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Huang Z, Long C, Yi C. The Relationship between Neighborhood Social Capital and the Health of Chinese Urban Elderly: An Analysis Based on CHARLS2018 Data. Healthcare (Basel) 2023; 11:healthcare11060909. [PMID: 36981565 PMCID: PMC10048430 DOI: 10.3390/healthcare11060909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/15/2023] [Accepted: 03/19/2023] [Indexed: 03/30/2023] Open
Abstract
There is growing interest in the relationship between neighborhood social capital and the health of urban older people, but existing research still falls short in exploring the relationship between the two. Based on 2018 CHARLS data, this paper quantitatively examines the association between neighborhood social capital and the self-rated health of urban older people. The study found that, after controlling for a series of variables, both increased social interaction and increased frequency of social interaction significantly improved urban older people's self-rated health. To implement the Health China strategy and improve the health of urban older people, further attention should be paid to the role of neighborhood social capital, creating a harmonious environment for neighborhood interaction and promoting the cultivation of neighborhood social capital.
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Affiliation(s)
- Ziqi Huang
- School of Public Administration, Beihang University, Beijing 100191, China
| | - Cuihong Long
- School of Economics, East China Normal University, Shanghai 200062, China
| | - Chengzhi Yi
- School of International and Public Affairs, China Institute for Urban Governance, Shanghai Jiaotong University, Shanghai 200030, China
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Stuijt CCM, van den Bemt BJF, Boerlage VE, Janssen MJA, Taxis K, Karapinar-Çarkit F. Differences in medication reconciliation interventions between six hospitals: a mixed method study. BMC Health Serv Res 2022; 22:722. [PMID: 35642033 PMCID: PMC9158255 DOI: 10.1186/s12913-022-08118-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 05/17/2022] [Indexed: 11/17/2022] Open
Abstract
Background Although medication reconciliation (MedRec) is mandated and effective in decreasing preventable medication errors during transition of care, hospitals implement MedRec differently. Objective Quantitatively compare the number and type of MedRec interventions between hospitals upon admission and discharge, followed by a qualitative analysis on potential reasons for differences. Methods This explanatory retrospective mixed-method study consisted of a quantitative and a qualitative part. Patients from six hospitals and six different wards i.e. orthopaedics, surgery, pulmonary diseases, internal medicine, cardiology and gastroenterology were included. At these wards, MedRec was implemented both on hospital admission and discharge. The number of pharmacy interventions was collected and classified in two subcategories. First, the number of interventions to resolve unintended discrepancies (elimination of differences between listed medication and the patient’s actual medication use). And second, the number of medication optimizations (optimization of pharmacotherapy e.g. eliminating double medication). Based on these quantitative results and interviews, a focus group was performed to give insight in local MedRec processes to address differences in context between hospitals. Descriptive analysis (quantitative) and content analysis (qualitative) was used. Results On admission 765 (85%) patients from six hospitals, received MedRec by trained nurses, pharmacy technicians, pharmaceutical consultants or pharmacists. Of those, 36–95% (mean per patient 2.2 (SD ± 2.4)) had at least one discrepancy. Upon discharge, these numbers were among 632 (70%) of patients, 5–28% (mean per patient 0.7 (SD 1.2)). Optimizations in pharmacotherapy were implemented for 2% (0.4–3.7 interventions per patient upon admission) to 95% (0.1–1.7 interventions per patient upon discharge) of patients. The main themes explaining differences in numbers of interventions were patient-mix, the type of healthcare professionals involved, where and when patient interviews for MedRec were performed and finally, embedding and extent of medication optimization. Conclusions Hospitals differed greatly in the number of interventions performed during MedRec. Differences in execution of MedRec and local context determines the number of interventions. This study can support hospitals who want to optimize MedRec processes. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08118-8.
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Social Capital as a Mediator and Moderator in the Association between Loneliness and Health, Israel as a Case Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063698. [PMID: 35329381 PMCID: PMC8955531 DOI: 10.3390/ijerph19063698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 02/05/2023]
Abstract
Loneliness has been associated with poor health. Social capital (SC) could possibly prevent the ill effects of loneliness. The study aims to assess the association of loneliness with physical and mental health in four different communities in Israel and study the impact of structural and cognitive SC on that association. A cross-sectional face-to-face survey with 4620 adults in four towns was conducted. The questionnaire included self-rated health (SRH), mental health (MH), loneliness, cognitive and structural SC and socioeconomic characteristics. Logistic regression analysis and mediation and moderation effects were calculated. Loneliness was associated with worse SRH (OR = 0.4–0.5) and worse MH (OR = 2.0–10). Both SC variables were associated with health. However, towns differ in these associations. Structural SC serves as a significant mediator between loneliness and SRH in all towns and is a mediator between loneliness and MH in two towns. Cognitive social capital was a moderator between loneliness and MH in two towns. This study suggests that increasing SC could possibly compensate for loneliness and buffer its effect on health. The study reinforces the need for the performance of separate health profiles to assess possible interventions for each community, as not always can we generalize these results to all communities.
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Oguttu JW, Ncayiyana JR. Social capital and self-rated health of residents of Gauteng province: Does area-level deprivation influence the relationship? SSM Popul Health 2020; 11:100607. [PMID: 32637552 PMCID: PMC7330610 DOI: 10.1016/j.ssmph.2020.100607] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/13/2020] [Accepted: 05/25/2020] [Indexed: 10/24/2022] Open
Abstract
Although social capital has been linked to population health, there is a dearth of studies on the phenomenon especially in sub-Saharan Africa. We investigated the individual and contextual effects of social capital indicators (group membership, registered to vote, perception towards safety in community and generalised trust) on the self-rated health (SRH) of the residents of Gauteng province. We used data from the 2015 Quality of Life (QoL) survey, which included a random representative sample of 27476 residents (level 1) in 508 administrative wards (level 2). We employed a multilevel logistic regression to examine the association of social capital and SRH (good vs poor). After adjusting for individual and area-level factors, no main effect of group membership (Adjusted OR: 0.93: 95% CI: 0.85-1.02), generalised trust (Adjusted OR: 1.01: 95% CI: 0.89-1.49) and registered to vote (Adjusted OR: 0.95; 95% CI: 0.82-1.10) was observed. However, if respondents were positive in their perception towards safety in community, there was a positive association with good SRH (Adjusted OR: 1.15; 95% CI: 1.01-1.31); while if residents reported a negative perception towards safety in community, a strong negative association with good SRH (Adjusted OR: 0.70; 95% CI: 0.62-0.79) was observed. Both ward variance and median odds ratio (MOR) indicate significant differences in good SRH by wards. A strong positive joint effect on the multiplicative scale was observed between satisfied with safety and the ward-level South African Multiple Deprivation Poverty Index (SAMPI), while a strong negative joint effect was also observed on a multiplicative scale between dissatisfied with safety and the SAMPI. Perception of safety in community is the core domain of social capital that significantly impacts the SRH of residents of Gauteng. Although the effect of perception towards safety in community on good SRH is influenced by ward deprivation,the effect is not dependent on the level of deprivation. Contextual factors as evidenced by the persistent MOR, in addition to individual factors, explain variation in reporting good SRH in the study area.
