The measurement of bridging social capital in population health research

Higher education as a pathway for female immigrants' establishment and well-being in Sweden

PURPOSE

This study focuses on higher education as a pathway to establishment in a new society for female immigrants and its role in well-being. Building on previous research that highlights social capital and empowerment as significant factors for successful establishment in a new society, and experiencing well-being, this study aims to explore if higher education can promote female immigrants' establishment in Swedish society.

METHODS

Interviews were used to explore female immigrants' experiences of higher education and establishment in Swedish society. Thematic analysis was used to analyse the empirical material, generating a nuanced understanding of the studied topic.

RESULTS

Higher education was found to promote establishment in Swedish society, ultimately leading to an experience of well-being. Pursuing higher education was perceived as a means of achieving personal fulfilment and success while fostering new social connections. Important factors in pursuing higher education included favourable living conditions, personal motivation, and a positive educational attitude.

CONCLUSION

The study provides insights into female immigrants' higher education experiences in a context that promotes establishment in Swedish society and well-being. However, more research is needed to fully investigate the driving factors for female immigrants pursuing higher education, considering their migrant background and living conditions.

Social capital and health beliefs: Exploring the effect of bridging and bonding social capital on health locus of control among women in Dhaka

This cross-sectional study examined if social capital affects women's health attributions. The study used the Internet Social Capital Scale (ISCS) and Multidimensional Health Locus of Control (MHLC) Scale to measure Social Capital and Health Locus of Control. A predefined 38-item questionnaire was used to survey 485 purposively selected women. A bidirectional reciprocal structural equation model was used to measure the covariance between Social Capital and Health Locus of Control. We hypothesized that women with strong social capital, particularly those rich in bridging ties, would exhibit a greater sense of agency and empowerment over their health, attributing their health outcomes less to internal factors like fate and more to external influences like powerful others and broader social support. However, we found that when women have higher social capital, their external health locus of control increases. Bridging and bonding social capital lower women's internal health control, but bridging social capital leads to higher attributes to powerful others. Likewise, we expected women with more social capital would exhibit a lower perception of uncontrollability over their health, but is not the case. The findings underscore the necessity for women to have more social capital.

Social Capital and Formal Volunteering Among Family and Unpaid Caregivers of Older Adults

Using data from 1745 caregivers in the National Study of Caregiving (2017), this study explores the connection between caregiving and formal volunteering by identifying the relationship between social capital and formal volunteering among family and other unpaid caregivers of older adults. In addition, this study examines the representative prevalence of formal volunteering in caregivers. We conducted logistic regression models along with established volunteerism correlates from the prior research literature. Approximately a quarter of caregivers participated in volunteering (25.4%). Being male, having higher educational attainment, being a spouse, living separately from the care recipient, caregiving for multiple care recipients, having a better quality of relationship with the care recipient, having better psychological well-being, receiving more social support, attending religious services, and participating in group activity were positively associated with formal volunteer participation. Findings underscore the role of both human and social capital, including the caregiving context, in formal volunteering among caregivers.

Residential segregation and Black-White differences in physical and mental health: Evidence of a health paradox?

Ample research finds that residential segregation is detrimental to Black Americans' physical health and exacerbates Black-White physical health disparities. However, less is known about how residential segregation may influence Black Americans' mental health and Black-White differences in mental health. Drawing on U.S. census data and a state representative study of Indiana residents (N = 2,685), I examine associations between residential segregation and multiple dimensions of physical and mental health. Consistent with past research, I find that residential segregation has an adverse association with physical health among Black respondents. In contrast, I find residential segregation to have a salubrious association with Black respondents' mental health, producing a Black mental health advantage at higher levels of segregation. I conclude by discussing the implications of these findings for research on residential segregation and health and the Black-White mental health paradox.

Social Capital and Mental Wellbeing of Older People Migrating along with Adult Children in Shenzhen, China

The phenomenon of 'older people migrating along' (OPMA) with adult children is a unique outcome of social changes that have occurred in China. These individuals generally experience different challenges and needs associated with mental wellbeing. However, there is limited research on the relationship between the social capital and mental health of OPMA in China. This study aims to examine the mental health status of OPMA and the effects of bonding social capital and bridging social capital on their mental wellbeing in China by conducting a quantitative research survey among 399 OPMA participants. We found that bonding social capital correlated to only one indicator of mental wellbeing, subjective happiness. Bridging social capital had significant relationships with four mental health indicators, namely, the 12-item General Health Questionnaire (GHQ-12), Geriatric Depression Scale (GDS), subjective happiness, and life satisfaction. Through strengthening bridging social capital, these older adults can benefit from more opportunities for participation in formal or informal organizations in their communities and improve their mental wellbeing.

Understanding community- and system-capacity change over time: A close look at changing social capital in Evidence2Success communities

Evidence in majority White and low-population areas suggest that community prevention systems can create social capital that is needed to support high-quality implementation and sustainability of evidence-based programs. This study expands prior work by asking the question: How does community social capital change during the implementation of a community prevention system in low-income, highly populated communities of color? Data were collected from Community Board members and Key Leaders in five communities. Linear mixed effect models analyzed data on reports of social capital over time, first as reported by Community Board members then by Key Leaders. Community Board members reported social capital improved significantly over time during the implementation of the Evidence2Success framework. Key Leader reports did not change significantly over time. These findings suggest that community prevention systems implemented in historically marginalized communities may help communities build social capital that is likely to support the dissemination and sustainability of evidence-based programs.

