The relationship between social capital and self-rated health: A gendered analysis of 17 European countries

Objective and subjective measures of air pollution and self-rated health: the evidence from Chile

PURPOSE

The literature exploring individual differences in self-rated health has grown fast in recent years. Self-rated health (SRH) is a good indicator of general health status. This empirical study explores the association between outdoor air pollution and SRH in Chile. This type of analysis is infrequent in Latin America.

METHODS

We used objective and subjective air pollution measures. The first corresponds to PM2.5, and the latter to the perception of a high level of air pollution. Drawing on data from two independent and repeated nationwide surveys over the period 2006-2017 at the individual level in Chile, we performed repeated cross-sectional analyses for each year of survey application. Ordered Logit (OL) and Logit (L) multivariate models were used to investigate the association between SRH and air pollution measures, considering other socioeconomic and demographic covariates.

RESULTS

We found that the higher is the level of air pollution, the lower the SRH in Chile, regardless of whether air pollution is physically measured or perceived by respondents. The results were consistent over the years in the sign and significance of regression coefficients using two surveys and two forms of the outcome variable.

CONCLUSIONS

Our findings add evidence that air pollution is a relevant determinant of SRH. In addition, they show that subjective measures of air pollution can be as reliable as physical measures in the analysis of the association between air pollution and human health.

Examining the Pathways from General Trust Through Social Connectedness to Subjective Wellbeing

The broad conceptualisation of wellbeing has allowed researchers to establish subjective wellbeing as a valid indicator of social development. However, changing social patterns, norms, and values suggest changes in how social determinants may predict subjective wellbeing. The current analysis tests a serial mediation hypothesis in which social participation and social resources mediate the effect of general trust on subjective wellbeing.

Data from 8725 participants were pooled from the German part of the European Social Survey (ESS) Wave 10. Structural models were estimated to access the path from general trust to subjective wellbeing (SWB). Three separate mediation analyses were performed to test (1) the indirect effect of general trust on SWB through social participation, (2) through social resources and (3) through social participation and social resources. A full-mediation model reveals the direct and indirect paths predicting SWB through general trust, social participation, and social resources. Gender, age, education, and household size were included as control variables.

The full-mediation model suggests significant results for direct paths from general trust to social participation, social resources, and SWB. Direct paths from social participation to social resources and SWB were also significant. However, the path from social resources to SWB became non-significant.

Results highlight general trust as a critical predictor of SWB. The finding that social participation is significant while social resources are not significant in a mediation model suggests that social participation directly affects wellbeing, independent of the effect of social resources. This highlights the importance of social participation in promoting wellbeing.

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.

Exploring dimensions of social capital in relation to healthy eating behaviours in the US rural south

OBJECTIVE

This study examined relationships between dimensions of social capital (SC) (social trust, network diversity, social reciprocity and civic engagement) and fruit, vegetable, and sugar-sweetened beverage (SSB) consumption among rural adults. Potential moderators (neighbourhood rurality, food security, gender and race/ethnicity) were explored to develop a more nuanced understanding of the SC-healthy eating relationship.

DESIGN

Data were from a 2019 mailed population-based survey evaluating an eleven-county initiative to address health equity. Participants self-reported health behaviours, access to health-promoting resources and demographics. Logistic regression models were used to analyse relationships between predictors, outcomes and moderators.

SETTING

Five rural counties, Georgia, USA.

PARTICIPANTS

1120 participants.

RESULTS

Among participants who lived in the country (as opposed to in town), greater network diversity was associated with consuming ≥ 3 servings of fruit (OR = 1·08; 95 % CI 1·01, 1·17, P = 0·029), yet among participants who lived in town, greater civic engagement was associated with consuming ≥ three servings of fruit (OR = 1·36; 95 % CI 1·11, 1·65, P = 0·003). Both food-secure and food-insecure participants with greater social reciprocity had lower odds of consuming 0 SSB (OR = 0·92; 95 % CI 0·86, 0·98, P = 0·014, OR = 0·92; 95 % CI 0·86, 0·99, P = 0·037, respectively). Men with greater social trust were more likely to consume 0 SSB (OR = 1·09; 95 % CI 1·01, 1·18, P = 0·038), and Whites with greater network diversity were more likely to meet daily vegetable recommendations (OR = 1·10; 95 % CI 1·01, 1·19, P = 0·028).

CONCLUSIONS

Findings provide a basis for future qualitative research on potential mechanisms through which SC and related social factors influence healthy eating in rural communities.

