Not belonging where others do: a cross-sectional analysis of multi-level social capital interactions on health and mental well-being in Wales

Covid and the common good: In-group out-group dynamics and Covid-19 vaccination in Wales and the United States

Vaccination is a social act, where benefits spill-over to third parties. How we approach such social decisions is influenced by whether likely beneficiaries share salient social identities with us. This study explores these dynamics using representative survey data from two contexts: national identity groups in Wales (N = 4187) and political partisans in America (N = 4864). In both cases, those in the minority in their local area were less likely to be vaccinated. In Wales, respondents who did not identify as Welsh were less likely to be vaccinated the greater the proportion of residents of their local area identified as Welsh. In America, the vaccination rate of Biden voters fell off more steeply than that of Trump voters as the proportion of Trump voters in their county increased. Results are robust to controlling for likely confounds and sensitivity analyses. In-group out-group dynamics help to shape important health decisions.

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

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

Sense of community and mental health: a cross-sectional analysis from a household survey in Wisconsin

BACKGROUND

In the USA, one in five adults live with a mental illness, and researchers have estimated that nearly half of the population will have a mental illness over the course of their lifetime. Research has shown significant associations between social relationships and mental health outcomes at the individual and population levels. This study aims to examine whether sense of community, a type of social capital, is associated with mental health.

METHODS

In a cross-sectional analysis, multiple logistic regression models were used to examine whether sense of community was associated with symptoms of depression, anxiety and stress reported over the last week. The analysis used data from the Survey of the Health of Wisconsin collected between 2014 and 2016. A total of 1647 observations are included in the analyses.

RESULTS

Compared with those who report a positive sense of community, those with a negative sense of community had a significantly higher odds of reporting depression, anxiety and stress symptoms. Socioeconomic status is negatively associated with depression and anxiety, but not with stress. Women were more likely to experience moderate, severe, or extremely severe anxiety and stress, compared with men.

CONCLUSION

This study extends current understanding of health benefits of social capital and found that individuals' sense of community is associated with reduced symptoms of depression, anxiety and stress. Further research examining mechanisms to support improved sense of community and other types of social capital could benefit health equity research.

Social capital and geographical variation in the incidence of COVID-19: an ecological study

BACKGROUND

The new behavioural norms needed to reduce the spread of COVID-19 are likely scaffolded by social capital. Research on social capital and COVID-19 has yielded mixed results, with some studies finding it to be protective while others identifying it as a risk factor. We examined the association between social capital and COVID-19 at a finer spatial scale than previous research, and examined changes in the relationship over the course of the pandemic.

METHODS

Routine COVID-19 surveillance data from Wales were linked to estimates of social capital at a small area level. Generalised linear mixed effects models predicting COVID-19 case rates across areas using social capital estimates and possible confounding variables were fitted to the data. A moving window version of the analysis explored whether this relationship varied across time.

RESULTS

Areas with higher levels of social capital had lower rates of COVID-19 (rate ratio for trust=0.94, 95% CI 0.92 to 0.96; rate ratio for belonging=0.94, 95% CI 0.92 to 0.96). These associations were strongest during periods of lockdown, with evidence that social capital was less protective, and potentially even a risk factor, during periods when restrictions were eased. Trust, but not belonging, remained protective after adjusting for deprivation, population density, ethnicity and proportion population aged over 65 years.

CONCLUSIONS

Social capital is an important public health resource, which should be considered in future pandemic preparedness. Its importance may be greatest during times when social activity is most restricted.

Health and Mental Health Disparities Between National Identity Groups in Wales

Despite close links with ethnic identity and other health-relevant identities, there is surprisingly little work on national identity in the context of population health. National identity is particularly important in multi-national states, where national identity is contested and where different nationalities often reflect both distinct ethnic groups and competing civic visions of national boundaries. The present study examines health disparities between national identity groups in Wales, a constituent nation of the UK. Using data from the National Survey for Wales (n = 23,303), latent class analysis was used to identify national identity groups in Wales. Generalised linear mixed-effects models were then fitted to the data to identity disparities between groups in terms of self-reported general and mental health, both unconditionally and conditionally on several socio-demographic and geographic variables. Analyses identified five groups: Anglophone Welsh, British, Cymry Cymraeg (Welsh-speaking Welsh), English and Ethnically Diverse. Striking health disparities were found, with the Cymry Cymraeg and Ethnically Diverse groups reporting better health than the other groups, especially the Anglophone Welsh and the English. These disparities could not be accounted for by differences in demographic, socio-economic or geographic factors.

The ethnic density effect in psychosis: a systematic review and multilevel meta-analysis

BACKGROUND

An 'ethnic' or 'group' density effect in psychosis has been observed, whereby the risk of psychosis in minority group individuals is inversely related to neighbourhood-level proportions of others belonging to the same group. However, there is conflicting evidence over whether this effect differs between minority groups and limited investigation into other moderators.

AIMS

To conduct a comprehensive systematic review and meta-analysis of the group density effect in psychosis and examine moderators.

METHOD

Four databases were systematically searched. A narrative review was conducted and a three-level meta-analysis was performed. The potential moderating effect of crudely and specifically defined minority groups was assessed. Country, time, area size and whether studies used clinical or non-clinical outcomes were also tested as moderators.

RESULTS

Thirty-two studies were included in the narrative review and ten in the meta-analysis. A 10 percentage-point decrease in own-group density was associated with a 20% increase in psychosis risk (OR = 1.20, 95% CI 1.09-1.32, P < 0.001). This was moderated by crudely defined minority groups (F6,68 = 6.86, P < 0.001), with the strongest associations observed in Black populations, followed by a White Other sample. Greater heterogeneity was observed when specific minority groups were assessed (F25,49 = 7.26, P < 0.001).

CONCLUSIONS

This is the first review to provide meta-analytic evidence that the risk of psychosis posed by lower own-group density varies across minority groups, with the strongest associations observed in Black individuals. Heterogeneity in effect sizes may reflect distinctive social experiences of specific minority groups. Potential mechanisms are discussed, along with the implications of findings and suggestions for future research.