Location, location, location: contextual and compositional health effects of social capital in British Columbia, Canada

Socioeconomic drivers of marine debris in North America

Economic development, coastal population growth, and expansion of tourism-related activities along coastlines have been the leading causes of marine debris pollution worldwide. While the problem of marine debris pollution has been increasingly recognized, there has been limited research on its socioeconomic drivers, primarily due to a paucity of consistent data on debris. The research described here utilizes newly available data from the U.S. National Oceanic and Atmospheric Association (NOAA) on marine debris along eight coastal states of North America to examine the relationship of such debris pollution with socioeconomic variables including population, age, education, and tourism, as well as the mitigating effect of social capital on debris pollution. The results indicate that marine debris increases with income; however, at higher income levels the amount of pollution starts to decline, supporting the "Environmental Kuznets" hypothesis. We also find that population growth along coastlines contributes to greater debris accumulation. Our results further highlight the significant roles social capital and education play in curbing debris pollution. Understanding the socioeconomic drivers of marine debris is an important first step in informing abatement policy and allocation of resources by public agencies to address the marine pollution problem.

How does social capital affect individual health among the elderly in rural China?-Mediating effect analysis of physical exercise and positive attitude

BACKGROUND

The elderly in rural areas comprise over half of the older population in China, and their health problems are a matter of great concern for the Chinese government and society. Among the many factors affecting health, social capital has generated much interest in academic research. Exploring the relationship between social capital and individual health among the elderly in rural China provides ways to improve the health of Chinese people, which has a positive impact on policy.

METHODS

We selected 3719 respondents from the 2016 China Family Panel Studies (CFPS). Structural and cognitive social capital were obtained via exponentiation of variables (mean of zero and a standard deviation of one) and by giving them equal weight. Ordinary least squares (OLS) and two-stage least squares (2SLS) estimators were used to analyze the association between social capital and individual health. We explored the mechanism linking structural and cognitive social capital with individual health through a mediation effect analysis.

RESULTS

After correcting for endogeneity bias, structural social capital had a positive correlation with individual health among the elderly, with a coefficient of 0.062 (95% CI: 0.020-0.104). Cognitive social capital also had a positive correlation with individual health, with a coefficient of 0.097 (95% CI: 0.060-0.135). Physical exercise and positive attitude were two significant mediating variables of the relationship between social capital and individual health in the study group, with mediating effects of 0.018 and 0.054, respectively.

CONCLUSIONS

Cognitive social capital played a stronger role than structural social capital in promoting individual health among the elderly. Physical exercise and positive attitude mediated the relationship between social capital and individual health. Policymakers should not only build basic medical and health care systems but also consistently cultivate and strengthen structural and cognitive social capital among the elderly in rural China.

Social capital and perceived stress: The role of social context

BACKGROUND

The aim of this study is twofold: to investigate how much variance in individual perceived stress is attributed to household and area levels, respectively, and to examine the association between social capital at the individual, household, and area levels and perceived stress, while adjusting for various cofounders at the individual, household, and area levels.

METHODS

This study used data from the 2010 Seoul Welfare Panel Study conducted by the Seoul Welfare Foundation. A total sample of 5881 individuals in 2820 households within 25 areas was used for multilevel analysis.

RESULTS

The results showed that a relatively large proportion of variance in perceived stress was attributed to the household level (45.86%) in comparison with the area level (6.96%), which indicates that household or family context is more important in explaining variance in perceived stress than area. This study also found that some components of social capital were negatively associated with perceived stress, and the association between social capital and perceived stress varied depending on levels and types of social capital measures.

LIMITATIONS

This study is based on a cross-sectional design, and thus it is not clear about the temporal order between the relationship between social capital and perceived stress.

CONCLUSIONS

Overall, this study showed that research on social capital and mental health can be advanced by systematically investigating the role of household social capital, not just geographical social capital.