Disentangling the complexities of modelling when high social capital contributes to indicating good health

The association between social capital and health is under continuous research. Based both on theoretical frameworks and previous empirical studies, the magnitude and sign of this association are ambiguous. Our main goal is to empirically investigate under which conditions is social capital relevant to obtain good or very good self-rated health, while acknowledging that different paths can lead to this outcome. The data used in this study come from the European Social Survey 2018 (47,423 observations for 29 European countries) and fuzzy-set qualitative comparative analysis was adopted. Our results show that neither the presence of social capital (as measured in this study - 'Generalised trust' and/or 'Informal social connections'), nor its absence, is a necessary condition for good or very good self-rated health. While not being necessary, there are contexts where social capital is relevant for health and, whenever it is present, it positively contributes to good or very good self-rated health. However, our results further suggest that social capital alone is not sufficient to be healthy. The relevance of social capital is contingent on the presence, or absence, of other conditions. What works for some individuals does not work for others. And for any given individual, rarely there is only one way to be healthy. Additionally, our findings suggest that the impact of belonging to a minority ethnic group on health might be stronger than what has been hitherto recognised.

Improving the sense of city belonging among migrant elderly following family from an elderly service perspective: a cross-sectional study

Background

The migrant elderly following family (MEFF), who migrates to new community to reunite with families, may face challenges of city integration and belonging. This study aims to explore from an elderly service perspective how to improve the sense of city belonging for MEFFs with and without hypertension/diabetes conditions.

Methods

Data were derived from the 2017 China Migrants Dynamic Survey and China National Statistical Yearbooks in 2017. The study included 882 MEFFs with hypertension or diabetes and 1266 MEFFs without hypertension and diabetes. Hierarchical linear modeling was applied to analyze the effects of individual and provincial elderly services on sense of city belonging among the MEFF with and without hypertension/diabetes.

Results

The MEFFs with hypertension or diabetes exhibited a greater sense of city belonging when they were familiar with a wider range of health education topics (γ = 0.05, p = 0.033) and were in those provinces with a greater number of licensed doctors (γ = 0.39, p < 0.001) and hospitals (p = 0.042). For those MEFFs without hypertension or diabetes, social security cards (γ = 0.57, p < 0.001) and awareness of a wider range of health education topics (γ = 0.07, p = 0.018) may help to improve their sense of city belonging.

Conclusion

This study calls for strengthening the accessibility in inclusive elderly services, and minimizing or even eliminating the inequality in elderly services at the individual and provincial levels to increase sense of city belonging among the MEFFs. For the MEFFs with hypertension or diabetes, health managers should focus on improving health information dissemination and increasing the number of doctors per 1000 people as well as and the number of hospitals to enhance the sense of city belonging. Moreover, the government should strengthen social security and health education to facilitate the adaptation and integration of MEFFs without hypertension and diabetes into the host city.

Assessment of self-rated health: The relative importance of physiological, mental, and socioeconomic factors

BACKGROUND

The general self-rated health (SRH) question is the most common health measure employed in large population surveys. This study contributes to research on the concurrent validity of SRH using representative data with biomarkers from the Czech Republic, a population not previously used to assess the SRH measure. This work determines the relative contribution of biomedical and social characteristics to an individual's SRH assessment. Studies have already explored the associations between SRH and markers of physical health. However, according to a PubMed systematic literature search, the issue of the relative importance of physiological and psychosocial factors that affect individuals' assessments of their SRH has generally been neglected.

METHODOLOGY/PRINCIPAL FINDINGS

Using data from a specialized epidemiological survey of the Czech population (N = 1021), this study adopted ordinary least squares regression to analyze the extent to which variance in SRH is explained by biomedical measures, mental health, health behavior, and socioeconomic characteristics. This analysis showed that SRH variance can be largely attributed to biomedical and psychological measures. Socioeconomic characteristics (i.e. marital status, education, economic activity, and household income) contributed to around 5% of the total variance. After controlling for age, sex, location, and socioeconomic status, biomarkers (i.e. C-reactive protein, blood glucose, triglyceride, low-density lipoprotein, and high-density lipoprotein), number of medical conditions, and current medications explained 11% of the total SRH variance. Mental health indicators contributed to an additional 9% of the variance. Body mass index and health behaviors (i.e. smoking and alcohol consumption) explained less than 2% of the variance.

CONCLUSIONS/SIGNIFICANCE

The results suggested that SRH was a valid measure of physiological and mental health in the Czech sample, and the observed differences were likely to have reflected inequalities in bodily and mental functions between social groups.

Bounded Solidarity as an Asset for Public Health Care Intervention

The relationship between social capital and public health has been extensively analyzed. However, not much has been written about the formation of social capital among citizens and public health workers in times of a pandemic. Our aim is to analyze social capital development through the prism of bounded solidarity and seek its manifestations toward public health workers. A qualitative self-administered survey was used to analyze what actions, practices, attitudes, and reasons inspired citizens to behave as they did with respect to public health workers during the first weeks of lockdown under the COVID-19 pandemic. Respondents, mostly from European countries, reveal that citizens aimed to prevent the collapse of the public health system through reinforcing trust toward institutions, legitimizing health care personnel expertise, practicing reciprocity and altruism, giving recognition to public health workers, and providing them with means. Finally, recommendations for public health communication on risks and crises are discussed.

