Social capital and health in China: exploring the mediating role of lifestyle

Social Support, Health Behaviors, Self-Esteem, and Successful Aging in a Sub-Saharan African Sample of Older Adults: Test of a Sequential Mediation Model

Background and Objectives

Previous research demonstrates that social support facilitates successful aging across all cultures. However, the factors that potentially mediate the link between social support and successful aging remain unclear. This study examined whether a healthy lifestyle and self-esteem mediate the association between social support and successful aging. It was hypothesized that the relationship between social support (family, friends, and significant other) and successful aging would be serially mediated by both healthy lifestyle and self-esteem.

Research Design and Methods

Participants were 479 Nigerian retirees (53.4% female) aged 60 to 90 years (Mage = 64.81, SD = 6.86). They provided information on relevant demographic variables and completed the following measures: Fantastic Lifestyle Checklist (Fitness Appraisal), Rosenberg Self-esteem Scale, Multidimensional Scale of Perceived Social Support Scale, and Successful Aging Inventory. Three separate regression models (family, friends, and significant other dimensions of social support) were conducted using the Hayes PROCESS macro for SPSS with 5,000 bootstrap estimates.

Results

Controlling for age and sex, family support, significant other support, friends support, healthy lifestyle, and self-esteem were directly associated with successful aging. The association between family support and successful aging was mediated by healthy lifestyle; and this was also seen for friends' support and significant other support. The sequential path from social support to successful aging through healthy lifestyle, and then via improved self-esteem, was significant for family support and significant other support, but not friends support.

Discussion and Implications

Findings suggest that middle-aged to older adults who have strong support from their families and significant others may be more likely to engage in healthy behaviors and, in turn, experience higher levels of self-esteem, thereby aging well.

Party membership and self-assessed health: Evidence from the Communist Party of China

Background

In some countries, party membership is often associated with returns. We studied the relationship between party membership and self-assessed health.

Methods

Data were obtained from the 2017 Chinese General Social Survey (N = 11,641). Self-assessed health was defined as the personal evaluation of physical and psychological well-being. Logistic regression was used to explore relevant associations.

Results

Members of the Communist Party of China (CPC) were more likely than non-CPC respondents to register self-assessments of relatively healthy physical (beta = 0.319, SE = 0.098, P < 0.01, CI: 0.127-0.512) and psychological (beta = 0.257, SE = 0.072, P < 0.01, CI: 0.115-0.399) conditions.

Conclusions

Previous studies have overlooked the health-related rewards of CPC membership. Reforms to China's public health system can be smoothly implemented probably because of the health benefits accrued to party members.

The Relationships between Social Capital, Metabolic, and Behavioral Risk Factors of Non-Communicable Diseases: A Systematic Review

Background

Contextual risk factors such as social capital have a vital role in affecting behavioral and biological risk factors of NCDs. We aimed to systematically identify the relationship between different aspects of social capital (SC) with metabolic, and behavioral risk factors of non-communicable diseases (NCDs).

Methods

This is a systematic review. The period of study was 2000-2021. We searched the English international databases, i.e. PubMed/Medline, Scopus, and Web of Science. Studies that reported NCDs' metabolic and behavioral risk factors as independent variables, were excluded. We also included studies if they analyzed the association between SC and metabolic and behavioral risk factors of NCDs.

Results

After the primary and quality appraisal process, 97 studies were entered in the final phase of the analysis. Five out of 18 studies reported an inverse association between SC and the level of alcohol drinking. Twenty-seven out of 32 studies reported a significant inverse association between SC and smoking and tobacco use, while only one study reported a significant positive association. Nine studies reported a significant inverse association between SC and high blood pressure. Three studies showed a significant inverse association between SC and diabetes. Seventeen studies indicated a significant positive association between SC and physical activity. Thirteen out of 17 studies reported a significant inverse association between SC, body mass index (BMI) and overweight.

Conclusion

High SC, people's participation and interaction are vital in tackling NCDs. Evidence shows positive effects of SC on prevention, control and improvement of NCDs' metabolic and behavioral risk factors.

The relationship between social capital and health from a configuration perspective: an evidence from China

BACKGROUND

The debate on the relationship between social capital and health is still ongoing. To enhance previous research, this study uses data drawn from China to analyse the situations in which social capital is related to good health and the various configurations that result in good health outcomes.