The relationship between social capital and health from a configuration perspective: an evidence from China

BACKGROUND

The debate on the relationship between social capital and health is still ongoing. To enhance previous research, this study uses data drawn from China to analyse the situations in which social capital is related to good health and the various configurations that result in good health outcomes.

METHODS

Using the data of China Family Panel Studies, the conditions of age, gender, marriage, education, income, structural social capital and cognitive social capital were included to analyse the sufficient and necessary conditions for achieving good general health and their different configurations using the fsQCA method.

RESULTS

None of the listed conditions were prerequisites for excellent general health in terms of either their presence or their absence. The sufficiency analysis found 11 configurations with an average of 3-4 conditions per configuration; in no configuration was the condition of social capital present alone. Structured social capital and cognitive social capital exhibited negative states in configurations 1 and 2, respectively. The most prevalent factor in all configurations was the condition of age.

CONCLUSIONS

The relationship between social capital and health is both positive and negative, with cognitive social capital playing a larger role in the positive relationship than structural social capital. Social capital is neither a necessary nor a sufficient condition for health, and it must be combined with a variety of other factors to promote health. A variety of methods can be used to promote an individual's health, as different populations require different approaches to good general health, and no single pathway applies to all populations. In the Chinese population, an individual's age is a significant determinant of their health status.

The Role of Digital Platforms in Women’s Entrepreneurial Opportunity Process: Does Online Social Capital Matter?

In response to investigating the role of IT on entrepreneurs, this research increases the understanding of the impact of online social capital created and developed on social media platforms regarding the entrepreneurial opportunity process of nascent female entrepreneurs. To fulfill that, this research employed the mixed-method approach allowing two phases to complement and prevent unjustified findings. In the two phases, a multilevel model that incorporates entrepreneurial capacity and resource acquisition as mediating variables is created, justified, and investigated. In the first phase, the researchers use Natural Language Processing (NLP) by analyzing big data on social media communities, followed by a quantitative confirmatory study using SmartPLS 3.3 in the second phase. Results show that nascent female entrepreneurs use online social capital, especially bridging social capital, to develop their entrepreneurial capacity and to access resources, both necessary to recognize and exploit entrepreneurial opportunities.

Adaptation of the personal social capital brief scale for the measurement of the offline and online social capital in Italy

Social Capital refers to the resources associated with durable and trustworthy social connections. Social Capital can be developed through offline and online relationships. It can be distinguished between cognitive Social Capital (perception of trustworthiness, reciprocity, and support) and structural Social Capital (density of social networks and membership, and participation in groups and associations). It can also be distinguished between bonding Social Capital (resources associated with informal networks; i.e., neighbors, friends, colleagues) and bridging Social Capital (resources associated with formal networks; i.e., community service, cultural, religious or political groups/associations). The different forms and dimensions of Social Capital may have distinct effects on health outcomes and self-rated health. Therefore, public health researchers need valid and reliable instruments to investigate Social Capital. However, valid instruments including the measurement of online Social Capital are not available. The Personal Social Capital Scale aims to assess bonding and bridging Social Capital by means of cognitive and structural items. In the present investigation, three studies were carried out (N = 1149) to adapt the Personal Social Capital Scale to develop the Personal On-Offline Social Capital Brief Scale, a brief scale for measuring online and offline bonding and bridging Social Capital in Italy. Factorial structure and convergent/divergent validity in relation to scales measuring constructs with different patterns of relationships with bonding and bridging Social Capital (i.e., social support and stress; sense of community and health) were also investigated. Overall, these studies provide evidence of reliability and validity related to the internal structure of the Personal On-Offline Social Capital Brief Scale in measuring online and offline bonding and bridging Social Capital and discriminating them from similar constructs. This scale is a useful instrument for planning public health interventions.

Exploring the associations of youth Facebook addiction with social capital perceptions

Purpose

Although Facebook addiction has been found to be a key motive for using Facebook, scant research has explored the association of Facebook addiction with social capital. While researchers addressed how Facebook use strengthened social capital, they did not address the resultant excessive and uncontrollable Facebook use, which is a key sign of Facebook addiction. Therefore, the authors develop this project to study this research gap.

Design/methodology/approach

This research explores the motive of Facebook addiction by using a questionnaire to examine the relationships between Facebook addiction and two types of social capital: cognitive and bonding social capital. The authors recruited Hong Kong youth through Facebook and peer groups to complete a set of questionnaires on Facebook addiction, cognitive social capital, bonding social capital and the degree of extraversion. Hierarchical regression is used for analyzing the data collected.

Findings

Hierarchical regression results indicated that the more addicted one was to Facebook, the lower the cognitive social capital one perceived. Such a negative relationship was particularly significant for female participants. A similar but marginally significant effect is also found for bonding social capital.