The effect of group involvement on post-disaster mental health: A longitudinal multilevel analysis

Involvement in voluntary associations is a key form of social capital and plays an especially important role following disaster as a venue for coordination and decision-making for the wider community. Yet, relatively little attention has been paid to how group involvement affects mental health, at either the individual or community level. The aim of this study was to assess the impact of involvement in voluntary associations on mental health among residents of bushfire-affected communities. A longitudinal sample of 642 individuals affected by the 2009 Victorian bushfires in south-eastern Australia were surveyed in 2012 and 2014 (3- and 5-years post-disaster). A further subsample (n = 552) of residents residing continuously within 22 bushfire-affected communities were examined for community-level effects using multilevel regression methods. After adjusting for demographics, disaster exposure, and network variables, group involvement at time 1 bore a curvilinear relationship with PTSD at both time points: moderate involvement was most beneficial, with no participation, or high amounts, yielding poorer outcomes. High amounts of group involvement was likewise linked to a greater risk of major depression. Furthermore, communities with higher median levels of group involvement reported lower levels of PTSD symptoms and major depression two years later. With respect to group involvement, more is not always better. For individuals, moderation - if possible - is key. Meanwhile, community-level health benefits come when most people participate to some extent, suggesting that the distribution of involvement across the community is important.

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.

Focusing neighborhood context and self-rated health in the Pró-Saúde Study

The influence of neighborhood characteristics on self-rated health has been little studied. A multilevel approach using hierarchical models was applied to analyze the relationship between the socioeconomic characteristics in 621 neighborhoods (level 2) in the city of Rio de Janeiro, Brazil, and the self-rated health of 3,054 university employees (level 1) from the baseline of the Pró-Saúde Study. Neighborhoods were created using the SKATER algorithm (Spatial ‘K’luster Analysis by Tree Edge Removal) to cluster census tracts according to four indicators and a minimum population of 5,000 people. After adjustment for individual factors (per capita income, schooling, age, sex, ethnicity, health-related behavior and chronic diseases), low level of neighborhood income and higher numbers of members per household were significantly associated with poor self-rated health. Participants living in medium income-level neighborhoods were 34% more likely to self-rate their health as being poor. Those living in areas with a higher density of members per household were 50% more likely to present poor self-rated health. Neighborhood context influences self-rated health, beyond the effect of individual factors. Worsening neighborhood socioeconomic conditions affect health adversely, which in turn increasing the chance of poor self-rated health.

Mental distress and perceived wealth, justice and freedom across eight countries: The invisible power of the macrosystem

Health and well-being have been related to macro-level factors such as income, income inequality or socioeconomic status. With regard to the increasing burden of disease due to mental disorders worldwide, the association between the macrosystem and mental distress should be further explored, too. In this context, the subjective evaluation of the macrosystem might play an important role. In the present exploratory study, we assessed symptoms of depression, anxiety and stress as well as perceived wealth, justice and freedom in population-based surveys in Spain, France, Germany, Poland, Russia, Sweden, the United Kingdom and the United States of America (n ≈ 1000 per country). The Swedish sample presented the lowest symptom ratings of depression, anxiety and stress and the highest self-rated health. The results also indicated that the subjective evaluation of the macrosystem matters in respect to mental distress. The complete model, including the control variables country, gender, age and education, and perceived wealth, justice and freedom predicted depression, anxiety and stress symptoms explained 8% of the variance of each symptom cluster. The present results encourage research to consider the macrosystem, and the subjective evaluation of macro-level factors, as a relevant component in biopsychosocial models of mental distress.

Alcohol intake among adolescent students and association with social capital and socioeconomic status

The aim was to evaluate the prevalence of alcohol consumption, binge drinking and their association with social capital and socioeconomic factors among Brazilian adolescents students. A cross-sectional study was carried out with a randomly selected representative sample of 936 adolescents aged 15 to 19 years. Information on alcohol consumption, social capital and socioeconomic status was collected using the Alcohol Use Disorders Identification Test, the Integrated Questionnaire for the Measurement of Social Capital and Social Vulnerability Index, respectively. The prevalence of alcohol consumption was 50.3% and binge drinking 36% the last year. Adolescents who reported believing that people in their community could help solve a collective problem (with the water supply) and those classified as having high social vulnerability had lower likelihood of binge drinking (PR = 0.776 [95%CI:0.620 to 0.971] and PR = 0.660 [95%CI:0.542 to 0.803], respectively). The prevalence of alcohol consumption and binge drinking the last year is high among participants. Those with higher socioeconomic status as well as lower perceptions of community capital social are more likely to display binge-drinking behavior.