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Affiliation(s)
- James W Oguttu
- Department of Agriculture and Animal Health, College of Agriculture & Environmental Sciences, University of South Africa, Pretoria, South Africa.,Division of Epidemiology and Biostatistics, School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Jabulani R Ncayiyana
- Division of Epidemiology & Biostatistics, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, South Africa
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Ji X, Chui CHK, Ni SG, Dong R. Life Satisfaction of Rural Migrant Workers in Urban China: The Roles of Community Service Participation and Identity Integration. JOURNAL OF SOCIAL SERVICE RESEARCH 2020; 46:273-282. [DOI: 10.1080/01488376.2018.1555110] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/06/2024]
Affiliation(s)
- XiaoWen Ji
- School of Psychology, Universite Laval, Quebec city, Quebec, Canada
| | - Cheryl H. K. Chui
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong
| | - Shi Guang Ni
- School of Psychology, Universite Laval, Quebec city, Quebec, Canada
- Center for social work and mental health, Tsinghua University Graduate School at Shengzhen, Shenzhen, China
- School of Business Administration, Zhejiang University of Finance and Economics, Hangzhou, China
| | - Rui Dong
- School of Business Administration, Zhejiang University of Finance and Economics, Hangzhou, China
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Rodgers J, Valuev AV, Hswen Y, Subramanian SV. Social capital and physical health: An updated review of the literature for 2007-2018. Soc Sci Med 2019; 236:112360. [PMID: 31352315 DOI: 10.1016/j.socscimed.2019.112360] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 05/08/2019] [Accepted: 06/10/2019] [Indexed: 01/03/2023]
Abstract
PURPOSE Social capital is frequently indicated as a determinant of population health. Despite an increase in the frequency of public health studies including such measures, our understanding of social capital's effects on health remains unclear. In 2008, a systematic review of the "first decade" of research on social capital and health was published in the textbook Social Capital and Health. Our study intends to update and expand upon this original review to account for developments in the literature over the second decade of research on social capital and health. METHODS We employed a systematic review of empirical studies investigating the relationship between measures of social capital and physical health outcomes published between January 1, 2007 and December 31, 2018. To identify potential studies, we conducted searches of PubMed, Embase, and PsychINFO databases in January 2019 using combinations of "social capital" and "physical health" search terms. RESULTS We identified 1,608 unique articles and reviewed 145 studies meeting our inclusion criteria. The most frequently examined health condition was self-reported health (57%), followed by mortality (12%), cardiovascular diseases (10%), obesity (7%), diabetes (6%), infectious diseases (5%), and cancers (3%). Of these studies, 127 (88%) reported at least partial support for a protective association between social capital and health. However, only 41 (28%) reported exclusively positive findings. The majority (59%) of results were mixed, suggesting a nuanced relationship between social capital and health. This finding could also be indicative of differences in study design, which showed substantial variation. CONCLUSIONS Despite limitations in the literature, our review chronicles an evolution in the field of social capital and health in terms of size and sophistication. Overall, these studies suggest that social capital may be an important protective factor for some physical health outcomes, but further research is needed to confirm and clarify these findings.
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Affiliation(s)
- Justin Rodgers
- Department of Social and Behavioral Sciences, Harvard University, 310 Huntington Ave, Boston, MA, 02115, USA.
| | - Anna V Valuev
- Department of Global Health and Health Policy, Harvard University, 14 Story Street Cambridge, MA, 02138, USA
| | - Yulin Hswen
- Department of Social and Behavioral Sciences, Harvard University, 310 Huntington Ave, Boston, MA, 02115, USA
| | - S V Subramanian
- Center for Population and Development Studies, Harvard University, 9 Bow Street, Cambridge, MA, 02138, USA
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Han S. Social capital and perceived stress: The role of social context. J Affect Disord 2019; 250:186-192. [PMID: 30856496 DOI: 10.1016/j.jad.2019.03.034] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 02/20/2019] [Accepted: 03/04/2019] [Indexed: 11/19/2022]
Abstract
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.
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Affiliation(s)
- Sehee Han
- Institute of Social Sciences, Kookmin University, 77 Jeongneung-Ro, Seongbuk-Gu, Seoul, South Korea.
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Yu R, Wong M, Woo J. Perceptions of Neighborhood Environment, Sense of Community, and Self-Rated Health: an Age-Friendly City Project in Hong Kong. J Urban Health 2019; 96:276-288. [PMID: 30511137 PMCID: PMC6458199 DOI: 10.1007/s11524-018-00331-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
To examine the relationships between perceptions of neighborhood environment, sense of community, and self-rated heath, we recruited 1798 people aged 60 years and older living in Hong Kong. With reference to the checklist of the essential features of age-friendly cities developed by the World Health Organization, perceptions of neighborhood environment were assessed using a questionnaire covering physical and social environmental domains, which mapped onto "outdoor spaces and buildings," "transportation," "housing," "social participation," "respect and social inclusion," "civic participation and employment," "communication and information," and "community support and health services." Sense of community was measured by the Brief Sense of Community Scale. Self-rated health was assessed by a single question. The relationships between these measures were analyzed using partial correlations, multivariate regression models, and path analyses. The mean age of the participants was 71.7 years; of which 54.3% were women. In multivariate regression models, perceived neighborhood environments were positively associated with sense of community and self-rated health. Among the domains of perceived neighborhood environment, "transportation" and "respect and social inclusion" were the physical and the social environmental domains most strongly associated with sense of community, respectively. In addition, sense of community accounted for part of the relationship between perceived neighborhood environments and self-rated health. The results of this study support the importance of perceived neighborhood environments for the sense that older person has of one's community, and self-rated health of older people which may be enhanced through the improvement of neighborhood environments.
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Affiliation(s)
- Ruby Yu
- Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, SAR, China. .,Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China.
| | - Moses Wong
- Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Jean Woo
- Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, SAR, China.,Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
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Two theoretical strands of social capital, and total, cardiovascular, cancer and other mortality: A population-based prospective cohort study. SSM Popul Health 2019; 7:100337. [PMID: 30623011 PMCID: PMC6302214 DOI: 10.1016/j.ssmph.2018.100337] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 11/05/2018] [Accepted: 12/06/2018] [Indexed: 12/05/2022] Open
Abstract
The aim is to prospectively investigate both the “cohesion” and “network” perspectives of social capital in relation to total, cardiovascular (CVD), cancer and all other causes mortality. The 2008 public health survey in Scania was a postal questionnaire with three letters of reminder, and it was answered in the Autumn by 28,198 respondents (55% participation) aged 18–80 from a stratified random sample of the population register. This baseline was connected with the national causes of death registry (Dödsorsaksregistret) with a more than five-year follow-up August 27- November 14 (depending on individual response) to December 31, 2013 (946 deaths). The analyses were performed in multiple adjusted survival (Cox-) regression models. Results show that low social participation, common to both theoretical perspectives, had consistently high hazard rate ratios (HRRs) of total, CVD, cancer and other morality, and that HRRs of total and CVD mortality remained statistically significant even after adjustments for all covariates including health behaviors, BMI, unmet healthcare needs and self-rated health, HRR 1.28 (1.08–1.52) and HRR 1.79 (1.28–2.50), respectively. In contrast, low social support, specific to the “network” perspective, showed no significant associations with mortality, except for low emotional and instrumental support and other causes mortality for which HRRs remained significant adjusted for demographics and socioeconomic status (SES). Generalized trust in other people, specific to the “cohesion” perspective, showed statistically significant HRRs for total and other causes mortality until adjustments for health-related behaviours and BMI, although not after complete adjustments, and significant HRRs for CVD and cancer mortality before adjustment for health behaviours. In conclusion, low social participation is consistently associated with all forms of mortality, and particularly total and CVD mortality. Social participation represents a strong core of social capital theory, and items should measure both variety of social contact surfaces and intensity. There is no consensus regarding the definition of social capital. The “network” and “cohesion” approaches are discussed in the public health literature. Generalized trust is specific to the cohesion approach also including social participation. Social support is sometimes defined as an aspect of network which also includes social participation. Social participation was the strongest predictor of total and cause-specific mortality.