Originality/value

This research sheds light on the impact of Facebook addiction on how one perceives shared meanings and the sense of belongingness with other people on social networks.

Peer review

The peer review history for this article is available at https://publons.com/publon/10.1108/OIR-06-2021-0300.

Prevalence and Factors Associated With Out-of-Pocket Pharmaceutical Expenditure Among Primary Healthcare Patients: Evidence From the Prover Project

OBJECTIVES

This study aimed to determine the prevalence and associated factors of out-of-pocket pharmaceutical expenditure (OOPPE) among primary healthcare patients.

METHODS

The study is part of the Prover Project, an exit survey conducted in 2017 in a large city (population 234 937) in Minas Gerais State, Brazil. A representative sample of patients (n = 1219) from pharmaceutical services based on primary healthcare was selected. Three components of OOPPE were assessed: the general prevalence, the types of medicines purchased (medicines for the treatment of chronic diseases, medicines for the treatment of acute diseases, or herbal medicines), and coverage by the National Health System. The factors associated with OOPPE were examined applying a modified Andersen's behavioral model of health services use. Data were analyzed using descriptive statistics and logistic regression.

RESULTS

The overall prevalence of OOPPE was 77%. Most patients who had OOPPE purchased medicines to treat chronic diseases (94%). In addition, these patients purchased medicines covered by public insurance but were out of stock (85%). OOPPE was associated with enabling factors, such as higher personal income (odds ratio [OR] 1.92; 95% confidence interval [CI] 1.02-3.62), holding health insurance (OR 1.40; 95% CI 1.01-1.95), and higher neighborhood trust (OR 1.34; 95% CI 1.01-1.79), and with need factors, that is, poorer perception of health (OR 1.63; 95% CI 1.20-2.21), multiple comorbidities (OR 1.70; 95% CI 1.18-2.46), and higher number of prescribed medicines (OR 2.84; 95% CI 1.90-4.26).

CONCLUSIONS

We found a high prevalence of OOPPE, identifying individuals more likely to incur these expenses. These findings are useful to inform policy makers from the healthcare system to plan and implement the needed interventions to protect primary care patients from this financial burden.

Social Capital during the First Wave of the COVID-19 Outbreak: The Case of the Island of Menorca

The rapidly evolving coronavirus pandemic has drastically altered the economic and social lives of people throughout the world. Our overall goal is to understand the mechanisms through which social capital shaped the community response to the pandemic on the island of Menorca, Spain, which was under a strict lockdown in 2020. Between April and June 2020, we performed qualitative interviews (n = 25) of permanent residents of the island. From the findings, it is evident that social capital is an important resource with the capacity to organize help and support. However, the dark sides of social capital, with lack of social cohesion and lack of trust, also emerged as an important negative issue. We identified sources of tension that were not resolved, as well as important sociodemographic differences that are primary drivers for health inequalities. The investment in social networks and social capital is a long-term need that should consider sociodemographic vulnerability.

The challenge of assessing social cohesion in health impact assessment

Health impact assessment (HIA) is a method by which a policy, programme or project falling outside traditional health fields, may be judged as to its potential effects on the health of a population to mitigate negative impacts and strengthen the positive ones. Proposals are analysed from the perspective of all the determinants of health. In France, HIAs are mainly applied to urban development projects where social cohesion (SCo) is a major issue. Although the HIA method is well structured as a step-by-step process, there are no guidelines for assessing SCo. This article opens with literature review to clarify the concept of SCo and to understand how the built environment influences SCo and how social environment influence health. Drawing on this work, this paper presents an analytical framework to assess SCo, integrating both the spatial and physical dimensions of urban design and the perceptions of the neighbourhood characteristics. Following a brief overview of the key findings from applying this framework to HIA of an urban development project, the paper discusses its related strengths and weaknesses. The framework could be a useful tool for HIA as it embraces knowledge from both urban planning and social sciences. It also allows for an overall analysis of all the indicators without relying on a checklist. Nevertheless, it should be tested further to improve its validity.

Social-life factors associated with participation in screening and further assessment of colorectal cancer: A nationwide ecological study in Japanese municipalities

The burden of colorectal cancer in developed countries is high, and it is a major public health concern in Japan. Improving the quality of evidence on colorectal cancer screening participation and further assessment participation rates is important to reduce this burden. This study examined the social-life factors that influence colorectal cancer screening programs in Japan, particularly the effects of the proportion of elderly people and social capital, using a municipality-level national database and existing health reports. Data from a national municipality-based study were analyzed to identify social-life factors associated with participation in colorectal cancer screening and further assessment. Administrative data on the Japanese municipal screening programs were drawn from the Report on Regional Public Health Services and Health Promotion Services 2017. Available data used as predictors of interest for all 1719 municipalities as of 2017 were from the national census, statistical reports on the land area by prefecture and municipality, municipal financial surveys, a survey of physicians, dentists and pharmacists, and other databases. The mean rate of participation in colorectal cancer screening was 13.8%, and that of further assessment was 73.6%. Multiple linear regression analyses of the two outcomes showed that the proportion of elderly people was most significantly positively associated with colorectal cancer screening programs (β = 0.51 for participation, β = 0.13 for further assessment participation), and the proportion of single-elderly-person households was most significantly negatively associated (β = −0.45 and −0.19, respectively). It is suggested that the health behaviors required for participation in colorectal cancer programs in Japanese elderly populations are greatly affected by family members.