Perceptions of community, social capital, and how they affect self-reported health: a multilevel analysis

OBJECTIVES

The link between social capital and self-reported health has been widely explored. On the other hand, we know less about the relationship between social capital, community socioeconomic characteristics, and non-social capital-related individual differences, and about their impact on self-reported health in community settings.

METHODS

Cross-sectional study design with a proportional sample of 7965 individuals from 20 US communities were analyzed using multilevel linear regression models, where individuals were nested within communities. The response rates ranged from 13.5% to 25.4%.

RESULTS

Findings suggest that perceptions of the community and individual level socioeconomic characteristics were stronger predictors of self-reported health than were social capital or community socioeconomic characteristics.

CONCLUSIONS

Policy initiatives aimed at increasing social capital should first assess community member's perceptions of their communities to uncover potential assets to help increase social capital.

Design of a Health-Promoting Neighborhood Intervention

Design and implementation of health-promoting community interventions can advance public health and community well-being; however, realization of such programs is often challenging. Even more challenging is the implementation of ecologic interventions to revitalize built urban environments. A structured intervention entitled `Intersection Repair` was devised in Portland, Oregon, by a non-profit organization, to implement urban gathering places in the public right of way; specific steps included situation analysis, community outreach, asset mapping, design workshops, construction permitting, building workshops, and process evaluation. The community created human-scale urban landscapes with interactive art installations to encourage social interactions. Such aesthetic improvements, which included painted street murals, information kiosks, hanging gardens, water fountains, benches, and so on, were intended to strengthen social networks and social capital by providing places for residents to engage in conversation. Community engagement in neighborhood design benefits the public at multiple levels, by promoting a healthier lifestyle, over and above urban landscape improvements.

Effects of Health Literacy and Social Capital on Health Information Behavior

This study aimed to examine whether social capital (bonding and bridging social capital) attenuate the effect of low functional health literacy on health information resources, efficacy, and behaviors. In-person interviews were conducted with 1,000 residents in Seoul, Korea, in 2011. The authors found that respondents' functional health literacy had positive effects on the scope of health information sources and health information self-efficacy but not health information-seeking intention. Respondents' social capital had positive effects on the scope of health information sources, health information efficacy, and health information-seeking intention. The authors found (a) a significant moderation effect of bridging social capital on the relation between health literacy and health information self-efficacy and (b) a moderation effect of bonding social capital on the relation between health literacy and health information-seeking intention.

Social capital and oral health

Social determinants have always been an important element of the oral health. It has been seen that social aspects like the organizations and relations influence the health of population. A new domain named social capital has come up into limelight which refers to "features of social organization, such as trust, norms and networks that can improve the efficacy of society by facilitating coordinated actions". The bonds between individuals, both in intimate relationships and in voluntary associations have been claimed to have health promoting effects. Oral health can never be segregated from general health as they are bidirectional in their relationship. Therefore determinants of general health and its promotion are interlinked with that of oral health. So, this review tries to figure out the effects of social capital on various aspects of oral health.

Collective efficacy and depressive symptoms in Brazilian elderly

The objective was to investigate the association between depressive symptoms and collective efficacy among the elderly in a municipality in southern Brazil. A cross-sectional population-based design was carried out. Structured interviews were held at the homes of 1007 elderly individuals. The presence of depressive symptoms was measured using the Geriatric Depression Scale, exposures were a standard 8-item collective efficacy scale and a single item about elderly participation in groups. Data were analyzed using Poisson regression to obtain the crude and adjusted prevalence ratios (PRs). The sample consisted mostly of female (63%), white (96%) and married (64%) elderly individuals. The mean age, income and educational level were, respectively: 73 years (SD=4), R$ 1836 (SD=2170) and 5 years of education (SD=4). After controlling for demographic, socioeconomic, behavioral and health-related variables, participants who reported low collective efficacy at the places where they lived presented a prevalence of depressive symptoms that was twice as high as the prevalence among those who reported high collective efficacy. In the same way, elderly individuals who did not participate in groups presented prevalence of the outcome around 64% higher than among those who took part in one or more groups. The study suggests that creation of and participation in social networks and community groups may be an important strategy for promoting mental health among the elderly.

