Individual social capital and survival: a population study with 5-year follow-up

Conceptualizing and Measuring Trust, Mistrust, and Distrust: Implications for Advancing Health Equity and Building Trustworthiness

Trust is vital to public confidence in health and science, yet there is no consensus on the most useful way to conceptualize, define, measure, or intervene on trust and its related constructs (e.g., mistrust, distrust, and trustworthiness). In this review, we synthesize literature from this wide-ranging field that has conceptual roots in racism, marginalization, and other forms of oppression. We summarize key definitions and conceptual frameworks and offer guidance to scholars aiming to measure these constructs. We also review how trust-related constructs are associated with health outcomes, describe interventions in this field, and provide recommendations for building trust and institutional trustworthiness and advancing health equity. We ultimately call for future efforts to focus on improving the trustworthiness of public health professionals, scientists, health care providers, and systems instead of aiming to increase trust in these entities as they currently exist and behave.

Social capital and all-cause mortality before and during the COVID-19 pandemic among middle-aged and older people: Prospective cohort study in Poland

Prior to the pandemic, studies demonstrated the mainly protective role of structural social capital on all-cause mortality, less evidence had been found for a protective role for cognitive social capital. However, some findings from the early stage of the pandemic suggest that civic participation and group affiliation may be associated with more COVID-19-related deaths, as was interpersonal trust. Thus, the study aimed to verify indicators of individual social capital as risk factors for 7.6-year all-cause mortality before COVID-19 pandemic and 1.6-year all-cause mortality during of the pandemic among men and women aged 50+ years in Poland. The Polish part of the COURAGE in Europe cross-sectional baseline study was conducted in 2011. The analysis included 2913 face-to-face interviews with randomly selected community-dwelling individuals. Information about deaths was obtained from the State Systems Department on Oct 7, 2021. Various aspects of structural and cognitive social capital were measured. The Cox proportional hazard models were used. Before the pandemic, a protective effect of structural (formal and informal social participation) and cognitive social capital (trust in family, trust in co-workers) on the risk of death was observed in women. However, a negative effect of cognitive social capital (trust in strangers) was found for women and men. No positive effect of social capital during the pandemic after controlling for the health-related characteristics was found. A negative effect of generalized trust on all-cause mortality during the pandemic was discerned for men, a negative effect of the level of one's social network was found in women. The observed patterns of relationships were totally different for analyzed periods of time, and different for men and women. Consequently, planning of social interventions directed towards middle and older age groups should consider various actions for men and women separately. The need for continuous evaluation of implemented social interventions was emphasized.

The civic engagement community participation thriving model: A multi-faceted thriving model to promote socially excluded young adult women

Social policies to promote socially excluded young adult women generally concentrate on education, employment, and residence but tend to neglect thriving. The current article puts forward a Civic Engagement Community Participation Thriving Model (CECP-TM) that views thriving as a social policy goal in and of itself. It posits that civic engagement, beyond its contribution to social justice, serves as a vehicle for thriving through self-exploration and identity formation. Both are considered key components of successful maturation and thriving. Nonetheless, civic engagement and self-exploration tend not to be nurtured in socially excluded young adult women, a unique group experiencing intersecting discrimination. The model shows how active civic engagement in the context of a community of peers contributes to developing a sense of belonging and connectedness and promotes new self-reflection, identity formation, and agency capabilities. When situated within the context of intersectionality, these encourage the development of critical consciousness and new understandings of “who I am and how I fit into the social world in which we live.” These can provide a sense of meaning, contribute to identity formation, and promote the thriving of the self and the community. Several examples illustrate the model.

The Influence of Question Wording on Interpersonal Trust

Abstract. We aimed to evaluate the impact of two question wordings, one more directive (reference, European Social Survey ) and one less directive (modified version), on self-reported trust. Using a randomly equivalent groups design, young adults ( n = 1,681) from the EPITeen cohort completed one of two questionnaires to evaluate trust. The final score ranged between 0 (lowest) and 30 (highest). Cronbach’s alphas were computed to assess reliability, and invariance tests were conducted to test the equivalence of both versions. Lower levels of interpersonal trust were attained with the reference version [ M ( SD):14.4(5.3) vs. 15.6(4.8); p < .001 and p = .005 for mean and variance comparison]. The reference version had better reliability (α = .742 vs. .686; p = .006). Strict invariance was achieved between the two formats, and similar effects of sociodemographic variables on trust were obtained, independently of the version used. The reference version presented better reliability than the modified one, supporting its ability to measure levels of trust among young adults.