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The disease burden of colorectal cancer is increasing in developed countries.

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An ecological study of the colorectal cancer screening program was conducted.

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The proportion of elderly people was positively associated with the screening rates.

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The single-elderly-person households was negatively associated with the screening rates.

Does social capital influence purpose in life and life satisfaction among Japanese health-literate professionals?

A strong sense of purpose and satisfaction in life is associated with multiple health benefits. There is also evidence to suggest that social capital predicts better health indicators. While both social capital and purpose and satisfaction in life direct better health, the relationship between social capital and purpose and satisfaction in life in terms of health, remains unclear. A retrospective cohort study was conducted on Japanese health management professionals (N = 4820). We analyzed the cohort’s demographics and reported changes in social capital (social engagement and trust), purpose in life, and life satisfaction using self-reported questionnaires and the Ikigai-9 scale. The cohort was categorized into group 1 (neither changes), group 2 (one changes), and group 3 (both change), based on the number of changes reported in social capital. Purpose in life and life satisfaction scores were then compared among the three groups. The purpose in life score (SD [standard deviation]) for groups 1, 2, and 3 was 30.7 (6.0), 32.5 (5.6), and 35.6 (5.2), respectively. Life satisfaction scores (SD) for groups 1, 2 and 3 were 3.35 (0.8), 3.67 (0.8), and 4.26 (0.7), respectively. We found a statistically significant difference in purpose and satisfaction in life among the three groups (F(2) = 361.4, p < 0.001 and F(2) = 703.9, p < 0.001). Social capital was associated with purpose and satisfaction in life among health-literate professionals. Strengthening social capital may increase individual purpose and satisfaction in life and ultimately yield better health.

Rasch model of the bridging social capital questionnaire

Bridging social capital is defined as the connections between individuals who are dissimilar with respect to socioeconomic status and other characteristics. We previously identified an important gap in the literature related to its measurement. We developed and validated a scale to measure bridging social capital to be used in Latinx immigrant populations living in the U.S using Classical Test Theory. The structure of the questionnaire comprised the following sub-scales: Socializing in the work place (5 items); Participation in community activities (16 items); Socializing in community activities (5 items); Contact with similar/different people (7 items); Assistance (17 items); Trust of institutions, corporations and other people (14 items); and Trust of intimate people (3 items). Although basic psychometric validation was performed on our original instrument (e.g., content and construct validity, internal consistency reliability), modern testing theory recommends a more comprehensive set of evaluations, including assessment of data quality, scaling assumptions, targeting, reliability, validity and responsiveness. Rasch measurement theory (RMT) is one of the Modern Test Theory methods that assesses the extent to which rigorous measurement is achieved. In the present work, our objective was to further evaluate the instrument using CTT and to use modern psychometric techniques to further validate the questionnaire and create version 2 (v2) using a new sample (N = 224). We developed a Rasch model of the questionnaire to evaluate item fit statistics, item category thresholds, person separation index (PSI), local dependency, differential item functioning (DIF), unidimensionality and targeting and item locations. Assistance was the most problematic sub-scale of all, as item-to-total correlations ranged from 0.27 to 0.66. There were no disordered thresholds on any item, either examined as part of the overall score or as part of sub-scales. However, the analysis provided evidence of the need to modify some of the sub-scales as there was lack of support for unidimensionality or fit to the Rasch model. The Bridging Social Capital Questionnaire v2 has 61 items (compared to 67 in version 1). Our questionnaire may be suitable for adaptation to other immigrant groups in different countries.

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The measurement of bridging social capital is crucial in underserved populations.

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It is crucial to use valid questionnaires to evaluate bridging social capital.

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The use of modern psychometric techniques to evaluate questionnaires is key.

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We present a validated questionnaire using the Rasch model.

Knowledge of prescribed drugs among primary care patients: findings from Prover Project

Background Evidence on patient medication knowledge and associated factors within primary care patients is limited, especially in developing countries. Objective To estimate the prevalence and investigate the role of individual and contextual factors on insufficient medication knowledge among primary care patients. Setting Public community pharmacies in a health pole city (234,937 inhab.) in Minas Gerais State, Brazil. Methods Exit-survey conducted with a representative sample of 1221 patients (≥ 18 years) interviewed after dispensing. Data collected for medicines included its name, therapeutic indication, dosage, time of administration, treatment duration, side effects and warnings. Information were compared to the prescription and official guidelines. Descriptive statistics and logistic regression analysis were applied. Main outcome measure Insufficient patient medication knowledge. Results Prevalence of insufficient medication knowledge was 30.1%. Side effects (96.3%) and warnings (71.1%) had the highest percentage of misses. Musculoskeletal system drugs presented the lowest knowledge score (mean = 5.9; SD = 1.9). Significant determinants of insufficient medication knowledge with respective odds ratio (OR) were: level of education (≤ 3 years, OR 1.50; 95% CI 1.06-2.11 and 4-7 years, OR 1.37; 95% CI 1.02-1.84), number of comorbidities (≤ 2, OR 1.36; 95% CI 1.04-1.77), use of prescription drugs in the last 15 days (no, OR 2.22; 95% CI 1.31-3.76) and number of people able to lend money (no person, OR 1.34; 95% CI 1.04-1.74). Conclusion Counselling and monitoring practices should be tailored to patients with less schooling, that are initiating treatment and with low disease burden. Equally important is the need to implement strategies to increase the patient's level of social capital to improve treatment knowledge.