Social Capital and Self-Rated Health Among Middle-Aged and Older Adults in China

This study examined the association between social capital, at both the individual and the community level, and self-rated health among older adults in China. Using data from the 2008 Pilot Survey of China Health and Retirement Longitudinal Study, a series of multilevel logistic models were estimated in SAS 9.2. The association between social capital and self-rated health was examined among 996 adults aged 45 or older from two provinces in China, while controlling for demographic characteristics and socioeconomic variables. Our results suggest the significant association between certain aspects of social capital, at both the individual and the community level, and self-rated health. The individual-level social capital in the form of perceived help in the future and the social capital of community in the form of the availability of amenities and associations within the community were significantly related to self-rated health. A significant cross-level interaction effect between individual- and community-level social capital was also observed.

A systematic review of the relationships between social capital and socioeconomic inequalities in health: a contribution to understanding the psychosocial pathway of health inequalities

Introduction

Recent research on health inequalities moves beyond illustrating the importance of psychosocial factors for health to a more in-depth study of the specific psychosocial pathways involved. Social capital is a concept that captures both a buffer function of the social environment on health, as well as potential negative effects arising from social inequality and exclusion. This systematic review assesses the current evidence, and identifies gaps in knowledge, on the associations and interactions between social capital and socioeconomic inequalities in health.

Methods

Through this systematic review we identified studies on the interactions between social capital and socioeconomic inequalities in health published before July 2012.

Results

The literature search resulted in 618 studies after removal of duplicates, of which 60 studies were eligible for analysis. Self-reported measures of health were most frequently used, together with different bonding, bridging and linking components of social capital. A large majority, 56 studies, confirmed a correlation between social capital and socioeconomic inequalities in health. Twelve studies reported that social capital might buffer negative health effects of low socioeconomic status and five studies concluded that social capital has a stronger positive effect on health for people with a lower socioeconomic status.

Conclusions

There is evidence for both a buffer effect and a dependency effect of social capital on socioeconomic inequalities in health, although the studies that assess these interactions are limited in number. More evidence is needed, as identified hypotheses have implications for community action and for action on the structural causes of social inequalities.

A meta-analysis of social capital and health: a case for needed research

Social capital refers to various levels of social relationships formed through social networks. Measurement differences have lead to imprecise measurement. A meta-analysis of eligible studies assessing the bivariate association between social capital and self-reported health and all-cause mortality was performed. Thirty-nine studies met inclusion criteria, showing social capital increased odds of good health by 27 percent (95% confidence intervals [CI] =21%, 34%). Social capital variables, reciprocity increased odds of good health by 39 percent (95% CI = 21%, 60%) and trust by 32 percent (95% CI =19%, 46%). Future research suggests operationalizing measures by assessing differences by race/ethnicity, gender and socioeconomic status.

A multilevel analysis of association between neighborhood social capital and depression: evidence from the first South African National Income Dynamics Study

BACKGROUND

As neuropsychiatric disorders account for a great proportion of the total burden of disease in sub-Saharan Africa, depression is rapidly emerging as a public health issue in South Africa. Given the divisions enforced by a legacy of the apartheid spatial and economic policies, features of communities such as neighborhood-level social capital may play a critical role in depression. However, the extent to which neighborhood-level social capital is associated with depression in South Africa at the population-level is unknown.

METHODS

Data from the first wave of the South African National Income Dynamics Study (SA-NIDS) was used to examine the association between the neighborhood-level social capital and individual depression using multilevel regression models.

RESULTS

There was a negative association between neighborhood-level social capital and depression score with social trust and neighborhood preference accounting for this association. Structural social capital, namely civic participation, was not related to depression. Individual predictors, including social class, self-rated health status and education, were strong covariates of depression.

LIMITATIONS

The cross-sectional design of the study limits our understanding of the temporal order of social capital and depression.