METHODS

Using the data of China Family Panel Studies, the conditions of age, gender, marriage, education, income, structural social capital and cognitive social capital were included to analyse the sufficient and necessary conditions for achieving good general health and their different configurations using the fsQCA method.

RESULTS

None of the listed conditions were prerequisites for excellent general health in terms of either their presence or their absence. The sufficiency analysis found 11 configurations with an average of 3-4 conditions per configuration; in no configuration was the condition of social capital present alone. Structured social capital and cognitive social capital exhibited negative states in configurations 1 and 2, respectively. The most prevalent factor in all configurations was the condition of age.

CONCLUSIONS

The relationship between social capital and health is both positive and negative, with cognitive social capital playing a larger role in the positive relationship than structural social capital. Social capital is neither a necessary nor a sufficient condition for health, and it must be combined with a variety of other factors to promote health. A variety of methods can be used to promote an individual's health, as different populations require different approaches to good general health, and no single pathway applies to all populations. In the Chinese population, an individual's age is a significant determinant of their health status.

Community organization guides standardization, adaptability, and innovation: lessons from peer support in the Shanghai Integration Model

Although there is broad evidence for the value of peer support (PS) in preventing and managing diabetes and other chronic diseases, identifying approaches to stage, scale, and adapt PS interventions is a challenge. Community organization may provide a process for such adaptation of standardized PS and diabetes management to individual communities. This community organization approach was used to develop PS in 12 communities in Shanghai, China. Through a convergent mixed methods design, project records, semi-structured interviews, and an implementation assessment characterized processes of adaptation of standardized materials, examined the extent to which the program was implemented, and identified key success factors and challenges. Findings from both interviews and the implementation assessment indicated that communities adapted standardized intervention components to meet the needs of their communities and assumed responsibility for implementation of different components of the program based on their community's available capacity. Additionally, community innovations occurring as part of the project were reported and standardized for dissemination in future iterations of the program. Key success factors identified included cooperation and collaboration among varied partners within and across communities. Two challenges illustrate the resilience of the community organization model in response to COVID-19 and the need for further adaptation in rural communities. Community organization provided a useful approach to standardization, adaptation, innovation, and reporting of PS interventions for diabetes management.

Association between social capital and food patterns in women from Southern Brazil

The present study aimed to verify the association between psychosocial aspects (social capital) and food patterns in adult women. A cross-sectional, population-based study was conducted with a representative sample of 1,128 women, aged 20 to 69 years, living in the urban area of the municipality of São Leopoldo, Rio Grande do Sul, Brazil, in 2015. The food patterns were identified based on the frequency of food intake and classified as: healthy (fruits, vegetables, and whole foods), at-risk (ultraprocessed foods), and Brazilian (rice and beans), while social capital was evaluated using a collective efficacy scale. It was observed that 18.9% of the sample was classified with high collective efficacy. After adjusting for potential confounding factors, a 44% higher probability was observed for adherence to the healthy pattern (PR [prevalence ratio] = 1.44; 95%CI [95% confidence interval]: 1.01-2.03; p = 0.040) and 71% higher for the Brazilian pattern (PR = 1.71; 95%CI: 1.18-2.47; p= 0.004) among women with a higher level of collective efficacy, when compared to those with a low level of collective efficacy. Thus, this study verified a significant relationship between psychosocial aspects and food intake in women.

Complex association of self-rated health, depression, functional ability with loneliness in rural community-dwelling older people

BACKGROUND

This study aimed to explore whether and how self-rated health, depression and functional ability interactively associated with loneliness using a sample group of older adults residing in China rural communities.

METHODS

Data on socio-demographic information, self-rated health, depressive symptoms, functional ability and loneliness (quantified via a single question) were collected from 1009 participants. Cross-tabulations with chi-square test, bivariate correlations, and Classification and Regression Tree (CART) models were employed for analysis.

RESULTS

We found that 45.1% of the participants were classified as lonely. Our results gain insight into the hierarchical order of predictors for the presence of loneliness, suggesting that there was a significant interaction between functional ability and depressive symptoms while self-rated health was not a significant factor. The probability of loneliness increased with the combination of limited functional ability and depression, and varied with different interaction of functional ability, depressive symptoms, and marital status, respectively. Notably, while there were some differences, similar associations were observed among older male and female respondents.

CONCLUSION

To delay or reduce loneliness, early detection which focuses on older people who report limitations in functional ability, depression, and being female, offers opportunities to start early interventions. Our findings might be helpful not only in designing and implementing loneliness prevention programs but also in improving healthcare for older rural community-dwelling people.