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Social Capital is Associated With Late HIV Diagnosis: An Ecological Analysis. J Acquir Immune Defic Syndr 2017; 73:213-21. [PMID: 27632146 DOI: 10.1097/qai.0000000000001043] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Late HIV diagnosis is associated with higher medical costs, early mortality among individuals, and HIV transmission in the population. Even under optimal configurations of stable or declining HIV incidence and increase in HIV case findings, no change in proportion of late HIV diagnosis is projected after year 2019. We investigated the association among social capital, gender, and late HIV diagnosis. METHODS We conduct ecological analyses (ZIP code, N = 166) using negative binomial regression of gender-specific rates of late HIV diagnoses (an AIDS defining illness or a CD4 count ≤200 cell/μL within 12 months of a new HIV diagnosis) in 2005 and 2006 obtained from the New York City HIV Surveillance Registry, and social capital indicators (civic engagement, political participation, social cohesion, and informal social control) from the New York Social Indicators Survey, 2004. RESULTS Overall, low to high political participation and social cohesion corresponded with significant (P < 0.0001) decreasing trends in late HIV diagnosis rates. Among men [relative risk (RR) = 0.66, 95% CI: (0.47 to 0.98)] and women [RR = 0.43, 95% CI: (0.28 to 0.67)], highest political participation was associated with lower relative odds of late HIV diagnosis, independent of income inequality. Highest informal social control [RR = 0.67, 95% CI: (0.48 to 0.93)] among men only and moderate social cohesion [RR = 0.71, 95% CI: (0.55 to 0.92)] among women only were associated with the outcome adjusting for social fragmentation, income inequality, and racial composition. DISCUSSION The magnitude of association between social capital and late HIV diagnosis varies by gender and by social capital indicator.
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Gunn CM, Parker VA, Bak SM, Ko N, Nelson KP, Battaglia TA. Social Network Structures of Breast Cancer Patients and the Contributing Role of Patient Navigators. Oncologist 2017; 22:918-924. [PMID: 28559408 DOI: 10.1634/theoncologist.2016-0440] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 03/13/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Minority women in the U.S. continue to experience inferior breast cancer outcomes compared with white women, in part due to delays in care delivery. Emerging cancer care delivery models like patient navigation focus on social barriers, but evidence demonstrating how these models increase social capital is lacking. This pilot study describes the social networks of newly diagnosed breast cancer patients and explores the contributing role of patient navigators. MATERIALS AND METHODS Twenty-five women completed a one hour interview about their social networks related to cancer care support. Network metrics identified important structural attributes and influential individuals. Bivariate associations between network metrics, type of network, and whether the network included a navigator were measured. Secondary analyses explored associations between network structures and clinical outcomes. RESULTS We identified three types of networks: kin-based, role and/or affect-based, or heterogeneous. Network metrics did not vary significantly by network type. There was a low prevalence of navigators included in the support networks (25%). Network density scores were significantly higher in those networks without a navigator. Network metrics were not predictive of clinical outcomes in multivariate models. CONCLUSION Patient navigators were not frequently included in support networks, but provided distinctive types of support. If navigators can identify patients with poorly integrated (less dense) social networks, or who have unmet tangible support needs, the intensity of navigation services could be tailored. Services and systems that address gaps and variations in patient social networks should be explored for their potential to reduce cancer health disparities. IMPLICATIONS FOR PRACTICE This study used a new method to identify the breadth and strength of social support following a diagnosis of breast cancer, especially examining the role of patient navigators in providing support. While navigators were only included in one quarter of patient support networks, they did provide essential supports to some individuals. Health care providers and systems need to better understand the contributions of social supports both within and outside of health care to design and tailor interventions that seek to reduce health care disparities and improve cancer outcomes.
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Affiliation(s)
- Christine M Gunn
- Evans Department of Medicine, Women's Health Unit, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Victoria A Parker
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Sharon M Bak
- Women's Health Unit Section of General Internal Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
| | - Naomi Ko
- Department of Hematology and Oncology, Boston Medical Center, Boston, Massachusetts, USA
| | - Kerrie P Nelson
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Tracy A Battaglia
- Department of Hematology and Oncology, Boston Medical Center, Boston, Massachusetts, USA
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12
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Noguchi M, Kobayashi T, Iwase T, Suzuki E, Kawachi I, Takao S. Social Capital and Suicidal Ideation in Community-Dwelling Older Residents: A Multilevel Analysis of 10,094 Subjects in Japan. Am J Geriatr Psychiatry 2017; 25:37-47. [PMID: 27890542 DOI: 10.1016/j.jagp.2016.10.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 09/29/2016] [Accepted: 10/27/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Social capital, the collective resources of groups including perceptions of trust and reciprocity, is recognized as an important contributor to suicide. We examined the association of individual- and community-level social capital with suicidal ideation after adjusting for social support among older adults living in the community. METHODS In August 2010 we sent questionnaires to all residents aged 65 years and older living in 3 rural municipalities (N = 21,232) in Okayama Prefecture, Japan; 13,919 questionnaires were returned (response rate: 65.6%). The final analysis included 10,094 participants. The outcome variable was suicidal ideation. Exposure variables were individual-level mistrust and lack of reciprocity (level 1), and the aggregated responses of these variables from 35 communities in the municipalities (level 2). Covariates included age, sex, educational attainment, marital status, the number of cohabitants, years of residence, self-rated socioeconomic status, disability, social support, and psychological distress. Multilevel logistic regression analysis was performed to obtain odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS After adjusting for social support and psychological distress, we found that mistrust and lack of reciprocity were only associated with suicidal ideation at the individual level. Stratified analysis showed that among subjects with psychological distress, mistrust was associated with suicidal ideation at individual (OR: 1.88; 95% CI: 1.42-2.51) and community levels (OR: 1.98; 95% CI: 1.02-3.81). CONCLUSIONS Our findings show that individual- and community-level social capital is a possible protective factor for suicidal ideation, particularly for people with psychological distress.
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Affiliation(s)
- Masayuki Noguchi
- Okayama Prefectural Mental Health and Welfare Center, Okayama, Japan
| | - Tomoko Kobayashi
- Department of Social Medicine, Graduate School of Medicine, Public Health, Osaka University, Osaka, Japan
| | - Toshihide Iwase
- The Support Center for Medical Cooperation, Human Resource Placement, and Career Promotion of Okayama Prefecture, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Etsuji Suzuki
- Department of Epidemiology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Soshi Takao
- Department of Epidemiology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
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Rippe RCA, Noppe G, Windhorst DA, Tiemeier H, van Rossum EFC, Jaddoe VWV, Verhulst FC, Bakermans-Kranenburg MJ, van IJzendoorn MH, van den Akker ELT. Splitting hair for cortisol? Associations of socio-economic status, ethnicity, hair color, gender and other child characteristics with hair cortisol and cortisone. Psychoneuroendocrinology 2016; 66:56-64. [PMID: 26773401 DOI: 10.1016/j.psyneuen.2015.12.016] [Citation(s) in RCA: 130] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 12/16/2015] [Accepted: 12/16/2015] [Indexed: 10/24/2022]
Abstract
The aim of this study was to examine associations of SES and ethnicity with hair cortisol and cortisone and to identify potential child and family characteristics that can assist in choosing covariates and potential confounders for analyses involving hair cortisol and cortisone concentrations. Hair samples were collected in 2484 6-year-old children from the Generation R Study, a prospective cohort in Rotterdam, the Netherlands. Measurements for cortisol and cortisone were used as the outcome in regression analyses. Predictors were SES, ethnicity, hair color and child characteristics such as birthweight, gestational age at birth, BMI, disease, allergy, and medication use. Lower family income, more children to be supported by this income, higher BMI and darker hair color were associated with higher hair cortisol and cortisone levels. Boys also showed higher levels. Ethnicity (Dutch and North European descent) was related to lower levels. High amounts of sun in the month of hair collection was related to higher levels of cortisone only. More recent hair washing was related to lower levels of cortisol and cortisone. Gestational age at birth, birth weight, age, medication use, hair washing frequency, educational level of the mother, marital status of the mother, disease and allergy were not associated with cortisol or cortisone levels. Our results serve as a starting point for choosing covariates and confounders in studies of substantive predictors or outcomes. Gender, BMI, income, the number of persons in a household, ethnicity, hair color and recency of hair washing are strongly suggested to take into account.