CONCLUSIONS

In post-apartheid South Africa, low social capital remains an important social determinant of health, including depression outcome. This is in addition to individual determinants related to class such as unemployment, education and social class which play an important role in influencing depression. Further research utilizing a longitudinal study design is warranted to examine the association between social capital and depression in South Africa.

Compositional and contextual associations of social capital and self-rated health in Seoul, South Korea: a multilevel analysis of longitudinal evidence

This study aims to examine the association between social capital at the individual and administrative-area levels and individual self-rated health while adjusting for various confounders at multiple levels using a multilevel analysis with longitudinal data from Seoul, South Korea. Respondents participating in Wave 1 (2009) and 2 (2010) of the Seoul Welfare Panel Study who have full information on the independent and dependent variables were used in the final analysis. This yielded a total of 5482 participants in 2742 households, which were in turn found within 25 administrative areas in Seoul, South Korea. The results of a three level random intercept logistic regression analysis showed that an individual level perceived helpfulness and organizational participation were associated with a higher likelihood of reporting good health after controlling for individual, household, administrative-area level variables, and baseline self-rated health. However, neither administrative-area level social capital variables were associated with self-rated health. The results suggest that individual level social capital plays an important role in enhancing individual health. The results also suggest that the relatively large size of the administrative-area used in this study may be one reason which may hinder detecting any significant associations at this level. Further research is also needed to seek more relevant contexts where contextual social capital would be operating.

Are residents of downtown Toronto influenced by their urban neighbourhoods? Using concept mapping to examine neighbourhood characteristics and their perceived impact on self-rated mental well-being

Background

There is ample evidence that residential neighbourhoods can influence mental well-being (MWB), with most studies relying on census or similar data to characterize communities. Few studies have actively investigated local residents’ perceptions.

Methods

Concept mapping was conducted with residents from five Toronto neighbourhoods representing low income and non-low income socio-economic groups. These residents participated in small groups and attended two sessions per neighbourhood. The first session (brainstorming) generated neighbourhood characteristics that residents felt influenced their MWB. A few weeks later, participants returned to sort these neighbourhood characteristics and rate their relative importance in affecting residents’ ‘good’ and ‘poor’ MWB. The data from the sorting and rating groups were analyzed to generate conceptual maps of neighbourhood characteristics that influence MWB.

Results

While agreement existed on factors influencing poor MWB (regardless of neighbourhood, income, gender and age), perceptions related to factors affecting good MWB were more varied. For example, women were more likely to rank physical beauty of their neighbourhood and range of services available as more important to good MWB, while men were more likely to cite free access to computers/internet and neighbourhood reputation as important. Low-income residents emphasized aesthetic attributes and public transportation as important to good MWB, while non-low-income residents rated crime, negative neighbourhood environment and social concerns as more important contributors to good MWB.

Conclusion

These findings contribute to the emerging literature on neighbourhoods and MWB, and inform urban planning in a Canadian context.

Perceived discrimination and depression among new migrants to Hong Kong: the moderating role of social support and neighborhood collective efficacy

BACKGROUND

Although it is well known that perceived discrimination is a risk factor contributing to depressive symptoms among immigrants, most previous studies (1) did not distinguish between discrimination based on immigrant status and race and (2) used cross-sectional data.

AIMS

To address these limitations, the present study examined whether perceived discrimination affects depressive symptomatology in a representative sample of newly arrived immigrants from Mainland China to Hong Kong using longitudinal data over a period of one year.

METHODS

A representative sample of 347 migrants aged 18 and older were interviewed face to face in 2007 and 2008. The 20-item Center for Epidemiology Studies of Depression (CES-D) scale was used to measure depressive symptoms and a series of sociodemographic questions (age, gender, marital status, education, and personal income), stress due to perceived discrimination, social support, and neighborhood collective efficacy were also included.

RESULTS

Perceived discrimination was significantly associated with depressive symptoms one year later, after adjusting for depressive symptoms at baseline assessment, sociodemographic characteristics, social support, and neighborhood collective efficacy. Moreover, both social support and neighborhood collective efficacy moderated the effect of perceived discrimination on depressive symptoms.

