社会资本在健康领域的应用现状

在解释收入不平等对健康差异的影响作用时，流行病学家引入了社会资本的概念，尽管社会资本理论自身还存在很多争议，但其与健康关系的研究引起了众多学者的兴趣。本文从各种社会资本的概念，社会资本在健康领域研究中的应用，社会资本影响健康的可能机制，各种测量方法和存在的不足以及在中国目前的应用现状等方面进行了浅析。     

Do bonding and bridging social capital affect self-rated health,depressive mood and cognitive decline in older Japanese? A prospective cohort study

Little is known regarding the longitudinal effects of bonding and bridging social capital on health. This study examined the longitudinal associations of bonding and bridging social capital with self-rated health, depressive mood, and cognitive decline in community-dwelling older Japanese. Data analyzed in this study were from the 2010 (baseline) and 2012 (follow-up) Hatoyama Cohort Study. Bonding social capital was assessed by individual perception of homogeneity of the neighborhood (the level of homogeneity among neighbors) and of networks (the amount of homogeneous personal networks) in relation to age, gender, and socioeconomic status. Bridging social capital was assessed by individual perception of heterogeneity of networks (the amount of heterogeneous personal networks) in relation to age, gender, and socioeconomic status. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate the effects of baseline social capital on poor health outcome at follow-up by logistic regression analysis. In total, 681 people completed baseline and follow-up surveys. The mean age of participants was 71.8 ± 5.1 years, and 57.9% were male. After adjusting for sociodemographics, lifestyle factors, comorbidity, functional capacity, baseline score of each outcome, and other bonding/bridging social capital, stronger perceived neighborhood homogeneity was inversely associated with poor self-rated health (OR = 0.55, 95% CI = 0.30–1.00) and depressive mood assessed by the Geriatric Depression Scale (OR = 0.58, 95% CI = 0.34–0.99). When participants who reported a depressive mood at baseline were excluded, stronger perceived heterogeneous network was inversely associated with depressive mood (OR = 0.40, 95% CI = 0.19–0.87). Neither bonding nor bridging social capital was significantly associated with cognitive decline assessed by the Mini-Mental State Examination. In conclusion, bonding and bridging social capital affect health in different ways, but they both have beneficial effects on the health of older Japanese. Our findings suggest that intervention focusing on bonding and bridging social capital may improve various health outcomes in old age.     

The measurement of social capital

Social capital has been defined as the resources available to individuals and groups through membership in social networks. The definition is consistent with either an individualistic approach, i.e. resources (such as information or instrumental assistance) that are accessed by individuals through their network connections; or a collective approach, e.g. the benefits accruing to members of a group – such as the ability of a community to engage in collective action – as a consequence of the existence of cohesive relationships. While research often restricts itself to a single level of analysis, the benefits (and downsides) of social capital accrue to both the individual as well as to the network to which he belongs. In the Dictionary of Epidemiology both the individual and collective levels of analysis were recognized in the definition of social capital.     

Toward an institutional perspective on social capital health interventions: lay community health workers as social capital builders

This article argues that social capital health research should move beyond a mere focus on social cohesion and network perspectives to integrate an institutional approach into the development of social capital health interventions. An institutional perspective, which is unique in its emphasis on linking social capital in addition to the bonding and bridging forms, contextualises social capital, allowing researchers to confront the complexity of social relationships. This perspective allows for the construction of interventions that draw on the resources of diverse actors, particularly the state. One intervention strategy with the potential to create community linkages involves lay community health workers (LCHWs), individuals who are trained to perform a variety of health-related functions but lack a formal professional health education. This article begins with a review of the institutional social capital-building literature. It then goes on to briefly review the social capital and health literature and discuss the state of intervention research. Thereafter, it describes LCHWs and discusses studies that have utilised LCHWs to tackle community health problems. In doing so, this article presents an institutional-based systematic framework for how LCHWs can build social capital, including a discussion of the ways in which LCHWs can successfully promote bonding, bridging and linking social capital.     

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.     

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.     

