Household social capital and socioeconomic inequalities in child undernutrition in rural India

Diverging destinies: How children are faring under demographic transition

India reached the replacement level of fertility in 2020. However, the journey of fertility transition is unconventional and heterogeneous within the country and across the different socio-economic groups. The fertility transition is considered to be faster than its socio-economic and health transition in several states. Thus, it has been presumed that the returns to fertility decline are heterogeneous across the states and population sub-groups. Our specific hypothesis is that although rich and poor, and educated and un-educated, everyone had significantly contributed to the fertility decline in response to family planning policies, only those socio-economically better-off have been investing relatively more in their children compared to the poor, and this has led to diverging destinies for children. We tested this supposition using a macro-level panel dataset (1992-2021), fixed and random effects, and IV regression models. The results confirm that child health care and outcomes have diverged while fertility declined from 1992 to 2021. These results are sustained in multiple robustness checks. While fertility is declining with highly state-sponsored family planning programmes, the persistent socio-economic inequalities are leading to unequal progress in health outcomes for children in India.

Exploring the structure of household social capital in rural Vietnam: Applying Bayesian network approach

This study aims to explore the structure of the households' social capital of rural Vietnam households with secondary data from 2008 to 2018. This paper applied the fundamental theories (resource and network theories) and the Bayesian network to estimate the interaction of proxies to explore the structure of social capital. Results showed that the triangle structure in household social capital with the core point is organization participation. The connections show the tendency from organization participation, linking to household networks. Alongside that, linking social capital and Organization participation are determinants of social capital indicators (social events, social cost). Therefore, this paper suggests employing proxies such as structured indicators for integrating social capital into the livelihood papers.

Differences in county-level cardiovascular disease mortality rates due to damage caused by hurricane Matthew and the moderating effect of social capital: a natural experiment

BACKGROUND

As the climate continues to warm, hurricanes will continue to increase in both severity and frequency. Hurricane damage is associated with cardiovascular events, but social capital may moderate this relationship. Social capital is a multidimensional concept with a rich theoretical tradition. Simply put, social capital refers to the social relationships and structures that provide individuals with material, financial, and emotional resources throughout their lives. Previous research has found an association between high levels of social capital and lower rates of cardiovascular (CVD) mortality. In post-disaster settings, social capital may protect against CVD mortality by improving access to life-saving resources. We examined the association between county-level hurricane damage and CVD mortality rates after Hurricane Matthew, and the moderating effect of several aspects of social capital and hurricane damage on this relationship. We hypothesized that (1) higher (vs. lower) levels of hurricane damage would be associated with increased CVD mortality rates and (2) in highly damaged counties, higher (vs. lower) levels of social capital would be associated with lower CVD mortality.

METHODS

Analysis used yearly (2013-2018) county-level sociodemographic and epidemiological data (n = 183). Sociodemographic data were compiled from federal surveys before and after Hurricane Matthew to construct, per prior literature, a social capital index based on four dimensions of social capital (sub-indices): family unity, informal civil society, institutional confidence, and collective efficacy. Epidemiological data comprised monthly CVD mortality rates constructed from monthly county-level CVD death counts from the CDC WONDER database and the US Census population estimates. Changes in CVD mortality based on level of hurricane damage were assessed using regression adjustment. We used cluster robust Poisson population average models to determine the moderating effect of social capital on CVD mortality rates in both high and low-damage counties.

RESULTS

We found that mean levels of CVD mortality increased (before and after adjustment for sociodemographic controls) in both low-damage counties (unadjusted. Mean = 2.50, 95% CI [2.41, 2.59], adjusted mean = 2.50, 95% CI [2.40, 2.72]) and high-damage counties (mean = 2.44, CI [2.29, 2.46], adj. Mean = 2.51, 95% CI [2.49, 2.84]). Among the different social capital dimensions, institutional confidence was associated with reduced initial CVD mortality in low-damage counties (unadj. IRR 1.00, 95% CI [0.90, 1.11], adj. IRR 0.91 CI [0.87, 0.94]), but its association with CVD mortality trends was null. The overall effects of social capital and its sub-indices were largely nonsignificant.