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Affiliation(s)
- Ralph C A Rippe
- Centre for Child and Family Studies, Leiden University, Leiden, The Netherlands
| | - Gerard Noppe
- Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Dafna A Windhorst
- Centre for Child and Family Studies, Leiden University, Leiden, The Netherlands; The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Child and Adolescent Psychiatry, Erasmus University Medical Center-Sophia Childreńs Hospital, Rotterdam, The Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Center-Sophia Childreńs Hospital, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Frank C Verhulst
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Center-Sophia Childreńs Hospital, Rotterdam, The Netherlands
| | | | - Marinus H van IJzendoorn
- Centre for Child and Family Studies, Leiden University, Leiden, The Netherlands; School of Pedagogical and Educational Sciences, Erasmus University, Rotterdam, The Netherlands.
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Chan MPL, Weinhold RS, Thomas R, Gohlke JM, Portier CJ. Environmental Predictors of US County Mortality Patterns on a National Basis. PLoS One 2015; 10:e0137832. [PMID: 26629706 PMCID: PMC4668104 DOI: 10.1371/journal.pone.0137832] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 08/22/2015] [Indexed: 11/23/2022] Open
Abstract
A growing body of evidence has found that mortality rates are positively correlated with social inequalities, air pollution, elevated ambient temperature, availability of medical care and other factors. This study develops a model to predict the mortality rates for different diseases by county across the US. The model is applied to predict changes in mortality caused by changing environmental factors. A total of 3,110 counties in the US, excluding Alaska and Hawaii, were studied. A subset of 519 counties from the 3,110 counties was chosen by using systematic random sampling and these samples were used to validate the model. Step-wise and linear regression analyses were used to estimate the ability of environmental pollutants, socio-economic factors and other factors to explain variations in county-specific mortality rates for cardiovascular diseases, cancers, chronic obstructive pulmonary disease (COPD), all causes combined and lifespan across five population density groups. The estimated models fit adequately for all mortality outcomes for all population density groups and, adequately predicted risks for the 519 validation counties. This study suggests that, at local county levels, average ozone (0.07 ppm) is the most important environmental predictor of mortality. The analysis also illustrates the complex inter-relationships of multiple factors that influence mortality and lifespan, and suggests the need for a better understanding of the pathways through which these factors, mortality, and lifespan are related at the community level.
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Affiliation(s)
- Melissa P. L. Chan
- Environmental Sciences Program, Southern Illinois University Edwardsville, Edwardsville, IL, 62026, United States of America
- * E-mail:
| | - Robert S. Weinhold
- Independent Researcher and Journalist, Colorado City, CO, 81019, United States of America
| | - Reuben Thomas
- School of Public Health, University of California, Berkeley, CA, 85736, United States of America
| | - Julia M. Gohlke
- School of Public Health, University of Alabama, Birmingham, AL, 35294, United States of America
| | - Christopher J. Portier
- National Center for Environmental Health and Agency for Toxic Substances and Disease Registry, U.S. Centers for Disease and Prevention, Atlanta, GA 30341, United States of America
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15
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School context, friendship ties and adolescent mental health: A multilevel analysis of the Korean Youth Panel Survey (KYPS). Soc Sci Med 2015; 145:209-16. [DOI: 10.1016/j.socscimed.2015.05.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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16
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Choi M, Mesa-Frias M, Nuesch E, Hargreaves J, Prieto-Merino D, Bowling A, Snith GD, Ebrahim S, Dale C, Casas JP. Social capital, mortality, cardiovascular events and cancer: a systematic review of prospective studies. Int J Epidemiol 2015; 43:1895-920. [PMID: 25369975 DOI: 10.1093/ije/dyu212] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Social capital is considered to be an important determinant of life expectancy and cardiovascular health. Evidence on the association between social capital and all-cause mortality, cardiovascular disease (CVD) and cancer was systematically reviewed. METHODS Prospective studies examining the association of social capital with these outcomes were systematically sought in Medline, Embase and PsycInfo, all from inception to 8 October 2012. We categorized the findings from studies according to seven dimensions of social capital, including social participation, social network, civic participation,social support, trust, norm of reciprocity and sense of community, and pooled the estimates across studies to obtain summary relative risks of the health outcomes for each social capital dimension. We excluded studies focusing on children, refugees or immigrants and studies conducted in the former Soviet Union. RESULTS Fourteen prospective studies were identified. The pooled estimates showed no association between most social capital dimensions and all-cause mortality, CVD or cancer. Limited evidence was found for association of increased mortality with social participation and civic participation when comparing the most extreme risk comparisons. CONCLUSIONS Evidence to support an association between social capital and health outcomes is limited. Lack of consensus on measurements for social capital hinders the comparability of studies and weakens the evidence base.
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Schölmerich VLN, Erdem Ö, Borsboom G, Ghorashi H, Groenewegen P, Steegers EAP, Kawachi I, Denktaş S. The association of neighborhood social capital and ethnic (minority) density with pregnancy outcomes in the Netherlands. PLoS One 2014; 9:e95873. [PMID: 24806505 PMCID: PMC4012999 DOI: 10.1371/journal.pone.0095873] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 04/01/2014] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Perinatal morbidity rates are relatively high in the Netherlands, and significant inequalities in perinatal morbidity and mortality can be found across neighborhoods. In socioeconomically deprived areas, 'Western' women are particularly at risk for adverse birth outcomes. Almost all studies to date have explained the disparities in terms of individual determinants of birth outcomes. This study examines the influence of neighborhood contextual characteristics on birth weight (adjusted for gestational age) and preterm birth. We focused on the influence of neighborhood social capital--measured as informal socializing and social connections between neighbors--as well as ethnic (minority) density. METHODS Data on birth weight and prematurity were obtained from the Perinatal Registration Netherlands 2000-2008 dataset, containing 97% of all pregnancies. Neighborhood-level measurements were obtained from three different sources, comprising both survey and registration data. We included 3.422 neighborhoods and 1.527.565 pregnancies for the birth weight analysis and 1.549.285 pregnancies for the premature birth analysis. Linear and logistic multilevel regression was performed to assess the associations of individual and neighborhood level variables with birth weight and preterm birth. RESULTS We found modest but significant neighborhood effects on birth weight and preterm births. The effect of ethnic (minority) density was stronger than that of neighborhood social capital. Moreover, ethnic (minority) density was associated with higher birth weight for infants of non-Western ethnic minority women compared to Western women (15 grams; 95% CI: 12,4/17,5) as well as reduced risk for prematurity (OR 0.97; CI 0,95/0,99). CONCLUSIONS Our results indicate that neighborhood contexts are associated with birth weight and preterm birth in the Netherlands. Moreover, ethnic (minority) density seems to be a protective factor for non-Western ethnic minority women, but not for Western women. This helps explain the increased risk of Western women in deprived neighborhoods for adverse birth outcomes found in previous studies.