The exchange and use of cultural and social capital among community health workers in the United States

Community health care workers (CHWs), lay community members with basic health care training, have been charged with providing appropriate care for vulnerable populations, addressing social determinants and improving population health. Frequently, CHWs lack the economic or cultural capital to accomplish these goals. Through analysis of 17 semi-structured interviews with CHWs and supervisors at a CHW programme in the United States, we draw on Bourdieu's theory of practice to examine how the exchange of cultural and social capital impact CHW effectiveness. We found that CHWs' reliance on bonding capital was perceived to effectively build social networks and mutual trust among marginalised communities. But, over-reliance on embodied cultural capital and bonding capital reduced integration into the health care field; limited access to bridging capital; and limited social standing. We highlight how the exchange of cultural to bonding and bridging capital presented structural limitations. Overall, the demonstrated tension demarcates and reinforces longstanding divisions between social issues and health care issues. Future efforts should focus on promoting the unique skills of CHWs within health care settings to avoid compromising CHWs' ability to advance population health.

Criminal victimization, cognitive social capital and mental health in an urban region in Germany: a path analysis

PURPOSE

There is ample evidence that experiencing a criminal victimization is associated with lasting emotional problems among victims. To date, the mechanisms behind this association are not well understood. Based on the theoretical assumptions derived from a transactional stress-appraisal and coping model this study analyses the role of cognitive social capital (SC) in the association between criminal victimization (CV) and victims' mental health.

METHODS

A cross-sectional, computer-aided telephone survey including a representative sample of 3005 persons from three German cities was conducted. Respondents were asked about CV during their lifetime, cognitive SC, perceived victimization risk, perceived safety and perceived ability to prevent victimization. The PHQ-4 was used as a measure of anxiety and depression. The data were analyzed by means of logistic regression models and a path model controlled for sociodemographic characteristics.

RESULTS

Lifetime CV with any type of crime was associated with a clinically relevant increased risk of mental disorder (PHQ-4 ≥ 9; OR 1.8, p ≤ 0.05). Path analyses revealed that the direct association between CV and PHQ-4 (β = 0.454; p ≤ 0.01) was significantly diminished by cognitive SC (β =  - 0.373; p ≤ 0.05).

CONCLUSION

Our results suggest that cognitive SC is an individual resilience factor against negative experiences related to CV and that it holds the potential to diminish negative mental health consequences of CV. Further research should explore to what extent an enhancement of cognitive SC can help to prevent anxiety and depression among crime victims.

Social networks, health and identity: exploring culturally embedded masculinity with the Pakistani community, West Midlands, UK

Background

Migrants from South Asia living in developed countries have an increased risk for developing cardiovascular disease (CVD), with limited research into underlying social causes.

Methods

We used social capital as an interpretive lens to undertake analysis of exploratory qualitative interviews with three generations of at-risk migrant Pakistani men from the West Midlands, UK. Perceptions of social networks, trust, and cultural norms associated with access to healthcare (support and information) were the primary area of exploration.

Results

Findings highlighted the role of social networks within religious or community spaces embedded as part of ethnic enclaves. Local Mosques and gyms remained key social spaces, where culturally specific gender differences played out within the context of a diaspora community, defined ways in which individuals navigated their social spheres and influenced members of their family and community on health and social behaviours.

Conclusions

There are generational and age-based differences in how members use locations to access and develop social support for particular lifestyle choices. The pursuit of a healthier lifestyle varies across the diverse migrant community, determined by social hierarchies and socio-cultural factors. Living close to similar others can limit exposure to novel lifestyle choices and efforts need to be made to promote wider integration between communities and variety of locations catering to health and lifestyle.

Assessment of health inequality between urban-to-urban and rural-to-urban migrant older adults in China: a cross-sectional study

BACKGROUND

Many studies focused on health inequality between migrant older adults and local older adults, while few study concerned the health inequalities between urban-to-urban and rural-to-urban migrant older adults. This study aimed to compare physical health and mental health between these two groups in Hangzhou, Zhejiang Province, China, and to explore the relationship between cognitive social capital, social integration and health among migrant older adults.

METHODS

A two-stage stratified sampling method was employed to recruit participants from May to August 2013 in Hangzhou. Measurement data were compared with student's t-tests and multivariate analysis of variance (MANOVA). Multiple linear regression was adopted in this study.