CONCLUSION

Hurricane damage is associated with increased CVD mortality for 18 months after Hurricane Matthew. The role of social capital remains unclear. Future research should focus on improving measurement of social capital and quality of hurricane damage and CVD mortality data.

Mediating role of social capital in the association between socioeconomic status and childcare practices in rural Malawi: a cross-sectional study

OBJECTIVES

Childcare practices determine the child nutritional outcomes, but resources for good practices are unequally distributed across socioeconomic status (SES). This study first examined the associations between social capital and childcare practices separately across SES groups. It then investigated the mediation effect of social capital between SES and childcare practices.

DESIGN

This cross-sectional study used the Short Version of the Adapted Social Capital Assessment Tool to measure structural social capital (group membership, social support and citizenship activities) and cognitive social capital of mothers. Data were analysed using multilevel logistic regressions with random intercepts and mediation modellings.

SETTING

Rural Lilongwe, Malawi.

PARTICIPANTS

A total of 320 mothers with a child aged between 12 months and 23 months.

PRIMARY OUTCOME MEASURES

Childcare practice outcomes included were minimum dietary diversity, handwashing and complete vaccination.

RESULTS

Among structural social capital dimensions, social support was found to be positively associated with minimum dietary diversity (adjusted OR (AOR)=1.44, 95% CI 1.22 to 1.71; p<0.001) and handwashing for all mothers (AOR=1.42, 95% CI 1.23 to 1.64; p<0.001). In the subgroup analysis, the higher SES group had higher odds of meeting the minimum dietary diversity (AOR=1.63, 95% CI 1.18 to 2.26; p=0.01) and handwashing with increased social support (AOR=1.53, 95% CI 1.13 to 2.08; p=0.01) than the lower SES. The mediation effect of social support accounted for 27.3% of the total effect between SES and minimum dietary diversity. Cognitive social capital was negatively associated with vaccination for the lower SES group (AOR=0.07, 95% CI 0.01 to 0.68; p=0.03).

CONCLUSIONS

To improve feeding and handwashing practices and to reduce health inequalities in rural Malawi, governments and organisations should consider promoting the value of social support and health. Future research is needed to explain the negative association between cognitive social capital and vaccination among the lower SES group.

Impact of education on health-beliefs in an emerging economy: Understanding urban vs. rural differences and the moderating effect of social capital

In this paper, we assert the critical influence of education on health-beliefs among women from India, an emerging economy. We further examine the urban vs. rural differences and the role of social capital in shaping health-beliefs of women. Using nationally representative data of eligible women from India, we find education to have a positive influence on health-beliefs. We find this effect to be higher in rural regions. Further, we find social capital to negatively moderate the effect of education. Our findings stress the importance of education, especially in rural regions.

Socioeconomic inequalities in mental distress and life satisfaction among older Chinese men and women: The role of family functioning

Despite growing concern over socioeconomic inequality in health, few studies have focused on health inequality among older adults. The present study examined the independent and joint effects of socioeconomic status (SES) and family functioning on mental health and subjective well-being and explored the gender differences in such relations. Representative survey data on older adults (N = 1,432) were drawn from the third wave of the Hong Kong Panel Study of Social Dynamics conducted in 2015. Descriptive analyses and ordinary least-squares regressions were conducted for data analysis. The results demonstrate that receipt of means-tested welfare payments was associated with more severe mental distress and lower life satisfaction; living in private (as opposed to public or subsidised) housing was associated with better mental health; whereas holding investments and larger residence size were related to higher life satisfaction. Moreover, greater family functioning predicted better mental health and greater subjective well-being and mitigated the detrimental effects of low SES. Gender differences were observed concerning the effects of different predictors. The findings could inform the development of health-promotion services sensitive to gender and socioeconomic differences and facilitate integration of individual- and family-level services for older adults.

