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.     

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.     

Healthy communities: the challenge of social capital in the Lisbon Metropolitan Area

The debate about social environment, sustainability and health has been highlighted by the interest in social capital. It has been suggested that social capital varies from place to place and that such variations are relevant for explaining variations in health. This paper explores the association between neighbourhood social capital (making a distinction between linking, bonding and bridging social capital) and self-rated health. The study has involved 4,577 residents in 143 neighbourhoods of the Lisbon Metropolitan Area. Logistic regression was used to measure the relationship between social capital and self-rated health. The results show that social capital was strongly associated with self-rated health, even after an adjustment for individual attributes. It is not possible to divorce health planning from urban planning and from the promotion of social capital. A sense of place, identity and belonging needs to be at the core of all healthy planning interventions.     

Intergenerational understandings of personal,social and community assets for health

Connecting local citizens of different ages in productive social activity is considered a pathway towards greater health. This research explores how older adults and young people interpret and access assets from their geographical community in relation to their well-being and the extent to which a process of intergenerational bridging contributes to the creation of additional assets for health. Data is presented from a process of place-mapping, interviews, observations and arts-based approaches to: a) understand how personal, social and community assets supported perceived health and wellbeing for the young children and older adults who participated; and b) explore the impact of intergenerational connection on enhancing social capital. The research utilised bonding, bridging and linking forms of social capital, across several interactions amongst 41 individuals who reside in the same geographical community (Victoria, Australia). Assets for health, common across generations and located within the same geographical community were identified. Social connections were strengthened through conversations, reflections and an integration of ideas facilitated through an arts-based approach. Findings suggest that through intergenerational connection and sharing of resources to support health, including the sharing of community assets, progress can be made towards community strengthening with implications for health and wellbeing.     

NEIGHBOURHOOD SOCIAL CAPITAL AND INDIVIDUAL SELF‐RATED HEALTH IN WALES

Although neighbourhood social capital can be beneficial for individual health, supporting evidence in the UK is scant. We aim to find the net effect of neighbourhood social capital and deprivation on individual health beyond sociodemographic composition of neighbourhood. We propose a multilevel path analytic model of health to delineate complex pathways involving neighbourhoods (measured as local super output area) and individuals. Analysis of the most recent data containing independent measures of neighbourhood social capital shows that neighbourhood social capital appears to be associated with benefits in some aspects of individual health in the Welsh setting. The improvement stands beyond individual determinants and neighbourhood deprivation. Social scientists and public health officials have reason to continue focusing on the neighbourhoods as well as the individuals to improve the health of the population. Copyright © 2011 John Wiley & Sons, Ltd.     

Linking social capital and self-rated health: a multilevel analysis of 11,175 men and women in Sweden

This multilevel study included 11,175 participants interviewed 2000-2002 in Sweden. The association between neighbourhood linking social capital (voting in national elections) and self-rated health was analysed. Individuals living in neighbourhoods with the lowest levels of linking social capital exhibited a significantly higher risk of poor health than individuals living in neighbourhoods with the highest levels of linking social capital, after adjustment for individual characteristics, including individual voting. The neighbourhood variance indicated significant differences in self-rated health between neighbourhoods. Both individuals and neighbourhoods need to be targeted in order to enhance people's health in neighbourhoods with low linking social capital.     

Neighbourhood social capital and common mental disorder: testing the link in a general population sample

General population multilevel studies of social capital and mental health are few in number. This multilevel study examined external measures of neighbourhood social capital and common mental disorders (CMD). Main effects and stress buffering models were tested. Based on data from over 9000 residents in 239 neighbourhoods in England and Scotland, there was no evidence of a main effect of social capital. For people living in deprived circumstances only, associations between neighbourhood social capital and CMD were seen. Elements of bridging social capital (contact amongst local friends) were associated with lower reporting of CMD. Elements of bonding social capital (attachment to neighbourhood) were associated with higher reporting of CMD. Findings provide some support for the hypothesis that social capital may protect against CMD, but indicate that initiatives should be targeted to deprived groups, focus on specific elements of social capital and not neglect the important relationship between personal socioeconomic disadvantage and CMD.     