RESULTS

A total of 1000 of participants who met the inclusion criteria were analyzed, consisting of 527 (52.7%) urban-to-urban and 473 (47.3%) rural-to-urban migrant older adults. There were no statistically significant difference in physical health and mental health between urban-to-urban and rural-to-urban groups on the whole. However, urban-to-urban migrant older adults had a higher reciprocity and social integration than did in rural-to-urban group (13.36 vs. 12.50, p < 0.01; 40.07 vs. 38.50, p < 0.01). And both of cognitive social capital and social integration were positively related to physical health (social reciprocity: t = 6.69, p < 0.01; social trust: t = 3.27, p < 0.01; social integration: t = 5.66, p < 0.01) and mental health (social reciprocity: t = 4.49, p < 0.01; social trust: t = 5.15, p < 0.01; social integration: t = 10.02, p < 0.01). Overall, the female, widowed, and the oldest among migrant older adults had a worse health.

CONCLUSIONS

Social capital and social integration were played important roles in health of migrant older adults. The female rural-to-urban migrant older adults, those aged over 70 years, and older adults who were not in marriage should be especially concerned in health policy making.

How does bridging social capital relate to health-behavior, overweight and obesity among low and high educated groups? A cross-sectional analysis of GLOBE-2014

Background

Social capital is an important determinant of health, but how specific sub-dimensions of social capital affect health and health-related behaviors is still unknown. To better understand its role for health inequalities, it is important to distinguish between bonding social capital (connections between homogenous network members; e.g. similar educational level) and bridging social capital (connections between heterogeneous network members). In this study, we test the hypotheses that, 1) among low educational groups, bridging social capital is positively associated with health-behavior, and negatively associated with overweight and obesity, and 2) among high educational groups, bridging social capital is negatively associated with health-behavior, and positively with overweight and obesity.

Methods

Cross-sectional data on educational level, health-behavior, overweight and obesity from participants (25–75 years; Eindhoven, the Netherlands) of the 2014-survey of the GLOBE study were used (N = 2702). Social capital (“How many of your close friends have the same educational level as you have?”) was dichotomized as: bridging (‘about half’, ‘some’, or ‘none of my friends’), or bonding (‘all’ or ‘most of my friends’). Logistic regression models were used to study whether bridging social capital was related to health-related behaviors (e.g. smoking, food intake, physical activity), overweight and obesity, and whether these associations differed between low and high educational groups.

Results

Among low educated, having bridging social capital (i.e. friends with a higher educational level) reduced the likelihood to report overweight (OR 0.73, 95% CI 0.52–1.03) and obesity (OR 0.58, 95% CI 0.38–0.88), compared to low educated with bonding social capital. In contrast, among high educated, having bridging social capital (i.e. friends with a lower educational level) increased the likelihood to report daily smoking (OR 2.11, 95% CI 1.37–3.27), no leisure time cycling (OR 1.55, 95% CI 1.17–2.04), not meeting recommendations for vegetable intake (OR 2.09, 95% CI 1.50–2.91), and high meat intake (OR 1.39, 95% CI 1.05–1.83), compared to high educated with bonding social capital.

Conclusions

Bridging social capital had differential relations with health-behavior among low and high educational groups. Policies aimed at reducing segregation between educational groups may reduce inequalities in overweight, obesity and unhealthy behaviors.

No unmet needs without needs! Assessing the role of social capital using data from European social survey 2014

This paper examines the determinants of unmet healthcare needs in Europe. Special emphasis is put on the impact of social capital. Data come from the European Social Survey, 2014. Our study includes 32,868 respondents in 20 countries. Because unmet needs are observed only in those individuals who are exposed to, and recognise, the need of medical care, sample selection can be an issue. To address it, we analyse the data using the bivariate sample selection model. When there is no need, there is no assessment of access to healthcare. Accordingly, in this situation, our model assumes that unmet need is unobserved. The magnitude and statistical significance of the error correlation support our modelling strategy. A high proportion (18.4%) of individuals in need in Europe reported unmet needs. Informal connections seem to mitigate barriers to access as well as trust in other people and institutions, particularly in health services. Financial strain still is a strong predictor of unmet needs. Other vulnerable groups include informal carers, minorities and individuals feeling discriminated. Unmet needs might also arise due to persistent needs of healthcare as it seems to be the case of individuals with lower health status and chronic conditions. A result that merits further research concerns the positive impact of civic engagement on unmet needs.

Higher child-raising costs due to maternal social isolation: Large population-based study in Japan

BACKGROUND

To assess the association between maternal social isolation and the child-rearing costs among mothers with 6-month-old infants.

METHODS

Data was analyzed from a population-based birth-cohort study in Japan, the Longitudinal Survey of Babies in the 21st Century (n = 40,643). Maternal isolation was defined by lack of social support among mothers expressing difficulties with child rearing. Child-rearing costs for one month (when the infant was 6-months-old) were self-reported in units of JPY 10,000 (approximately 80 USD). The association between maternal social isolation and child-rearing cost was assessed using generalized linear models adjusted for child, maternal, and family level characteristics.