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Affiliation(s)
- Vera L. N. Schölmerich
- Erasmus University Medical Centre, Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine, Rotterdam, the Netherlands
- VU University Amsterdam, Department of Organizational Sciences, Amsterdam, the Netherlands
- Harvard School of Public Health, Department of Social and Behavioral Sciences, Boston, Massachusetts, United States of America
| | - Özcan Erdem
- Municipality of Rotterdam, Research and Business Intelligence, Rotterdam, the Netherlands
- Erasmus University Medical Center, Department of Public Health, Rotterdam, the Netherlands
| | - Gerard Borsboom
- Erasmus University Medical Center, Department of Public Health, Rotterdam, the Netherlands
| | - Halleh Ghorashi
- VU University Amsterdam, Department of Sociology, Amsterdam, the Netherlands
| | - Peter Groenewegen
- VU University Amsterdam, Department of Organizational Sciences, Amsterdam, the Netherlands
| | - Eric A. P. Steegers
- Erasmus University Medical Centre, Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine, Rotterdam, the Netherlands
| | - Ichiro Kawachi
- Harvard School of Public Health, Department of Social and Behavioral Sciences, Boston, Massachusetts, United States of America
| | - Semiha Denktaş
- Erasmus University Medical Centre, Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine, Rotterdam, the Netherlands
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Jongeneel-Grimen B, Droomers M, van Oers HAM, Stronks K, Kunst AE. The relationship between physical activity and the living environment: a multi-level analyses focusing on changes over time in environmental factors. Health Place 2014; 26:149-60. [PMID: 24448404 DOI: 10.1016/j.healthplace.2013.12.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 12/02/2013] [Accepted: 12/03/2013] [Indexed: 10/25/2022]
Abstract
There is limited evidence on the causality of previously observed associations between neighborhood characteristics and physical activity (PA). We aimed to assess whether individual-level PA was associated with changes in fear of crime, social cohesion, green spaces, parking facilities, social disorder, and physical disorder that occurred over the past 3 years. In general, in neighborhoods where residents had more favorable perceptions of the environment in 2006, residents were more likely to be physically active in 2009. In addition, improvements between 2006 and 2009 with respect to perceived social cohesion, green spaces, social disorder, and physical disorder were associated with increased odds of being active in 2009. For both the levels in 2006 and trends in the period 2006-2009, the associations were somewhat stronger among women than among men, but associations did not vary by age or length of residence. For several environmental factors, we observed that not only the levels at a certain point in time, but also recent improvements over time were related to PA. These results provide new support for a causal relationship between these environmental factors and PA.
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Affiliation(s)
- Birthe Jongeneel-Grimen
- Department of Public Health, Academic Medical Center (AMC), University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands.
| | - Mariël Droomers
- Department of Public Health, Academic Medical Center (AMC), University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands.
| | - Hans A M van Oers
- Centre for Public Health Status and Forecasting, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands; Academic Collaborative Centre for Public Health Brabant, Tranzo, Faculty of Social Sciences, University of Tilburg, P.O Box 90153, 5000 LE Tilburg, The Netherlands.
| | - Karien Stronks
- Department of Public Health, Academic Medical Center (AMC), University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands.
| | - Anton E Kunst
- Department of Public Health, Academic Medical Center (AMC), University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands.
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Kunst AE, van Hooijdonk C, Droomers M, Mackenbach JP. Community social capital and suicide mortality in the Netherlands: a cross-sectional registry-based study. BMC Public Health 2013; 13:969. [PMID: 24139454 PMCID: PMC3856594 DOI: 10.1186/1471-2458-13-969] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Accepted: 10/03/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Evidence on the effect of community social capital on suicide mortality rates is fragmentary and inconsistent. The present study aims to determine whether geographic variations in suicide mortality across the Netherlands were associated with community social capital. METHODS We included 3507 neighbourhoods with 6207 suicide deaths in the period 1995-2000. For each neighbourhood, we measured perceived social capital using information from interview surveys, and we measured structural aspects of social capital using population registers. Associations with mortality were determined using Poisson regression analysis with control for confounders at individual level (age, sex, marital status, country of origin) and area level (area income, population density, religious orientation). RESULTS Suicide mortality rates were related to the measure of perceived social capital. Mortality rates were 8 percent higher (95% confidence interval (CI): 2 to 16 percent) in areas with low capital. In stratified analyses, this difference was found to be significantly larger among men (12 percent, CI: 2 to 22) than women (1 percent, CI: -9 to 13), larger among those age 0-50 (18 percent, CI: 8 to 29) than older residents (-2 percent, CI: -12 to 8), and larger among the unmarried (30 percent, CI: 16-45) than the married (-2 percent, CI: -12 to 9). Associations with the structural aspect of social capital were in the same direction, but weaker, and not statistically significant. CONCLUSIONS This study contributed some evidence to assume a modest effect of community social capital on suicide mortality rates. This effect may be restricted to specific population groups such as younger unmarried men.
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Affiliation(s)
- Anton E Kunst
- Department of Public Health, Academic Medical Centre (AMC), University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.
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Area-level deprivation and overall and cause-specific mortality: 12 years' observation on British women and systematic review of prospective studies. PLoS One 2013; 8:e72656. [PMID: 24086262 PMCID: PMC3782490 DOI: 10.1371/journal.pone.0072656] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 07/12/2013] [Indexed: 12/01/2022] Open
Abstract
Background Prospective studies have suggested a negative impact of area deprivation on overall mortality, but its effect on cause-specific mortality and the mechanisms that account for this association remain unclear. We investigate the association of area deprivation, using Index of Multiple deprivation (IMD), with overall and cause-specific mortality, contextualising findings within a systematic review. Methods And Findings We used data from 4,286 women from the British Women’s Heart Health Study (BWHHS) recruited at 1999-2001 to examine the association of IMD with overall and cause-specific mortality using Cox regression models. One standard deviation (SD) increase in the IMD score had a hazard ratio (HR) of 1.21 (95% CI: 1.13-1.30) for overall mortality after adjustment for age and lifecourse individual deprivation, which was attenuated to 1.15 (95% CI: 1.04-1.26) after further inclusion of mediators (health behaviours, biological factors and use of statins and blood pressure-lowering medications). A more pronounced association was observed for respiratory disease and vascular deaths. The meta-analysis, based on 20 published studies plus the BWHHS (n=21), yielded a summary relative risk (RR) of 1.15 (95% CI: 1.11-1.19) for area deprivation (top [least deprived; reference] vs. bottom tertile) with overall mortality in an age and sex adjusted model, which reduced to 1.06 (95% CI: 1.04-1.08) in a fully adjusted model. Conclusions Health behaviours mediate the association between area deprivation and cause-specific mortality. Efforts to modify health behaviours may be more successful if they are combined with measures that tackle area deprivation.
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Kim H, Lee M, Kim H, Lee K, Chang S, Kim V, Myong JP, Jeon S. Factors affecting diabetic screening behavior of Korean adults: a multilevel analysis. Asian Nurs Res (Korean Soc Nurs Sci) 2013; 7:67-73. [PMID: 25029924 DOI: 10.1016/j.anr.2013.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Revised: 01/21/2013] [Accepted: 03/05/2013] [Indexed: 11/18/2022] Open
Abstract
PURPOSE We investigated the role of individual and community level factors on diabetes screening test behavior. METHODS We used individual-level data from 170,193 adults aged 30 years or older who were not diagnosed with diabetes and participated in the 2009 community health survey. Community-level data includes 253 communities and were collected from various national statistics. Multilevel logistic regression analysis was conducted. RESULTS The rate of diabetes screening within the year prior to this study was 53.2%. Community variance of Model I, Model II and Model III was 0.236, 0.252 and 0.238, respectively. The proportional change in variance of Model II and Model III was -6.8% and -1.2%. The odds ratio for participation of diabetic screening of areas with bottom financial independence compared to areas with top was 0.84 (95% confidence interval, 0.74-0.96); the odds ratio of areas with top internist compared to areas with bottom was 1.15 (95% confidence interval, 1.01-1.31). CONCLUSION This study identified a contextual effect influencing the participation of Korean adults in diabetes screening. It is necessary to develop specific policies that consider not only individual factors, but also community factors relating to individual behaviors to increase the likelihood of diabetes screening.