Association between social capital and sleep duration among rural older adults in China

OBJECTIVE

Sleep disturbances are great challenges to older adults' health promotion. The study tested gender differences in the association between different dimensions of social capital and self-reported sleep duration of Chinese rural older adults.

DESIGN

The data of rural older adults were extracted from a national cross-sectional survey of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and analyzed in this study.

SETTING

CLHLS covered 23 provinces in China.

PARTICIPANTS

The 6552 rural respondents aged ≥65 years old were involved.

MAIN OUTCOME MEASURES

Generalized trust, informal social participation, formal social participation and social support were used to assess social capital. Self-reported sleep duration was measured as health outcome.

RESULTS

Low level of generalized trust had harmful effect on insufficient sleep (AOR 1.110, 95% CI 1.018-1.324), and having no formal or informal social participation was significantly positively associated with long sleep (AOR_formal 1.424, 95% CI 1.007-2.013; AOR_informal 1.241, 95% CI 1.016-1.516). Rural older female adults with no emotional social support had higher odds of insufficient sleep (AOR 1.502, 95% CI 1.258-1.978). Meanwhile, both informal and formal social participation showed inverse association with long sleep for females.

CONCLUSIONS

This study found the relationship between social capital, sleep duration and the gender differences in Chinese rural older adults. More targeted sleep disturbance interventions could be taken in social capital of rural older adults, and gender differences should be considered when making social capital-embedded health promotion policies and interventions.

Quantifying the Influence of Informal Payments on Self-Rated Health: Evidence from 26 Post-Communist Countries

In contrast to previous studies that have focused on proximal outcomes such as access to and the utilization of healthcare, this study establishes and quantifies the influence of informal payments (IP) directly on population self-rated health, which can be considered the ultimate outcome. More specifically, we examine how making informal payments influences self-rated health by testing several theoretically-grounded explanations of the influence of making IP. Using the quasi-experimental instrumental variable technique increases the likelihood that our findings are not the result of reverse causality, omitted variable problem, and measurement error. Our main finding is that overall, making informal payments have a negative influence on self-rated health. However, this influence is higher for men, those who are poorer, live in rural areas, have a university education, and have lower social capital. Theoretical approaches that have stood out in explanations regarding the effects of making IP on self-rated health are Public Choice Theory, Institutional Theory, and Sociological Theories of Differences in Life Opportunities, Social Determinants of Health, and Social Capital.

Types of social capital in relation to self-rated health: Gender differences in a nationally representative cross-sectional study of South Korean adults

Socio-economic and cultural transformations in South Korea have led to societal heterogeneity, potentially changing the role of social capital. We examined whether six factors (i.e. group membership, out-group trust, civic responsibility, acceptance, political activism, and institutional trust) that represent bonding, bridging, and linking social capital are associated with self-rated health (SRH), and whether these associations vary by gender. We analysed data from 8,000 adults in the Korea Social Integration Survey. We first conducted exploratory and confirmatory analyses to create and verify a social capital scale. Then, we performed multivariable logistic regression analyses to study how each type of social capital was related to SRH, adjusting for survey design and sampling weights. High levels of group membership and civic responsibility were associated with good SRH among men only, while high levels of out-group trust, acceptance, and institutional trust were associated with good SRH only for women. High levels of political activism were negatively related to good SRH for both men and women. Overall, associations between different types of social capital and SRH differed by gender in the South Korean context; thus, men and women may benefit from health interventions that enhance different forms of social capital.

Social Capital and Self-Rated Health: Empirical Evidence from China

This study assesses the relationship between social capital and self-reported health (SRH) by comparing different genders and ages. It utilizes data from the 2016 China Family Panel Study data with a sample of 30,657 adult individuals from 25 provincial-level administrative regions in China. This was a cross-sectional study conducted with computer-assisted face-to-face interviews to assess social capital and self-rated health among Chinese adults. A multi-level Poisson regression model is employed to model social capital-related dependent variables using the independent variable of fair/poor health status. In terms of social relations, mobile phone use can improve men's health. However, this effect is insignificant for women. Moreover, gender and age interact with the relationship between social capital and individual health. The relationship between trust and self-rated health is not significantly different between men and women. The frequency of feeling lonely and the lack of feelings for the community in which they live have a negative impact on self-rated health, but there are no obvious differences in terms of gender. The number of meals per week with family members is negatively correlated with men's SRH, but there is no correlation with adult women 41 and above. Lack of help from neighbors is negatively correlated with men's health, but not with that of adult women 40 and below. Being a member of the Chinese Communist Party or a member of the Chinese Communist Youth League is positively correlated with SRH for women 60 and above.