RESULTS

Of the sample, 258 (0.6%) women were classified as socially isolated. In the crude model, isolated mothers paid JPY 6980 (95% confidence interval [CI]: 4753-9207), approximately USD$87, more per month on child-rearing expenses compared to non-isolated mothers. This finding was similar in the multivariable adjusted model (marginal effect: JPY 4,186, 95% CI, 2235-6136). Stratified analysis comparing low income vs. non-low income mothers showed that, among the former group, socially isolated mothers spend more on child rearing than mothers who are not isolated (marginal effect: JPY 13,218, 95% CI:784 to 2565), while among the non-low income group, a significant association was not observed.

CONCLUSIONS

Socially isolated mothers spent JPY4,186 (approximately USD 35) more per month on child-rearing costs compared to non-isolated mothers when the infant was aged 6 months old. In nationwide terms, this cost could be roughly calculated as JPY 350 million (approximately USD 2.9 million) in 2001. Provision of social network connections and support for socially isolated mothers is suggested to be an efficient public health policy.

Development of an exercise adherence program for breast cancer survivors with cancer-related fatigue-an intervention mapping approach

PURPOSE

Cancer-related fatigue (CRF) is the most common and distressing symptom in breast cancer survivors (BCS), with severe impact on quality of life. CRF can be reduced through exercise, but conversely, is also a barrier to exercising. The aim of this article was to apply the intervention mapping protocol (IMP) to develop an exercise adherence intervention for BCS with CRF.

METHOD

The program was developed using the IMP, which consists of six steps. Based on the data from focus group interviews and literature review, we produced a logic model of change.

RESULTS

Two performance objectives (survivors adopt and maintain exercise and survivors cope with fatigue) and 17 change objectives were generated. Also, we designed theory-based methods of change, and strategies for practical application. A structured program plan that includes intervention content and methods, ranges, and program data was proposed. Finally, an implementation and evaluation plan was developed.

CONCLUSION

The IMP provided a useful framework to systematically plan an exercise adherence program. This study resulted in a theory and practice-based exercise adherence program, based on behavioral change theories, and practice-based knowledge that fits the needs of BCS with CRF.

Child Loss, Social Capital, and Depressive Symptoms Among Elderly Adults in Urban and Rural China

OBJECTIVE

The purpose of this study was to examine the moderating effects of individual and community social capital on the relationship between child loss and depressive symptoms among elderly adults in China.

METHOD

A sample of 2,581 elderly adults in 272 rural communities and 826 elderly adults in 116 urban communities was drawn from Chinese Health and Retirement Longitudinal Studies. Hierarchical linear modeling was applied in the analysis.

RESULTS

Social participation as an indicator of individual social capital has a buffering effect on depressive symptoms among rural bereaved parents while it is not beneficial for urban bereaved parents. In contrast, community social capital may be a protective factor for the mental health of urban bereaved parents, but no so for those in rural areas.

DISCUSSION

These findings highlight the complex interplay of social capital and broader socio-cultural contexts in rural and urban China and suggest policy implications.

Particularized trust, generalized trust, and immigrant self-rated health: cross-national analysis of World Values Survey

OBJECTIVES

This research examined the associations between two types of trust, generalized and particularized, and self-rated health among immigrants.

STUDY DESIGN

Data were drawn from the World Values Survey (WVS6), the latest wave of cross-sectional surveys based on face-to-face interviews.

METHODS

The immigrant subsample analyzed herein contains 3108 foreign-born individuals clustered from 51 countries. Given the hierarchically nested data, two-level logistic regressions models were estimated using HLM (Hierarchical Linear Modeling) 7.1.

RESULTS

At the individual level, net of socio-economic and demographic factors (age, gender, marital status, education, income, neighborhood security, and subjective well-being), particularized trust was positively related to physical health (odds ratio [OR] = 1.11, P < .001). Generalized trust, however, was not a significant predictor. At the country level, based on alternative models, the aggregate measure of particularized trust was negatively associated with subjective health. The odds of being healthy were on average about 30% lower.

CONCLUSION

The interdisciplinary literature on social determinants of health has largely focused on the salubrious impact of trust and other forms of social capital on physical well-being. Many previous studies based on general, not immigrant, populations also did not differentiate between generalized and particularized types of trust. Results from this study suggest that this conceptual distinction is critical in understanding how and to what extent the two are differentially related to immigrant well-being across multiple levels of analysis.

Investigating the Associations between Ethnic Networks, Community Social Capital, and Physical Health among Marriage Migrants in Korea

This study examines factors associated with the physical health of Korea's growing immigrant population. Specifically, it focuses on the associations between ethnic networks, community social capital, and self-rated health (SRH) among female marriage migrants. For empirical testing, secondary analysis of a large nationally representative sample (NSMF 2009) is conducted. Given the clustered data structure (individuals nested in communities), a series of two-level random intercepts and slopes models are fitted to probe the relationships between SRH and interpersonal (bonding and bridging) networks among foreign-born wives in Korea. In addition to direct effects, cross-level interaction effects are investigated using hierarchical linear modeling. While adjusting for confounders, bridging (inter-ethnic) networks are significantly linked with better health. Bonding (co-ethnic) networks, to the contrary, are negatively associated with immigrant health. Net of individual-level covariates, living in a commuijnity with more aggregate bridging social capital is positively linked with health. Community-level bonding social capital, however, is not a significant predictor. Lastly, two cross-level interaction terms are found. First, the positive relationship between bridging network and health is stronger in residential contexts with more aggregate bridging social capital. Second, it is weaker in communities with more aggregate bonding social capital.