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Affiliation(s)
- Hyeongsu Kim
- Department of Preventive Medicine, School of Medicine, Konkuk University, Seoul, South Korea
| | - Minjung Lee
- Department of Preventive Medicine, School of Medicine, Konkuk University, Seoul, South Korea
| | - Haejoon Kim
- Department of Preventive Medicine, School of Medicine, Korea University, Seoul, South Korea
| | - Kunsei Lee
- Department of Preventive Medicine, School of Medicine, Konkuk University, Seoul, South Korea
| | - Sounghoon Chang
- Department of Preventive Medicine, School of Medicine, Konkuk University, Seoul, South Korea.
| | - Vitna Kim
- Department of Preventive Medicine, School of Medicine, Konkuk University, Seoul, South Korea
| | - Jun Pyo Myong
- Department of Preventive Medicine, Center for Occupational and Environmental Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Soyoun Jeon
- Department of Emergency Medical Technology, Daejeon Health Sciences College, Daejeon, South Korea
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Kuipers MAG, Jongeneel-Grimen B, Droomers M, Wingen M, Stronks K, Kunst AE. Why residents of Dutch deprived neighbourhoods are less likely to be heavy drinkers: the role of individual and contextual characteristics. J Epidemiol Community Health 2013; 67:587-94. [PMID: 23533267 DOI: 10.1136/jech-2012-201242] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Earlier research has shown that residents of Dutch deprived neighbourhoods drink less alcohol than people in other areas. We aimed to assess the role of individual and neighbourhood characteristics in a cross-sectional, nationwide, multilevel study. METHODS Individual data of 30,117 Dutch adults, living in 1722 neighbourhoods across the Netherlands, were obtained from the 2004 to 2009 national health survey (POLS). Chronic heavy alcohol consumption was measured as ≥14 drinks/week for women and ≥21 for men, and episodic heavy drinking as ≥6 drinks/day at least once a week. Neighbourhood deprivation was dichotomous; deprived districts as selected by the Dutch government versus other areas. Multilevel logistic regression models of the association between deprivation and heavy drinking were corrected for age, gender, household composition, population density and potential predictors ethnicity, socioeconomic status (education, income), neighbourhood-level social cohesion and percentage Muslims. RESULTS The prevalence of heavy drinking was lower in deprived neighbourhoods than in the rest of the Netherlands. This association was found for both chronic and episodic heavy drinking (OR=0.58 (0.47 to 0.72) and OR=0.57 (0.45 to 0.72), respectively). Adding ethnicity to the model reduced these associations by approximately one half. Socioeconomic composition did not contribute to the relationship. The proportion of Muslims explained a small part, while social cohesion explained even less of the association. Stronger associations were observed for women and older adults than for men and younger adults. CONCLUSIONS The lower prevalence of heavy drinking occurring in deprived areas is largely explained by the ethnicity of neighbourhood residents.
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Affiliation(s)
- Mirte A G Kuipers
- Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
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Allebeck P. Social capital: much discussed, somewhat controversial, but more to do. Eur J Public Health 2013; 23:1. [PMID: 23288921 DOI: 10.1093/eurpub/cks180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Compositional and contextual associations of social capital and self-rated health in Seoul, South Korea: a multilevel analysis of longitudinal evidence. Soc Sci Med 2012; 80:113-20. [PMID: 23261256 DOI: 10.1016/j.socscimed.2012.12.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Revised: 11/13/2012] [Accepted: 12/04/2012] [Indexed: 11/22/2022]
Abstract
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.
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Okamoto M, Kawakami N, Kido Y, Sakurai K. Social capital and suicide: an ecological study in Tokyo, Japan. Environ Health Prev Med 2012. [PMID: 23180068 DOI: 10.1007/s12199-012-0321-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE The aim of this study is to clarify the association between area-based social capital and suicide rate among municipalities of Tokyo. METHODS The study areas were 20 administrative municipalities of Tokyo. Social capital (i.e., organizational membership, social trust, fairness, helpfulness, and confidence in organizations) was measured based on data from a previous survey (response rate 28 %). Gender-specific age-adjusted suicide rates averaged over 5 years, sociodemographic, and other area characteristics were obtained from relevant national statistics. Multiple linear regression analysis of suicide rates was applied on each social capital variable, adjusting for the other area characteristics. RESULTS There was no significant crude Pearson's correlation between any social capital variable and suicide rate. Multiple regression analyses revealed a significant negative association between social trust and suicide rate for men (p = 0.04). CONCLUSIONS While based on only limited evidence from a cross-sectional ecological study, area-based social trust may be associated with decreased suicide rates for men in Tokyo.
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Affiliation(s)
- Masumi Okamoto
- Department of Mental Health, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
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Kuipers MAG, van Poppel MNM, van den Brink W, Wingen M, Kunst AE. The association between neighborhood disorder, social cohesion and hazardous alcohol use: a national multilevel study. Drug Alcohol Depend 2012; 126:27-34. [PMID: 22572208 DOI: 10.1016/j.drugalcdep.2012.04.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Revised: 03/06/2012] [Accepted: 04/14/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Evidence on associations of alcohol use with neighborhood disorder and social cohesion is limited. The aim of this study was to further investigate these associations. METHODS Individual data of 14,258 Dutch adults, living in 1546 neighborhoods across The Netherlands, were obtained from the 2006 to 2009 national health survey (POLS). Data on neighborhood disorder and social cohesion were derived from the 2006 Netherlands Housing Research (WoON). Hazardous drinking was measured as: ≥14, ≥21, and ≥28 drinks/week for women, and ≥21, ≥28, and ≥35 for men. Multilevel logistic regression models were adjusted for age, gender, ethnicity, marital status, education, income, wealth, predominant neighborhood religion, and population density. Potential mediation of psychological distress (depression and anxiety) and general mental health (MHI-5 score) was tested. RESULTS High neighborhood disorder was associated with more hazardous alcohol use for women (OR cut-off 3: 3.72 [2.03-6.83]), but not for men (OR cut-off 3: 1.08 [0.72-1.62]). There was no mediation by psychological distress, and modest mediation by general mental health. Social cohesion had no linear association with hazardous alcohol use, but for males moderate social cohesion was associated with more hazardous alcohol use (OR cut-off 1: 1.29 [1.08-1.53]). In predominantly Protestant neighborhoods this association seemed weaker. CONCLUSIONS Hazardous alcohol use seems to have a stronger and more consistent relationship with neighborhood disorder than with social cohesion. This suggests that negative aspects of the social environment have more impact on the prevalence of hazardous alcohol use than positive factors related to sociability and support.