Social inequality and health: the role of social capital

The aim of the article is to examine whether and to what degree the unequal distribution of social capital in the population explains the relationship between socioeconomic position and health in Norway. Theoretical insight and empirical evidence seem to suggest that social capital mediates the effect of socioeconomic position on health outcomes. However, only a few studies have addressed this question and those that have done so have used few and simple indicators of social capital. This study is based on a nationwide cross-sectional survey (N = 3190) commissioned by Statistics Norway. The survey was designed to cover a comprehensive set of variables measuring different aspects of the theoretical construct of social capital. Two health outcomes, self-perceived health and longstanding illness, were analysed. The results showed that the mediating role of social capital between socioeconomic position and health was negligible for both health outcomes. After controlling for socio-demographic variables and socioeconomic position, only neighbourhood satisfaction and generalised trust showed a significant association with self-perceived health, whereas none of the social capital variables had any significant association with longstanding illness. Some theoretical and methodological implications of the results are discussed.     

国内外社会资本健康的研究现状及趋势的文献计量分析

目的 分析国内外社会资本与健康相关的研究文献,归纳社会资本与健康相关研究现状,为我国此类研究提供参考。 方法 在CNKI、Web of Science数据库中检索出社会资本健康相关研究文献并进行整理和分析,检索到中文127篇,英文189篇,利用CiteSpace软件进行可视化分析。 结果 我国关于社会资本与健康的相关研究自2000年出现,2016年出现社会资本与健康行为的相关研究;国内研究普遍使用回归、综述、模型等方法,国外研究方法较国内丰富且深入;除社会资本外,中英文献关键词频率最高的分别为健康和self-rated health。 结论 我国社会资本与健康相关研究方法简单且较少评估测量工具效度,社会资本健康行为还需要进行深度研究,研究对象更具有特点及针对性以及健康研究主题需细化。     

Lost in translation: a genealogy of the "social capital" concept in public health

STUDY OBJECTIVE: To examine the genealogy of the social capital concept in public health, with attention to the epistemological concerns and academic practices that shaped the way in which this concept was translated into public health. DESIGN: A citation-network path analysis of the public health literature on social capital was used to generate a genealogy of the social capital concept in public health. The analysis identifies the intellectual sources, influential texts, and developments in the conceptualisation of social capital in public health. PARTICIPANTS: The population of 227 texts (articles, books, reports) was selected in two phases. Phase 1 texts were articles in the PubMed database with "social capital" in their title published before 2003 (n = 65). Phase 2 texts are those texts cited more than once by phase 1 articles (n = 165). MAIN RESULTS: The analysis shows how the scholarship of Robert Putnam has been absorbed into public health research, how three seminal texts appearing in 1996 and 1997 helped shape the communitarian form that the social capital concept has assumed in public health, and how both were influenced by the epistemological context of social epidemiology at the time. CONCLUSIONS: Originally viewed in public health research as an ecological level, psychosocial mechanism that might mediate the income inequality-health pathway, the dominance of the communitarian approach to social capital has given disproportionate attention to normative and associational properties of places. Network approaches to social capital were lost in this translation. Recovering them is key to a full translation and conceptualisation of social capital in public health.     

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.     

社会资本测量及其在健康领域应用

目的 社会资本是一个多维度多层面的概念,对其进行定量测量是一个非常复杂的程序。本文介绍了社会资本的相关概念及常用测量工具,并讨论了社会资本测量在健康领域的相关实证应用。建议在进行社会资本测量时,应根据调查所在地区的社会人口学特征、经济文化水平等因素,并结合研究目的选择需要测量的社会资本的维度,选用信度和效度量好的测量工具,或采用定性分析和定量测量结合的方法研究社会资本与健康的关联。     

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.     