Trust and all-cause mortality: a multilevel study of US General Social Survey data (1978-2010)

Background

Within public health research, generalised trust has been considered an independent predictor of morbidity and mortality for over two decades. However, there are no population-based studies that have scrutinised both contextual-level and individual-level effects of generalised trust on all-cause mortality. We, therefore, aim to investigate such associations by using pooled nationally representative US General Social Survey (GSS) data linked to the National Death Register (NDI).

Methods

The combined GSS–NDI data from the USA have 90 contextual units. Our sample consisted of 25 270 respondents from 1972 to 2010, with 6424 recorded deaths by 2014. We used multilevel parametric Weibull survival models reporting HRs and 95% CI (credible intervals for Bayesian analysis). Individual-level and contextual-level generalised trust were the exposures of interest; covariates included age, race, gender, marital status, education and household income.

Results

We found a robust, significant impact of individual-level and contextual-level trust on mortality (HR=0.92, 95% CI 0.88 to 0.97; and HR=0.96, 95% CI 0.93 to 0.98, respectively). There were no discernible gender differences. Neither did we observe any significant cross-level interactions.

Conclusion

High levels of individual and contextual generalised trust protect against mortality, even after considering numerous individual and aggregated socioeconomic conditions. Its robustness at both levels hints at the importance of psychosocial mechanisms, as well as a trustworthy environment. Declining trust levels across the USA should be of concern; decision makers should consider direct and indirect effects of policy on trust with the view to halting this decline.

Social capital and frequent attenders in general practice: a register-based cohort study

Background

Frequent attendance to primary care constitutes a large use of resources for the health care system. The association between frequent attendance and illness-related factors has been examined in several studies, but little is known about the association between frequent attendance and individual social capital. The aim of this study is to explore this association.

Methods

The analysis is conducted on responders to the North Denmark Region Health Profile 2010 (n = 23,384), individually linked with information from administrative registers. Social capital is operationalized at the individual level, and includes cognitive (interpersonal trust and norms of reciprocity) as well as structural (social network and civic engagement) dimensions. Frequent attendance is defined as the upper-quartile of the total number of measured consultations with a general practitioner over a period of 148 weeks.

Results

Using multiple logistic regression, we found that frequent attendance was associated with a lower score in interpersonal trust [OR 0.86 (0.79–0.94)] and social network [OR 0.88 (0.79–0.98)] for women, when adjusted for age, education, income and SF12 health scores. Norms of reciprocity and civic engagement were not significantly associated with frequent attendance for women [OR 1.05 (0.99–1.11) and OR 1.01 (0.92–1.11) respectively]. None of the associations were statistically significant for men.

Conclusion

This study suggests that for women, some aspects of social capital are associated with frequent attendance in general practice, and the statistically significant dimensions belonged to both cognitive and structural aspects of social capital. This association was not seen for men. This indicates a multifaceted and heterogeneous relationship between social capital and frequent attendance among genders.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-5230-2) contains supplementary material, which is available to authorized users.

Effects of multi-dimensional social capital on mental health of children in poverty: An empirical study in Mainland China

Using the data of 1314 underprivileged children in Xiushui, China, this study adopted an ecological framework to explore how social capital embedded in family, peer, school, and community interplay and affect the mental health of poor children. Structural equation modeling was employed to verify the hypothesized model. The results demonstrated that higher levels of family, peer, and school social capital were all associated with better mental health outcomes of children in poverty. Moreover, family, peer, and school social capital fully mediated the effect of community social capital on children's mental health. Theoretical and practical implications were discussed.