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Affiliation(s)
- Mirte A G Kuipers
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
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Place-specific constructs of social capital and their possible associations to health: A Japanese case study. Soc Sci Med 2012; 75:225-32. [DOI: 10.1016/j.socscimed.2012.03.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Revised: 02/07/2012] [Accepted: 03/13/2012] [Indexed: 10/28/2022]
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Mohnen SM, Völker B, Flap H, Subramanian S, Groenewegen PP. You have to be there to enjoy it? Neighbourhood social capital and health. Eur J Public Health 2012; 23:33-9. [DOI: 10.1093/eurpub/cks039] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Cramm JM, van Dijk HM, Nieboer AP. The importance of neighborhood social cohesion and social capital for the well being of older adults in the community. THE GERONTOLOGIST 2012; 53:142-52. [PMID: 22547088 DOI: 10.1093/geront/gns052] [Citation(s) in RCA: 204] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
PURPOSE OF THE STUDY We aimed to investigate whether social capital (obtaining support through indirect ties such as from neighbors) and social cohesion (interdependencies among neighbors) within neighborhoods positively affect the well being of older adults. DESIGN AND METHODS This cross-sectional study included 945 of 1,440 (66% response rate) independently living older adults (aged ≥70 years) in Rotterdam. We fitted a hierarchical random effects model to account for the hierarchical structure of the study design: 945 older adults (Level 1) nested in 72 neighborhoods (Level 2). RESULTS Univariate analyses showed that being born in the Netherlands, house ownership, education, income, social capital of individuals, neighborhood security, neighborhood services, neighborhood social capital, and neighborhood social cohesion were significantly related to the well being of older adults. Multilevel analyses showed that social capital of individuals, neighborhood services, neighborhood social capital, and neighborhood social cohesion predicted the well being of older adults. Single and poor older adults reported lower well being than did better off and married older adults. However, the effects of marital status and income were mediated by neighborhood services, social capital, and social cohesion. Neighborhood services, social capital, and social cohesion may act as buffer against the adverse effects of being single and poor on the well being of older adults. IMPLICATIONS The results of this study support the importance of social capital of individuals, as well as social capital within the neighborhood and social cohesion within the neighborhood for well being of older adults. The well being of older adults may also be enhanced through the improvement of quality of neighborhood services.
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Affiliation(s)
- Jane M Cramm
- Institute of Health Policy and Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3000 DR Rotterdam, the Netherlands.
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Hanibuchi T, Kondo K, Nakaya T, Shirai K, Hirai H, Kawachi I. Does walkable mean sociable? Neighborhood determinants of social capital among older adults in Japan. Health Place 2012; 18:229-39. [DOI: 10.1016/j.healthplace.2011.09.015] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2011] [Revised: 08/18/2011] [Accepted: 09/24/2011] [Indexed: 11/15/2022]
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Health-related behavior as a mechanism behind the relationship between neighborhood social capital and individual health--a multilevel analysis. BMC Public Health 2012; 12:116. [PMID: 22325740 PMCID: PMC3347984 DOI: 10.1186/1471-2458-12-116] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2011] [Accepted: 02/10/2012] [Indexed: 11/30/2022] Open
Abstract
Background Although various studies have found a positive association between neighborhood social capital and individual health, the mechanism explaining this direct effect is still unclear. Neighborhood social capital is the access to resources that are generated by relationships between people in a friendly, well-connected and tightly knit neighborhood community. We expect that the resources generated by cohesive neighborhoods support and influence health -improving behaviors in daily life. We identify five different health-related behaviors that are likely to be affected by neighborhood social capital and test these behaviors separately as mediators. Methods The data set pertaining to individual health was taken from the 'health interview' in the 'Second Dutch national survey of general practice' (DNSGP-2, 2002). We combine these individual-level data with data from the 'Dutch housing demand survey' (WBO, 1998 and WoON, 2002) and statistical register information (1995-1999). Per neighborhood 29 WBO respondents, on average, had answered questions regarding social capital in their neighborhood. These variables have been aggregated to the neighborhood level by an ecometric methodology. In the main analysis, in which we tested the mediation, multilevel (ordered) logistic regressions were used to analyze 9253 adults (from the DNSGP-2 data set) from 672 Dutch neighborhoods. In the Netherlands, on average, neighborhoods (4-digit postcodes) comprise 4,000 inhabitants at highly variable population densities. Individual- and neighborhood-level controls have been taken into account in the analyses. Results In neighborhoods with a high level of social capital, people are more physically active and more likely to be non-smokers. These behaviors have positive effects on their health. The direct effect of neighborhood social capital on health is significantly and strongly reduced by physical activity. This study does not support nutrition and sleep habits or moderate alcohol intake as possible explanations of the effects of neighborhoods on health. Conclusions This study is one of the first to test a mechanism explaining much of the direct effect of small-area social capital on individual health. Neighborhood interventions might be most successful at improving health if they stimulate both social interaction and physical activity.
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Han S, Kim H, Lee HS. A multilevel analysis of social capital and self-reported health: evidence from Seoul, South Korea. Int J Equity Health 2012; 11:3. [PMID: 22280458 PMCID: PMC3276420 DOI: 10.1186/1475-9276-11-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Accepted: 01/26/2012] [Indexed: 12/04/2022] Open
Abstract
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.
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Affiliation(s)
- Sehee Han
- Department of Public Administration, Hanyang University, 17 Haengdang-dong, Seongdong-gu, Seoul, 133-791, South Korea.
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Elgar FJ, Davis CG, Wohl MJ, Trites SJ, Zelenski JM, Martin MS. Social capital, health and life satisfaction in 50 countries. Health Place 2011; 17:1044-53. [DOI: 10.1016/j.healthplace.2011.06.010] [Citation(s) in RCA: 122] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Revised: 05/31/2011] [Accepted: 06/25/2011] [Indexed: 12/20/2022]
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Yiengprugsawan V, Caldwell BK, Lim LLY, Seubsman SA, Sleigh AC. Lifecourse Urbanization, Social Demography, and Health Outcomes among a National Cohort of 71,516 Adults in Thailand. INTERNATIONAL JOURNAL OF POPULATION RESEARCH 2011; 2011:464275. [PMID: 22428087 PMCID: PMC3303129 DOI: 10.1155/2011/464275] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2011] [Accepted: 07/13/2011] [Indexed: 11/18/2022]
Abstract
We examine the influence of urbanization on household structure, social networks, and health in Thailand. We compare lifetime urban or rural dwellers and those who were rural as children and urban as adults. Data derived from a large national cohort of 71,516 Sukhothai Thammathirat Open University adult students participating in an on-going longitudinal study of the health-risk transition in Thailand. The rural-urban group, one-third of cohort households, was significantly different from other groups (e.g., smaller households). The rural-rural and the urban-urban groups often were the two extremes. Urbanization, after adjusting for covariates, was a risk factor for poor overall health and depression. Urbanization is a mediator of the health-risk transition underway in Thailand. Health programs and policies directed at transitional health outcomes should focus on the health risks of the urbanizing population, in particular smoking, drinking, low social trust, and poor psychological health.