Spatial and social determinants of urban health in low-, middle- and high-income countries

Urban populations around the world face increasingly common health problems. This is partly because of common spatial and socio-economic factors that result in substantial inequalities in health among urban populations. Spatial methods can now map out dimensions of urban living, such as the segregation of poor communities as a result of population concentration of poverty in deprived neighbourhoods. Even in rich countries such as the UK, separate from the health disadvantages of living in a poor neighbourhood, if you live in a neighbourhood that is surrounded by deprivation, you have a higher risk of mortality. However, neighbourhood deprivation is not synonymous with poor social capital. Some communities can be resilient to the health-damaging aspects of living in a poor neighbourhood if they have access to social support and other social ties.     

Poor people, poor places, and poor health: the mediating role of social networks and social capital

This paper explores the dynamics between poverty and exclusion; neighbourhood, and health and well being by considering the role of social networks and social capital in the social processes involved. It is based on qualitative research taking two deprived areas as exemplary case studies, and involving depth interviews with residents. Neighbourhood influences on networks and social capital were explored, network typologies developed reflecting structural and cultural aspects of individual's networks, and pathways implicated in health effects considered. The complexity of social capital is addressed. The role of three factors in influencing social networks and social capital are demonstrated: neighbourhood characteristics and perceptions; poverty and social exclusion, and social consciousness. Perceptions of inequality could be a source of social capital as well as demoralisation. Different network structures-dense and weak, homogeneous and heterogeneous- were involved in the creation of social capital and had implications for well being. Coping, enjoyment of life and hope are identified as benefits. Although participation in organisations was confirmed as beneficial, it is suggested that today's heterogeneous neighbourhoods also require regenerated local work opportunities to develop bridging ties necessary for the genesis of inclusive social capital and better health. Despite the capacity of social capital to buffer its harsher effects, the concept is not wholly adequate for explaining the deleterious effects of poverty on health and well being.     

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.     

Children's health-related quality of life,neighbourhood socio-economic deprivation and social capital. A contextual analysis

Neighbourhood objective socio-economic indicators and community-reported subjective measures of social capital were examined in relation to children's health-related quality of life in the Netherlands. Three different data-sources were used: (1) objective neighbourhood socio-economic indicators, (2) subjective neighbourhood data on social capital, and (3) individual data of a family cohort study, including questions on children's health-related quality of life, and family socio-economic status. Multilevel analyses were conducted using both neighbourhood level and individual level data. Neighbourhood socio-economic status and social capital were associated. Measures of socio-economic deprivation and social capital were both non-specifically associated with children's general health and satisfaction, independent of possible individual-level confounders. However, children's mental health and behaviour were specifically associated with one aspect of social capital, the degree of informal social control in the neighbourhood.     

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.     

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.     

Social capital and mental health: an interdisciplinary review of primary evidence

An interdisciplinary interrogation of primary evidence linking social capital and mental health sought to establish: (1) 'quality of evidence' (assessed in terms of study design, methods used to address stated questions, rigor of data analysis, and logic and clarity of interpretation of results), and (2) applicability of the evidence to public health policy and practice with respect to mental health. It is found that social capital, a complex and compound construct, can be both an asset and a liability with respect to mental health of those in receipt of and those providing services and other interventions. The most meaningful assessment of social capital or components thereof may examine individual access to rather than possession of social capital, a property of groups, and therefore an ecological variable. Theoretical advances in research on social capital serve to identify mainly two types of social capital: bonding (between individuals in a group) and bridging (between groups). Each type of social capital has cognitive and/or structural component(s) and may operate at micro and/or macro level(s). Effective mental health policy and service provision may build or strengthen bridging social capital and benefit from both bonding and bridging social capital where either or both exist. Established indicators of social capital are amenable to quantitative and qualitative assessment, preferably in tandem. However studies that employ combined research design are rare or non-existent. Interdisciplinary multi-method investigations and analyses are called for in order to unravel mechanisms whereby social capital and mental health might be meaningfully associated.     