'Opportunity structures': urban landscape,social capital and health promotion in Australia

This paper presents data from 40 in-depth interviews that were conducted as part of a study of social capital and health in relation to people's perceptions of the influence of 'place' on their participation levels and health. These data were used to examine features of the western suburbs of Adelaide that were perceived as health damaging and health promoting. The paper demonstrates that our Australian suburban respondents expressed a considerable concern about these features and the impact they have on their perception of community and their ability to participate in it. Safety, connectedness to the area, the reputation of an area and the extent and nature of community facilities are all seen as important to a healthy community. The research found that in the more deprived socioeconomic areas within the study area, there was a significant degree of dissatisfaction with features of the urban environment, such as availability of amenities, provision of public transport, and proximity of industry to private dwellings. The paper concludes by considering certain features of urban environments that might make them more supportive of health through encouraging contact between people. We conclude that these environments could be improved using the following measures: a subsidy scheme to support the viability of local shops and cafés (thereby providing meeting places and employment); parks with facilitators (who could play a role in increasing safety in the park but also encouraging community development); attractive places to walk; and a general environmental improvement program.     

Family social capital and health – a systematic review and redirection

The level (or scale) at which social capital can be conceptualised and measured ranges potentially from the macro‐level (regional or country level), to the meso‐level (neighbourhoods, workplaces, schools), down to the individual level. However, one glaring gap in the conceptualisation of social capital within the empirical literature has been the level of the family. Our aim in this review is to examine the family as the ‘missing level’ in studies on social capital and health. To do so, we conducted a systematic review on the use and measurement of this notion in the health literature, with the final intention of articulating a direction for future research in the field. Our findings are consistent with the notion that family social capital is multidimensional and that its components have distinct effects on health outcomes. Further investigation is needed to understand the mechanisms through which family social capital is related to health, as well as determining the most valid ways to measure family social capital.     

Bonding and bridging neighborliness: An individual-level study in the context of health

Although previous research provides a compelling picture of social capital's role in predicting health outcomes, only a modicum of research has tested the more detailed roles of the dimensions of bonding and bridging social capital, with no research focusing exclusively on bonding and bridging neighborliness or ethnicity. To help fill this gap in the literature, the current study measures individual-level bonding and bridging neighborliness for four U.S. ethnic groups—and then, with cross-sectional data from a 2007 national telephone survey of U.S. adults, employs ordinal logistic regression and OLS regression to test the individual-level predictors of self-rated health and stress, when controlling for BMI and demographics. Bonding neighborliness was associated with self-rated health and inversely associated with stress, whereas bridging neighborliness was not significantly linked to either health outcome. When also controlling for neighborhood composition, the bonding neighborliness findings remained generally consistent, while the association between bridging neighborliness and self-rated health gained significance. These results indicate the protective effects that bonding neighborliness can have on health outcomes, as well as the more modest protective effects of bridging neighborliness. These findings have implications for future research and practice, highlighting the potential of health interventions and policies that target the development of bonding social capital.     

Social capital and self-rated health in Argentina

The potential link between social capital and health suggests important pathways by which health may be improved. We examine this relationship using a unique data set from Argentina. This national survey allows us to determine whether the relationships between social capital and health that have been found in the US and Europe also apply to countries in South America (Argentina is the second-largest country in South America with a population of approximately 40 million). We estimate a causal effect of individual-level social capital on health using a measure of informal social interactions as our measure of social capital. Using information about access to public transportation as instrumental variables, we find that both men and women with higher levels of social capital report better health.     

The social vagina: labia elongation and social capital among women in Rwanda

Far from being an individual concern, vaginas are located within complex socio-cultural settings. The acceptability of policies that focus on health-promoting behavioural change is influenced by values regarding normative gender and sexual roles. In Rwanda, the elongation of the labia minora through manual manipulation is not an individual act but takes place in social groups and thus cannot be fully understood by focusing one's attention solely on the individual-related behavioural components but, rather, on the social environment in which it exists. This paper aims to increase knowledge about labia elongation and assesses whether this vaginal practice produce social capital.     

The relationship between social capital and self-rated health in a Japanese population: a multilevel analysis

Objective  

The aim of this study was to use a multilevel analysis to examine whether cognitive and structural dimensions of regional social capital were associated with individual health outcomes after adjusting for compositional factors.