CONCLUSIONS

Perceived discrimination is a common experience for new Mainland immigrants to Hong Kong, and it predicts depressive symptoms. Therefore, interventions that reduce discrimination and strengthen social support and neighborhood collective efficacy should be designed and implemented to improve the mental health of new immigrants in Hong Kong.

Rural food insecurity in the United States as an overlooked site of struggle in health communication

This article indicates the need for health communication scholars to attend to the growing national problem of rural food insecurity. A review of the health communication literature reveals that food insecurity and rural health overall are research issues that have been overlooked. Using the Culture-Centered Approach ( Dutta, 2008 ), while simultaneously searching for community assets as well as problems, we explore aspects of rural residents' food environments, culture, and institutional structures that empower and constrain their communities. Twelve focus groups (n = 86), segmented by race/ethnicity, were conducted in rural central Texas. Results were analyzed using grounded theory methodology. Our findings outline problems and personal obstacles described by participants, as well as creative solutions and coping mechanisms illustrative of individual agency and social capital inherent in their rural culture. We conclude by providing suggestions for future research that will aid health communication scholars to further the conversation on rural food insecurity.

A multilevel analysis of social capital and self-reported health: evidence from Seoul, South Korea

Background

This study aims to resolve two limitations of previous studies. First, as only a few studies examining social capital have been conducted in non-western countries, it is inconclusive that the concept, which has been developed in Western societies, applies similarly to an Asian context. Second, this study considers social capital at the individual-level, area-level and cross-levels of interaction and examines its associations with health while simultaneously controlling for various confounders at both the individual-level and area-level, whereas previous studies only considered one of the two levels. The purpose of this study is therefore to examine the associations between social capital and health by using multilevel analysis after controlling for various confounders both at the individual and area-levels (i.e., concentrated disadvantage) in non-western countries.

Methods

We conducted a cross-sectional survey from December 2010 to April 2011 in Seoul, South Korea. The target population included respondents aged 25 years and older who have resided in the same administrative area since 2008. The final sample for this study consisted of 4,730 respondents within all 25 of Seoul's administrative areas.

Results

In our final model, individual-level social capital, including network sources (OR = 1.23; 95% CI = 1.11-1.37) and organizational participation (OR = 2.55; 95% CI = 2.11-3.08) was positively associated with good/very good health. Interestingly, the individual × area organizational participation cross-level interaction was negatively associated with good/very good health (OR = 0.40; 95% CI = 0.32-0.50), indicating that in areas with higher organizational participation, individuals with high organizational participation were less likely to report good/very good health when compared to low organizational participation individuals.

Conclusion

Our study provides evidence that individual-level social capital is associated with self-reported health, even after controlling for both individual and area-level confounders. Although this study did not find significant relationships between area-level organizational participation and self-reported health, this study found the cross-level interaction for social capital. Hence, in areas with lower organizational participation, the probability of reporting good/very good health is higher for individuals with high organizational participation than individuals with low organizational participation. This study, albeit tentatively, suggests that policy makers should focus upon social capital when making policies which aim to enhance one's health.

The importance of addressing social determinants of health at the local level: the case for social capital

Social determinants are gaining momentum in public health practice. Many proposed solutions for tackling social determinants are outside the scope of local public health professionals. This article reviews the literature to find possible moderating variables which may buffer the effects of the social determinants of health at the local level, and allow social determinants to be addressed within the purview of local health departments. The systematic approach employed for this article entailed searches of electronic academic databases (PubMed, EBSCO and Medline) and additional searches using Internet search engines and relevant websites for articles published between 1,975 and May 2010. The search revealed 2,554 articles, and 36 were determined appropriate for inclusion. The purpose of the search was to identify published articles relating to social determinants of health, social capital and effective approaches for addressing both at the level of the local health department. The search was then expanded to include unpublished material, to include the perspectives of local health departments. This process resulted in the inclusion of content from five sources. In this article, the case is made for focusing on social capital interventions to mitigate health problems associated with social determinants. Examples of successful interventions are provided to aid public health professionals in developing locale-specific solutions for addressing social determinants.