Social capital and health: a meta-analysis

The relationship between social capital and health has received extensive attention in fields such as public health, medicine, epidemiology, gerontology and other health-related disciplines. In contrast, the economics literature on this subject is relatively small. To address this research gap, we investigate the cross-disciplinary empirical literature using meta-analysis. We analyze 12,778 estimates from 470 studies. Our analysis finds that social capital is significantly related to a variety of positive health outcomes. However, the effect sizes are consistently very small. This finding is robust across different types of social capital (e.g., cognitive, structural, bonding, bridging, linking), and for many different measures of health outcomes (e.g., mortality, disease/illnesses, depression). The small effects that we estimate cast doubt on recent initiatives to promote health through social capital such as those by the WHO, the OECD, and US Healthy People 2020.     

Perceptions of the neighbourhood environment and self rated health: a multilevel analysis of the Caerphilly Health and Social Needs Study

Background  

In this study we examined whether (1) the neighbourhood aspects of access to amenities, neighbourhood quality, neighbourhood disorder, and neighbourhood social cohesion are associated with people's self rated health, (2) these health effects reflect differences in socio-demographic composition and/or neighbourhood deprivation, and (3) the associations with the different aspects of the neighbourhood environment vary between men and women.     

The Impact of a Prevention Delivery System on Perceived Social Capital: the PROSPER Project

The current study examined the impact of the PROSPER delivery system for evidence-based prevention programs on multiple indicators of social capital in a rural and semi-rural community sample. Utilizing a randomized blocked design, 317 individuals in 28 communities across two states were interviewed at three time points over the course of 2.5 years. Bridging, linking, and the public life skills forms of social capital were assessed via community members’ and leaders’ reports on the perceptions of school functioning and the Cooperative Extension System, collaboration among organizations, communication and collaboration around youth problems, and other measures. Longitudinal mixed model results indicate significant improvements in some aspects of bridging and linking social capital in PROSPER intervention communities. Given the strength of the longitudinal and randomized research design, results advance prevention science by suggesting that community collaborative prevention initiatives can significantly impact community social capital in a rural and semi-rural sample. Future research should further investigate changes in social capital in different contexts and how changes in social capital relate to other intervention effects.     

An examination of social capital and social disorganisation in neighbourhoods in the British household panel study

Recent developments in social science research suggest that social environmental factors may be important for explaining community variations in health. We investigate the structural sources of two mechanisms that produce community variations in health. Using survey data collected from a representative cross-section of British households we examine variations in neighbourhood social capital and neighbourhood social disorganisation across a sample of British neighbourhoods. Adjusting for respondent's attributes, we assess the effects of neighbourhood characteristics measured by the 1991 census in Britain. The results show that concentrated affluence, residential instability and ethnic heterogeneity predict social capital for women. Population density is the only neighbourhood characteristic to predict social capital for men. For both men and women concentrated disadvantage and population density are associated with social disorganisation. Residential instability is additionally associated with social disorganisation for women. For women it was found that neighbourhood characteristics interact with individual social class in accounting for variations in social capital, the effects of neighbourhood characteristics being larger for those in professional and managerial and skilled non-manual occupations. The results show that neighbourhood structural characteristics influence social organisation processes. This helps establish a link between the structural characteristics of neighbourhoods and individual health outcomes.     

A multilevel analysis of social capital and self-rated health: Evidence from China

We investigate relationship between social capital and self-rated health (SRH) in urban and rural China. Using a nationally representative data collected in 2005, we performed multilevel analyses. The social capital indicators include bonding trust, bridging trust, social participation and Chinese Communist Party membership. Results showed that only trust was beneficial for SRH in China. Bonding trust mainly promoted SRH at individual level and bridging trust mainly at county level. Moreover, the individual-level bridging trust was only positively associated with SRH of urban residents, which mirrored the urban–rural dual structure in China. We also found a cross-level interaction effect of bonding trust in urban area. In a county with high level of bonding trust, high-bonding-trust individuals obtained more health benefit than others; in a county with low level of bonding trust, the situation was the opposite.