in public health in order to stimulate further debate.     

News, social capital and health in the context of Katrina

This study assesses the public health functions played by news information and social capital in the context of Hurricane Katrina. In-depth interviews were conducted with 57 hurricane shelter residents between 4 and 6 weeks after the hurricane. Depression was more common for participants who relied more on news information than for other participants after the hurricane (adjusted odds ratio [AOR], 5.49; 95% CI, 1.29 to 23.35; p=.021). Depression was more common for participants with relatively low levels of pre-hurricane positive social interactions (AOR, .16; 95% CI, .02 to 1.83; p=.046) and post-hurricane positive social interactions (AOR, .02; 95% CI, .00 to .74; p=.033) and high levels of post-hurricane negative social interactions (AOR, 17.05; 95% CI, .92 to 315.64; p=.047). Illness and injury were more common for participants who had relied more on news information than for other participants after the hurricane (AOR, 1.13; 95% CI, 1.02 to 2.77; p=.046).     

Racially mixed neighborhoods, perceived neighborhood social cohesion, and adolescent health in Canada

Using data from the Canadian Census and the National Longitudinal Survey of Children and Youth, we examine the effects of neighborhood concentration of racial minorities on general health status and depressive symptoms of Canadian adolescents. We also examine the role of perceived neighborhood cohesion and the extent to which it contributes to adolescent health. Our findings show that the racial concentration of ethnic minorities represents a health disadvantage for visible minority youth while perceived neighborhood cohesion is found to be a protective factor for both health outcomes. Perceived neighborhood cohesion is beneficial for the general health status (but not depression) of adolescents residing in neighborhoods with a high concentration of racial minorities.     

Community, social capital and Indigenous health in the Northern Territory

Objective. The objective of this paper is to explore the discourse of ‘community’ and its offshoots, ‘social capital’ and ‘community capacity building’, in the contexts of health service delivery to, and the health status of, Indigenous people in the Northern Territory of Australia, and to link this discourse to the wider context of social control and the management of diversity in a multicultural society.

Design. The discourse is subjected to critical theoretical and historical analysis and comparisons are drawn between this and similar discourses in the immigration and settlement area.

Results/conclusions. The constitution of Indigenous society as a series of ‘communities’ and the orientation of primary health care policy towards ‘capacity building’ has the effect, if not the intention, of depoliticising Indigenous health, whilst reproducing, legitimising and mystifying relations of white dominance and permitting the maintenance of a health service delivery system for Indigenous people which, in relation to need, is grotesquely underfunded and incapable of making serious inroads into the appalling health problems of the Indigenous population.     

Maternal social capital and child health in Vietnam

STUDY OBJECTIVE: To explore the association between maternal social capital and child physical and mental health in Vietnam. DESIGN: Cross sectional survey. Measures of maternal structural social capital comprised group membership, citizenship, and social support. Measures of cognitive social capital comprised trust, social harmony, sense of fairness, and belonging. Child health was measured by anthropometrics and mothers' reports of acute and chronic physical health problems and child mental health. PARTICIPANTS: 2907 mothers and their 1 year old or 8 year old children from five provinces in Vietnam. MAIN RESULTS: The study found low levels of group membership and citizenship and high levels of cognitive social capital and support, and generally higher levels of social capital among the mothers of 8 year old compared with 1 year old children. All but one association was in the hypothesised direction (that is, higher levels of social capital associated with reduced risk of child health problems). There were more statistically significant relations between maternal social capital and the health of 1 year olds compared with 8 year old children, and between measures of social support and cognitive social capital and child health, than with group membership and involvement in citizenship activities. CONCLUSION: This study is the first to explore the association between multiple dimensions of social capital and a range of different child health outcomes in the developing world. These results now need to be tested using longitudinal data.     

青少年社会资本与健康行为间的相关性

探讨中国西南地区青少年社会资本与其健康行为间的关系,为推进学校健康促进工作提供参考.方法 在重庆市主城区及周边区县学校,根据年级及学校地理位置,采用分层随机抽样,共抽10所学校1 885名学生,采用“社会资本量表”和“健康行为量表”收集资料,并对获得的数据运用探索性及典型相关分析方法进行处理.结果 青少年的社会资本越多,则越能养成良好的健康行为(第1典型相关系数R=0.78,P<0.05),表现为家庭氛围越好、亲子关系越好、手足互动越好、亲友互动越好、社区参与越多、代间沟通越多、亲师关系越好、同伴关系越好、师生关系越好、社团参与越多的青少年,其健康行为越好(负荷量分别为-0.705,-0.687,-0.567,-0.705,-0.536,-0.521,-0.542,-0.711,-0.612,-0.688);社区参与越多、亲师关系越好、同伴关系越差、社团参与越多的青少年(负荷量分别为0.475,0.411,-0.504,0.426),则越能落实营养行为、健康责任行为及运动行为(第2典型相关系数R=0.45,P<0.05);家庭氛围越好、亲子关系越好、同伴关系越差、社团参与越少(负荷量分别为0.547,0.431,-0.415,-0.362),则越能履行营养行为(第3典型相关系数R=0.31,P<0.05).结论 青少年的社会资本与健康行为密切相关,家庭内、外社会资本及学校社会资本对其健康行为养成具有正向效应.     

Mother's social capital and child health in Indonesia

Social capital has been shown to be positively associated with a range of health outcomes, yet few studies have explored the association between mother's social capital and children's health. This study examines the relation between mothers' access to social capital (via participation in community activities) and child health. Instrumental variable estimation was applied to cross sectional data of the Indonesian Family Life Survey (IFLS) 2007 which consist of face-to-face interviews among the adult population in Indonesia (N_mothers = 3450, N_children = 4612, N_communities = 309, and participation rate at 92%). The findings show strong evidence for the causal flow running from a mother's social capital to her children's health. All instruments are highly correlated with mothers' social capital but uncorrelated with child health. The findings are also robust to individual and community characteristics associated with child health, and suggest that enlarging mothers' social capital through various community activities is a particularly relevant intervention for reducing child health disparities in Indonesia.