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Affiliation(s)
- Vasoontara Yiengprugsawan
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra ACT 0200, Australia
| | - Bruce K. Caldwell
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra ACT 0200, Australia
| | - Lynette L.-Y. Lim
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra ACT 0200, Australia
| | - Sam-ang Seubsman
- School of Human Ecology, Sukhothai Thammathirat Open University, Nonthaburi 11120, Thailand
| | - Adrian C. Sleigh
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra ACT 0200, Australia
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Blackman T, Wistow J, Byrne D. A Qualitative Comparative Analysis of factors associated with trends in narrowing health inequalities in England. Soc Sci Med 2011; 72:1965-74. [PMID: 21640455 DOI: 10.1016/j.socscimed.2011.04.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2010] [Revised: 12/18/2010] [Accepted: 04/04/2011] [Indexed: 10/18/2022]
Abstract
This study explores why progress with tackling health inequalities has varied among a group of local authority areas in England that were set targets to narrow important health outcomes compared to national averages. It focuses on premature deaths from cancers and cardiovascular disease (CVD) and whether the local authority gap for these outcomes narrowed. Survey and secondary data were used to create dichotomised conditions describing each area. For cancers, ten conditions were found to be associated with whether or not narrowing occurred: presence/absence of a working culture of individual commitment and champions; spending on cancer programmes; aspirational or comfortable/complacent organisational cultures; deprivation; crime; assessments of strategic partnership working, commissioning and the public health workforce; frequency of progress reviews; and performance rating of the local Primary Care Trust (PCT). For CVD, six conditions were associated with whether or not narrowing occurred: a PCT budget closer or further away from target; assessments of primary care services, smoking cessation services and local leadership; presence/absence of a few major programmes; and population turnover. The method of Qualitative Comparative Analysis was used to find configurations of these conditions with either the narrowing or not narrowing outcomes. Narrowing cancer gaps were associated with three configurations in which individual commitment and champions was a necessary condition, and not narrowing was associated with a group of conditions that had in common a high level of bureaucratic-type work. Narrowing CVD gaps were associated with three configurations in which a high assessment of either primary care or smoking cessation services was a necessary condition, and not narrowing was associated with two configurations that both included an absence of major programmes. The article considers substantive and theoretical arguments for these configurations being causal and as pointing to ways of improving progress with tackling health inequalities.
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Affiliation(s)
- Tim Blackman
- Durham University, School of Applied Social Sciences, 32 Old Elvet, Durham DH1 3HN, United Kingdom.
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Smith MV, Lincoln AK. Integrating social epidemiology into public health research and practice for maternal depression. Am J Public Health 2011; 101:990-4. [PMID: 21493925 DOI: 10.2105/ajph.2010.196576] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The impact of maternal depression on women and their families has been well documented. Given the prevalence and impact of this problem, one important strategy is to strengthen and expand our public health approaches. Although principles of social epidemiology are increasingly used in the field of maternal and child health, few public health efforts to address maternal mental health have incorporated ecosocial frameworks such as community connectedness, quality of social relationships, and social capital. One method to augment current public health approaches to maternal depression is through the incorporation of a perspective focusing on community, cohesion, group membership, and connectedness--a concept often described as social capital. We describe the relevance of this ecosocial perspective for mental health promotion programs for mothers.
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Affiliation(s)
- Megan V Smith
- Department of Psychiatry and the Child Study Center, Yale University School of Medicine, New Haven, CT, USA.
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Nauenberg E, Laporte A, Shen L. Social capital, community size and utilization of health services: a lagged analysis. Health Policy 2011; 103:38-46. [PMID: 21269724 DOI: 10.1016/j.healthpol.2010.12.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2010] [Revised: 12/09/2010] [Accepted: 12/19/2010] [Indexed: 10/18/2022]
Abstract
OBJECTIVES We examine the relationship between social capital, community size and GP visits, and conceptualize social capital as a stock variable measured at a prior point in time. METHODS Data from the 2002 Canadian Community Health Survey and the 2001 Canadian Census are merged with GP visit data from the Ontario Health Ministry. Negative binomial regression is used to measure the impact of community-level (CSC) and individual-level social capital (ISC) on GP visits. CSC is measured with the Petris Index using employment levels in religious and community-based organizations, and ISC is measured along multiple dimensions. RESULTS The effect of social capital varies by community size. A one standard deviation increase in the Petris Index in larger communities (population>100,000) leads to a 2.6% decrease in GP visits with an annual offset in public spending of $66.4M. Tangible social support-a measure of ISC-also exhibited large effects on GP visits. In smaller communities (population 10,000-100,000), only increased ISC exhibited an impact on GP visits. Age had no effect on the association between social capital and GP visits. CONCLUSIONS Each form of social capital likely operates through different mechanisms and impact differs by community size. Stronger CSC likely obviates some physician visits in larger communities that involve counseling/caring services while some forms of ISC may act similarly in smaller communities.
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Affiliation(s)
- Eric Nauenberg
- Department of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada.
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Neighborhood social capital and individual health. Soc Sci Med 2010; 72:660-7. [PMID: 21251743 DOI: 10.1016/j.socscimed.2010.12.004] [Citation(s) in RCA: 184] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2009] [Revised: 08/25/2010] [Accepted: 12/02/2010] [Indexed: 11/23/2022]
Abstract
Neighborhood social capital is increasingly considered to be an important determinant of an individual's health. Using data from the Netherlands we investigate the influence of neighborhood social capital on an individual's self-reported health, while accounting for other conditions of health on both the level of the neighborhood and the individual. We use national representative data ('The Housing and Living Survey', 2006) on the Netherlands with 61,235 respondents in 3273 neighborhoods. The cross-sectional data were combined with information provided by Statistics Netherlands on neighborhoods, i.e., the percentage of residents in the highest income quintile per neighborhood and the municipality's degree of urbanity. The association of neighborhood social capital with individual health was assessed by multilevel logistic regression analysis. Our results show that neighborhood social capital is positively associated with health. Interestingly, residents in urban neighborhoods benefit particularly from their neighborhood social capital.
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Chu KP, Shema S, Wu S, Gomez SL, Chang ET, Le QT. Head and neck cancer-specific survival based on socioeconomic status in Asians and Pacific Islanders. Cancer 2010; 117:1935-45. [PMID: 21509771 DOI: 10.1002/cncr.25723] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Revised: 09/13/2010] [Accepted: 09/13/2010] [Indexed: 11/07/2022]
Abstract
BACKGROUND Lower socioeconomic status (SES) has been linked to higher incidence of head and neck cancer (HNC) and lower survival. However, little is known about the effect of SES on HNC survival in Asians and Pacific Islanders (APIs). This study's purpose was to examine the effect of SES on disease-specific survival (DSS) and overall survival (OS) in APIs with HNC using population-based data. METHODS A total of 53,544 HNC patients (4,711 = APIs) were identified from the California Cancer Registry from 1988 to 2007. Neighborhood (block-group-level) SES, based on composite Census 1990 and 2000 data, was calculated for each patient based on address at diagnosis, categorized into statewide quintiles, and collapsed into 2 groups for comparison (low SES = quintiles 1-3; high SES = quintiles 4-5). DSS and OS were computed by the Kaplan-Meier method. Adjusted hazards ratios (HR) were estimated using Cox proportional hazards regression models. RESULTS Among APIs, lower neighborhood SES was significantly associated with poorer DSS (HR range for oral cavity, oropharynx, or larynx/hypopharynx cancer, 1.07-1.34) and OS (HR, 1.13-1.37) after adjusting for patient and tumor characteristics. Lower SES was significantly associated with poorer survival in API with all HNC sites combined: DSS HR: 1.26 (95% confidence interval [CI], 1.08-1.48) and OS HR, 1.30 (95% CI, 1.16-1.45). CONCLUSIONS Neighborhood SES was associated with longer DSS and OS in API with HNC. The effect of SES on HNC survival should be considered in future studies, and particular attention should be paid to clinical care of lower-SES HNC patients.
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Affiliation(s)
- Karen P Chu
- Stanford University Medical Center, Stanford, California 94305-5847, USA
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Kunitz SJ. Commentary: Comments on the diversity in associations between community social capital and health. Int J Epidemiol 2008; 37:1393-4. [PMID: 18812361 DOI: 10.1093/ije/dyn203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Stephen J Kunitz
- Division of Social & Behavioral Medicine, Department of Community & Preventive Medicine, University of Rochester School of Medicine, PO Box 278969, Rochester, NY 14627-8969, USA.
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