Disentangling the directions of associations between structural social capital and mental health: Longitudinal analyses of gender, civic engagement and depressive symptoms

The present paper analysed the directions of associations between individual-level structural social capital, in the form of civic engagement, and depressive symptoms across time from age 16-42 years in Swedish men and women. More specifically, we asked whether civic engagement was related to changes in depressive symptoms, if it was the other way around, or whether the association was bi-directional. This longitudinal study used data from a 26-year prospective cohort material of 1001 individuals in Northern Sweden (482 women and 519 men). Civic engagement was measured by a single-item question reflecting the level of engagement in clubs/organisations. Depressive symptoms were assessed by a composite index. Directions of associations were analysed by means of gender-separate cross-lagged structural equation models. Models were adjusted for parental social class, parental unemployment, parental health, and family type at baseline (age 16). Levels of both civic engagement and depressive symptoms were relatively stable across time. The model with the best fit to data showed that, in men, youth civic engagement was negatively associated with depressive symptoms in adulthood, thus supporting the hypothesis that involvement in social networks promotes health, most likely through provision of social and psychological support, perceived influence, and sense of belonging. Accordingly, interventions to promote civic engagement in young men could be a way to prevent poor mental health for men later on in life. No cross-lagged effects were found among women. We discuss this gender difference in terms of gendered experiences of civic engagement which in turn generate different meanings and consequences for men and women, such as civic engagement not being as positive for women's mental health as for that of men. We conclude that theories on structural social capital and interventions to facilitate civic engagement for health promoting purposes need to acknowledge gendered life circumstances.

Latino Civic Group Participation, Social Networks, and Physical Activity

OBJECTIVES

We examined whether social networks and resource awareness for physical activity may mediate the relationship between civic group participation and physical activity.

METHODS

This is a cross-sectional study of a randomly selected sample of 335 Latinos (mean age 42.1 ± 16.4 years) participating in the San Diego Prevention Research Center's 2009 Household Community Survey. Serial multiple mediation analysis tested the hypothesis that civic group participation is associated with meeting physical activity recommendations through an indirect mechanism of larger social networks followed by greater knowledge of physical activity community resources.

RESULTS

The indirect effects of level of civic group participation as well as religious, health, neighborhood, or arts group participation on meeting national physical activity recommendations were significant in models testing pathways through social network size and physical activity resource awareness. The direct effect was only significant for health group indicating that participating in a health group predicted physical activity independent of social network size and awareness of physical activity resources.

CONCLUSION

Belonging to civic groups may promote physical activity engagement through social network diffusion of information on community physical activity resources which has implications for health.

Women's relative immunity to the socio-economic health gradient: artifact or real?

Background

Individual and area socio-economic status (SES) are significant predictors of morbidity and mortality in developed and developing countries. However, the span in health from poorest to richest, that is, the socio-economic gradient, appears steeper for men than women.

Objective

Our aim is to understand women's apparent immunity to the health harms of the SES gradient.

Design

Findings from a non-systematic search of Medline for population-based, SES gradient studies reporting results for both men and women and with health outcomes of morbidity, mortality or self-rated health (SRH) were reflectively analyzed.

Results

The 36 papers reviewed generally showed women to be relatively immune to the SES gradient for all but cardiovascular health outcomes. However, addressing the interconnected nature of socio-economic circumstances, exploring whether some measures of SES had ambiguous meanings for either women or men, including modifiers of SES such as household circumstances, social capital or area gender equity, or using indicators of area SES that were contextual rather than aggregates of individual, compositional measures increased the SES gradient for women. Outcome measures that combined mental and physical health, accounted for gender differences in SRH and adjusted for sex-specific differences in causes of mortality also explained some of the observed amelioration of the SES gradient among women.

Conclusions

Socio-economic circumstances have a real and sustained impact on individual health. The SES gradient appears stronger for men than for women for all health outcomes other than heart disease. However, some of the observed variability between men and women may be an artifact of biased methodology. Considering webs of causation rather than individual markers of SES along with other sources of gender bias can explain much of women's blunted socio-economic gradient and deepen understanding of the pathways from SES to morbidity and mortality overall.