Psychological distress among immigrants and visible minorities in Canada: a contextual analysis

BACKGROUND

Immigrants to Canada are less likely to report depression compared with the non-immigrant population. This healthy migrant effect has not so far been explained by demographic and socioeconomic determinants of health.

AIM

The present study examined whether the psychological health advantage of immigrants varied across Canadian health regions and investigated the hypothesis of immigrant density as a determinant of immigrant mental health advantage.

METHODS

Data from the 2000-2001 Canadian Community Health Survey were used to build multi-level models estimating variation in depression within and between health regions by immigrant/visible minority status.

RESULTS

Immigrant and visible minority residents were less likely to experience depression compared with the general population. Depression varied across health regions and the extent of variation was greater for visible minorities. The likelihood of depression decreased with increasing percentage of immigrants in the region among visible minority participants but not among whites.

CONCLUSIONS

The protection against depression afforded by immigrant and visible minority status in Canada appears to depend on contextual factors, notably the percentage of immigrants in the region. Future work should seek to better characterize the experiences of visible minorities in different settings.

Collective efficacy and major depression in urban neighborhoods

Depression contributes substantially to the global burden of disease and disability. Population-level factors that shape depression may be efficient targets for intervention to decrease the depression burden. The authors aimed to identify the relation between neighborhood collective efficacy and major depression. Analyses were conducted on data from the New York Social Environment Study (n = 4,000), a representative study of residents of New York, New York, conducted in 2005. Neighborhood collective efficacy was measured as the average neighborhood response on a well-established scale. Major depression was assessed with the Patient Health Questionnaire. A marginal modeling approach was applied to present results on the additive scale relevant to public health and intervention. Analyses were adjusted for demographic and socioeconomic characteristics, recent life events that could contribute to both depression and change in residence, and individual perception of collective efficacy. Collective efficacy was related to major depression among older adults; marginal models estimated a 6.2% (95% confidence interval: 0.1, 17.5) lower prevalence of depression if all older adults (65 years and older) had lived in high versus low collective efficacy neighborhoods. Similar results were suggested among younger adults; however, the confidence interval crossed the null. These and other study findings suggest that community-randomized trials targeting collective efficacy merit consideration.

Food insecurity, social capital and perceived personal disparity in a predominantly rural region of Texas: an individual-level analysis

Few studies have addressed the association of food insecurity with place of residence and perceptions of collective social functioning such as perceived social capital and perceived personal disparity. This study assessed the association between food insecurity and measures of perceived personal disparity and perceived social capital in a region of Central Texas, USA comprised of one urban and six rural counties. Food insecurity, perceived social capital, perceived personal disparity, and sociodemographic control measures were derived from the 2006 Brazos Valley Community Health Assessment on an analytic sample of 1803 adult participants (74% response rate). Robust multinomial regression models examined associations between food insecurity and perceived personal disparity, perceived social capital, education, age, residence in a poor or low-income household, minority group membership, and rural residence. A model was estimated for food insecurity (n = 1803, p < 0.0001). Residents with low social capital, higher levels of perceived personal disparity, rural residence, residence in a low-income or poor household, minority group membership, and lower levels of educational attainment were more likely to experience food insecurity. Rural residence (p = 0.021) was significant only for the comparison between those who never, and those who often experienced food insecurity, and findings for the stratified rural and urban samples were roughly equivalent to the combined sample. Individual level measures of collective social functioning are important correlates of food insecurity. In this study, both perceived personal disparity and perceived social capital play an important role, regardless of rural or urban residence.

Social capital and mental health in Japan: a multilevel analysis

Background

A national cross-sectional survey was conducted in Japan. This is because the growing recognition of the social determinants of health has stimulated research on social capital and mental health. In recent years, systematic reviews have found that social capital may be a useful factor in the prevention of mental illness. Despite these studies, evidence on the association between social capital and mental health is limited as there have been few empirical discussions that adopt a multilevel framework to assess whether social capital at the ecological level is associated with individual mental health. The aim of this study was to use the multilevel approach to investigate the association between neighborhood social capital and mental health after taking into account potential individual confounders.