The correlates of social capital and adherence to healthy lifestyle in patients with coronary heart disease

OBJECTIVE

To investigate the correlates of social capital and adherence to healthy lifestyle in patients with coronary heart disease (CHD).

METHODS

This register-based, cross-sectional study consisted of individuals diagnosed with CHD at four community health service centers, Shanghai, China, between April and July 2016 (n=609). The sociodemographic characteristics, social capital, adherence to physical activity, and nutrition data were obtained through face-to-face interviews. Social capital was assessed by social participation, social networking, social support, social trust, and sense of belonging. Physical activity and nutrition were measured with the Health-Promoting Lifestyle Profile II. The independent two-sample t-test and Pearson's correlations were used to analyze associations among variables. Hierarchical multiple regression models were used to evaluate effects of social capital on adherence to physical activity and nutrition.

RESULTS

The average age of the sample was 60.87 (standard deviation [SD] =6.91), with 54.4% being male and 45.6% female. The average score of physical activity and nutrition were 2.38 (SD =0.59) and 2.78 (SD =0.50), respectively. The final model significantly explained 28.9% of variance in physical activity (F=34.96, P<0.001) and 30.5% of variance in nutrition (F=37.73, P<0.001). Most of the subdimensions of social capital were significantly associated with physical activity and nutrition, after controlling for marital status and education level.

CONCLUSION

The results suggested that social capital was the correlate of adherence to long-term healthy lifestyle, including physical activity and nutrition. These findings highlight the need to take into account social capital in developing intervention strategies to improve the adherence to the long-term healthy lifestyle for patients with CHD.

The development of a bridging social capital questionnaire for use in population health research

Bridging social capital is defined as the connections between individuals who are dissimilar with respect to socioeconomic and other characteristics. There is an important gap in the literature related to its measurement. We describe the development and validation of a questionnaire to measure bridging social capital. We focused the development of the questionnaire to be suitable for use in Latino immigrant populations in the U.S. The structure of the questionnaire comprised the following: Socialization in the job place (5 items); Membership in community activities (16 items); Participation in community activities (5 items); Contact with similar/different people (7 items); Assistance (17 items); Trust of institutions, corporations and other people(14 items); and Trust of intimate people (3 items). First, we used focus groups (N=17 participants) to establish content validity with an inductive thematic analysis to identify themes and subthemes. Changes were made to the questionnaire based on difficulty, redundancy, length and semantic equivalence. Second, we analyzed the questionnaire's psychometric properties (N=138). We tested internal consistency with Cronbach alpha and construct validity with a Confirmatory Factor Analysis (CFA) for each sub-scale to test theoretical unity; discriminant validity to observe differences between participants from high and low SES backgrounds and different language; and content validity with an independent expert panel. Cronbach alphas ranged from 0.80 (Assistance) to 0.92 (Trust). CFA results indicated that CFI and TLI were higher than 0.90 in almost all the scales, with high factor loadings. The Wilcoxon tests indicated that there were statistically significant mean differences between SES and language groups (p<0.00). The independent expert panel determined that the questionnaire had good content validity. This is the first demonstration of a psychometrically validated questionnaire to measure bridging social capital in an immigrant population in the United States. Our questionnaire may be suitable for further refinement and adaptation to other immigrant groups in different countries.

Is Social Network Diversity Associated with Tooth Loss among Older Japanese Adults?

BACKGROUND

We sought to examine social network diversity as a potential determinant of oral health, considering size and contact frequency of the social network and oral health behaviors.

METHODS

Our cross-sectional study was based on data from the 2010 Japan Gerontological Evaluation Study. Data from 19,756 community-dwelling individuals aged 65 years or older were analyzed. We inquired about diversity of friendships based on seven types of friends. Ordered logistic regression models were developed to determine the association between the diversity of social networks and number of teeth (categorized as ≥20, 10-19, 1-9, and 0).

RESULTS

Of the participants, 54.1% were women (mean age, 73.9 years; standard deviation, 6.2). The proportion of respondents with ≥20 teeth was 34.1%. After adjusting for age, sex, socioeconomic status (income, education, and occupation), marital status, health status (diabetes and mental health), and size and contact frequency of the social network, an increase in the diversity of social networks was significantly associated with having more teeth (odds ratio = 1.08; 95% confidence interval, 1.04-1.11). Even adjusted for oral health behaviors (smoking, curative/preventive dental care access, use of dental floss/fluoride toothpaste), significant association was still observed (odds ratio = 1.05 (95% confidence interval, 1.02-1.08)).

CONCLUSION

Social connectedness among people from diverse backgrounds may increase information channels and promote the diffusion of oral health behaviors and prevent tooth loss.