Maternal education and the multidimensionality of child health outcomes in India

Maternal education plays a central role in children's health, but there has been little research comparing the role of maternal education across health outcomes. It is important to distinguish child health outcomes from medical care outcomes. Health outcomes such as short-term morbidity and stunting are multifactorial in origin and determined by a range of factors not necessarily under a mother's control. Mother's education, given the necessary structural factors such as medical centres, is likely to lead to increased access to, and uptake of, medical services. Using data from the 2004-05 India Human Development Survey, eight separate logistic regressions were carried out on 11,026 women of reproductive age and their last-born child under five years of age. The results showed that maternal education had the strongest association with medical care, immunization (except polio) and iron supplementation for pregnant mothers, moderate association with underweight and weak association with short-term diseases and stunting. In addition, the study investigated whether maternal education impacts child health and medical care outcomes through the intervening roles of empowerment and human, social and cultural capital. These intervening linkages were found to be missing for short-term diseases and stunting, bolstering the argument that the influence of maternal education is limited for these outcomes.

Comparing the association between social capital and self-rated health in poor and affluent nations

Country context has been shown to influence the association between social capital and health; however, few studies have examined how the level of societal affluence affects the relationship between social capital and health. Drawing on the study of individual-level socioeconomic variation in the returns to social capital by Uphoff and colleagues (2013), we examine two possible explanations about the differential impact of social capital on health based on country-level socioeconomic variation. The buffer hypothesis posits that social capital will have a greater benefit for poorer (versus more affluent) nations, whereas the dependency hypothesis suggests that social capital will be more beneficial in more affluent (versus poorer) nations. Using Waves 5 and 6 of the World Values Survey, we employed multilevel ordered logistic regression to examine whether national wealth moderates the association between social capital-as measured by particularized and generalized trust-and self-rated health across 72 countries. We also assessed five potential explanations for the moderating role of economic context based on the buffer and dependency hypotheses: institutional effectiveness, economic inequality, coverage of health services, human capital, and access to clean water and sanitation services. In support of the dependency hypothesis, we found that both particularized and generalized trust were associated with self-rated health to a greater extent in more affluent countries than in poorer countries; however, none of the potential explanations that we tested accounted for this pattern. Further, we found that particularized trust was more strongly associated with self-rated health compared to generalized trust across all countries. Future research should focus on the mechanisms by which economic context modifies the relationship between social capital and self-rated health.

Does social capital moderate the association between children's emotional overeating and parental stress? A cross-sectional study of the stress-buffering hypothesis in a sample of mother-child dyads

Parental stress has been shown associated with children's eating behaviors. The stress-buffering hypothesis suggests that social resources, i.e., resources accessed via one's social networks, may prevent or attenuate the impact of stress on health. Prior research on the stress-buffering hypothesis has found evidence for the protective effects of social support (emotional, instrumental, or informational resources available in a person's life); less is known about social capital (resources available through one's social networks) as a stress buffer. Further, these studies have often examined the association between a person's direct access to social resources and their health; less research has examined whether the benefits of social resources may extend two degrees from parents to their children. Using data from a community-based birth cohort of mother-child dyads, this study examined whether mother's social capital moderated the association between maternal stress and children's emotional overeating (EO). Mothers completed health questionnaires on an annual basis and a one-time social network questionnaire in 2011-2012. EO was measured using the Children's Eating Behavior Questionnaire. Maternal stress was measured using the 18-item Parental Stress Scale. Social capital was measured using a position generator and based on the number of occupations to which a mother had access. Poisson regression analysis was used. Results showed that mother's social capital moderated the positive association between greater maternal stress and children's EO, such that maternal stress was associated with children's EO in only those mothers with low social capital. This study suggests that social capital may disrupt the transmission of maternal stress from parent to child, thereby playing a potential role in the production and reproduction of health inequalities.

Social capital and child nutrition in India: The moderating role of development

Empirical studies of social capital rarely take into account the socioeconomic context of the region in which it operates, indeed as most of this research has been located in high income countries. It is imperative to investigate how development may influence the impact of social capital, especially in developing countries. This paper examines the relationship between social capital and child nutrition using the India Human Development Survey, 2005-2006. Using a multilevel framework and a sample of 6770 rural children under the age of five, it finds that household based bridging social capital, expressed as connections with development based organizations, is positively associated with child nutrition. Bonding social capital, expressed as ties with caste and religious based organizations, has the opposite impact. At the village level, contextual measures of social capital are associated with nutritional status of children, but their influence is conditional on local development.