Methodology/Principal Findings

We conducted a multilevel analysis on 5,956 individuals nested within 199 neighborhoods. The outcome variable of self-reported mental health was measured by the one dimension of SF-36 and was summed to calculate a score ranging from 0 to 100. This study showed that high levels of cognitive social capital, measured by trust (regression coefficient = 9.56), and high levels of structural social capital, measured by membership in sports, recreation, hobby, or cultural groups (regression coefficient = 8.72), were associated with better mental health after adjusting for age, sex, household income, and educational attainment. Furthermore, after adjusting for social capital perceptions at the individual level, we found that the association between social capital and mental health also remained.

Conclusions/Significance

Our findings suggest that both cognitive and structural social capital at the ecological level may influence mental health, even after adjusting for individual potential confounders including social capital perceptions. Promoting social capital may contribute to enhancing the mental health of the Japanese.

Neighbourhood characteristics, individual attributes and self-rated health among older Canadians

This study drew on three cycles of the Canadian Community Health Survey and the 2001 Census to examine between-neighbourhood variation in positive and negative self-rated health and the relative effect of individual and neighbourhood characteristics on self-rated health among Canadian adults aged > or = 65. Multilevel logistic regression results showed that there was modest, but significant between-neighbourhood variation in self-rated health. Neighbourhood factors including income, education, and percentage of people aged > or = 65, and visible minority accounted for about 50% and 30% of the neighbourhood variation in negative and positive self-rated health, respectively. Relative to neighbourhood-level characteristics, individual characteristics had a stronger effect on self-rated health with involvement in physical activity, alcohol consumption, sense of community belonging, income, and education being the most important. Although the findings suggest that neighbourhood effects on self-rated health are modest and that individual-level factors are relatively more important determinants of health, research concern for contextual influences on health should continue.

Social Capital and Health

Social capital is widely considered to influence health. It is usually defined as a list of components such as social networks, social participation, trust and reciprocity. It is trust and reciprocity that are the subjects of this article. The presumed relationship of each with health is rarely explained in social capital studies. Trust is usually treated simplistically, both conceptually and in relation to measurement, while reciprocity is misunderstood, under-theorized and rarely measured. Pathways from trust and reciprocity to better health may be by way of reduced stress. Clarification and valid measures are needed to progress studies of social capital and health.

[Association between contextual factors and self-rated health: a systematic review of multilevel studies]

The influence of residential characteristics on self-rated health has received little research attention, especially in Brazil. This study summarizes the available evidence on the association between contextual factors and self-rated health, using a systematic review of articles published from January 1995 to August 2005. We searched for the terms neighbourhood or neighborhood, ecological, contextual, environment, and community, combined with self-rated health, self-reported health, and multilevel or hierarchical in digital bases. Most of the 18 reviewed studies analyzed socioeconomic indicators, while some investigated psychosocial variables and a few included physical environmental indicators. Spatial units of reference varied from census tracts to States. Differences among scales of contextual analysis and several indicators, with different categories, were identified. The associations corroborate the hypothesis that neighborhood context influences self-rated health, beyond the effect of individual factors. Physical and psychosocial neighborhood characteristics are important contextual factors in the determination of self-rated health. Worse socioeconomic neighborhood conditions have a negative effect on health, thereby increasing the odds of worse self-rated health.

Toward the next generation of research into small area effects on health: a synthesis of multilevel investigations published since July 1998

To map out area effects on health research, this study had the following aims: (1) to inventory multilevel investigations of area effects on self rated health, cardiovascular diseases and risk factors, and mortality among adults; (2) to describe and critically discuss methodological approaches employed and results observed; and (3) to formulate selected recommendations for advancing the study of area effects on health. Overall, 86 studies were inventoried. Although several innovative methodological approaches and analytical designs were found, small areas are most often operationalised using administrative and statistical spatial units. Most studies used indicators of area socioeconomic status derived from censuses, and few provided information on the validity and reliability of measures of exposures. A consistent finding was that a significant portion of the variation in health is associated with area context independently of individual characteristics. Area effects on health, although significant in most studies, often depend on the health outcome studied, the measure of area exposure used, and the spatial scale at which associations are examined.