Sex differences in the association between self-rated health and high-sensitivity C-reactive protein levels in Koreans: a cross-sectional study using data from the Korea National Health and Nutrition Examination Survey

BACKGROUND

No studies have investigated the association between self-rated health (SRH) and high-sensitivity C-reactive protein (hs-CRP) levels in South Koreans. We explored this association and analyzed differences between sexes.

METHODS

Using cross-sectional data from the 2015-2017 Korea National Health and Nutrition Examination Survey, we analyzed the association between SRH and high hs-CRP levels (> 1.0 mg/L) in 14,544 Koreans aged ≥ 19 years who responded to the SRH survey and had available hs-CRP test results. Differences in sociodemographic factors were analyzed using the Pearson's chi-square test for categorical variables or the Mann-Whitney U test for continuous variables. Multiple logistic regression analysis was used to measure the association between hs-CRP levels and SRH according to sex while adjusting for other possible confounders.

RESULTS

The percentage of very poor to poor SRH was higher in the high hs-CRP group (22.4%) than in the low hs-CRP group (17.66%). Among men, the risk of a high hs-CRP level increased with worse SRH (adjusted for confounders; P for trend < 0.001). After adjusting for all confounders, including chronic diseases, men with very poor SRH showed a higher odds ratio (OR) for high hs-CRP levels than those with very good SRH (fully adjusted OR, 1.74; 95% CI, 1.04-2.90). Significant correlations were absent among women.

CONCLUSIONS

Poor SRH was correlated with low-grade inflammation (high hs-CRP levels) among Korean male adults. These findings could be useful for developing health improvement programs and in goal setting at a national scale.

Gender inequalities in poor self-rated health: Cross-national comparison of South Korea and Japan

BACKGROUND

Japan and South Korea represent "outliers" among rich nations with regard to having achieved high life expectancy but also ranking near the bottom on United Nations indices of gender equality. In the present study, we compared gender inequalities in self-rated health (SRH) across the life course captured in nationally representative surveys from South Korea and Japan. Our comparative analysis focused on the following questions, (1) Do Japan and South Korea exhibit similar patterns of gender inequalities in health as found in western settings (e.g. the "gender paradox" whereby women enjoy longer life expectancy, but worseself-rated health compared to men)? (2) Can gender differences in educational attainment and income account for gender differences in health in Japan & Korea? (3) Do gender inequalities in self-rated health differ over the life-course in Japan compared to South Korea?

METHODS

Cross-sectional data were drawn from nationally representative surveys in South Korea and Japan. We analyzed data for 239,076 participants aged 20 years or older (226,105 in South Korea and 12,971 in Japan). We evaluated the gender gap in poor SRH between two countries using logistic regression models controlling for covariates sequentially.

RESULTS

(1) The absolute female/male gap in prevalence of poor SRH was much narrower in Japan compared to South Korea; (2) the prevalence ratios of poor SRH (women relative to men) were significantly higher in South Korea than in Japan after retirement age; (3) but the difference in the prevalence ratios of poor SRH by gender between two countries largely disappeared after adjusting for educational attainment & comorbidity.

CONCLUSIONS

Each country needs to analyze their specific situations to understand what determines their population health status. In addition, there must exist other reasons for the"gender paradox" - i.e. why Japan & Korea have managed to achieve high longevity without gender equality.

A retrospective assessment of metropolitan religious adherence rate, individual and neighborhood social capital and their impact on women's health

Background

Social capital is a multilevel construct impacting health. Community level social capital, beyond the neighborhood, has received relatively less attention. Moreover, the measurement of community level social capital has tended to make use of aggregated individual data, rather than observable community characteristics.

Methods

Herein, metropolitan religious adherence, as an observable community-level measure of social capital, is used. We match it to city of residence for 2826 women in the Fragile Families Childhood Wellbeing Study (a cohort study) who have lived continuously in that city during a nine-year period. Using ordered logistic regression with clustered standard errors to account for area effects, we look at the relationship between metropolitan religious adherence and self-rated health, while controlling for lagged individual, neighborhood, and socioeconomic factors, as well as individual level religious attendance.

Results

Religious adherence at the community level is positive and statistically significant; every 1% increase in area religiosity corresponds to a 1.2% increase in the odds of good health.

Conclusions

These findings shed light on a possible pathway by which social capital may improve health, perhaps acting as a stress buffer or through spillover effects of reciprocity generated by exposure to religion.