Sense of control as a mediator of the association between social capital and health inequality in China

Social capital was shown to be associated with health. However, less is known about the pathways of the association and whether the mediating effect of the pathways varies across different income groups. Using adults (≥18 years) data from the 2010 Chinese General Social Survey (N = 3265), we examined the mediating effect of sense of control between social capital and health and whether income groups moderated the mediating effect in China. Health and sense of control were factor scores. Social capital measurements included frequency of socializing, civic participation, trust, and reciprocity. We categorized equivalized household income into quintiles (Q1 (lowest income) to Q5 (highest income)). Multivariable linear regression models showed that frequency of socializing (β: 0.07; 95% CI: 0.04, 0.11), trust (β: 0.06; 95% CI: 0.02, 0.09), and reciprocity (β: 0.07; 95% CI: 0.03, 0.11) were positively associated with health. Moderated mediation analysis further showed that sense of control mediated the association between frequency of socializing and health in all income groups, with the mediating effect decreasing when income increased (β (95% CI) from Q1 to Q5: 0.026 (0.015, 0.040); 0.022 (0.012, 0.036); 0.018 (0.009, 0.030); 0.013 (0.005, 0.024); 0.008 (0.000, 0.018)). Moderated mediation analysis also showed the same patterns for the mediating effect of sense of control on the association between trust and health and reciprocity and health. Our study suggested that employing social capital to promote sense of control could not only be beneficial for people's health but also be helpful to narrow the health gap on the income gradient.

Association between social capital and self-rated health among community-dwelling older adults

Background

It is less known about whether the association of social capital with self-rated health (SRH) varies by the presence of health conditions and how social capital, together with other variables, is linked to self-rated health in later life.

Objectives

This article aimed to explore the association of social capital with self-rated health and to examine whether the association varies among older people with and without health conditions, with a special focus on how social capital and relevant factors have an effect on self-rated health among community-dwelling older adults.

Methods

Cross-sectional data were obtained from a survey that commenced from July to September 2017 in Anhui Province. Data on socio-demographic information, social capital (six dimensions), and self-rated health were analyzed. Binary logistic regression and classification and regression tree (CART) models were used to estimate the association.

Results

Based on the findings, we found that social capital regarding less social support (adjusted odds ratio (AOR) = 1.57, 95% CI: 1.21-2.04), and less reciprocity (AOR = 1.73, 95% CI: 1.29-2.31) were associated with self-rated health among general older adults. Social capital as measured by less social participation (AOR = 1.55, 95% CI: 1.06-2.27), less cohesion (AOR = 0.63, 95% CI: 0.42-0.94), and less reciprocity (AOR =1.77, 95% CI: 1.17-2.68) were linked to self-rated health among older people with health conditions. While social capital regarding less social support (AOR = 2.15, 95% CI: 1.39-3.33) was related to self-rated health among older people without health conditions. We observed the interacting effect of social capital in the CART model, an implication that much focus should be geared toward vulnerable subgroups, especially depressed and lonely older people, as they have low reciprocity and little cohesion.

Conclusion

This work demonstrates that social capital may be relevant in devising programs and measures to improve self-rated health among community-dwelling older adults with comorbidity.

Intergenerational reproduction and adult self-rated physical health in China

We used cross-sectional data from the 2017 Chinese General Social Survey to investigate whether and how Chinese parents utilize their socioeconomic resources to facilitate the acquisition of socioeconomic resources by their children that in turn affect the self-rated health of the adult children. We found that father's type of work unit (danwei) and father's membership in the Chinese Communist Party were not independently associated with the self-rated health of survey respondents. Father's education was associated with the self-rated health of women, especially younger women, and self-reported childhood social class was associated with the self-rated health of men and older women, most strongly so for younger men. Two thirds of the association between father's education and self-rated health among younger women was statistically explained by personal socioeconomic resources and almost a quarter of the association between self-reported childhood social class and self-rated health among younger men was statistically explained by personal socioeconomic resources. Our study illuminates the importance of intergenerational reproduction in fostering the good health of Chinese adults, especially for those who grew up after the Chinese economic reform of the 1970s.

Social capital and health information seeking in China

Background

People’s potentials to seek health information can be affected by their social context, such as their social networks and the resources provided through those social networks. In the past decades, the concept of social capital has been widely used in the health realm to indicate people’s social context. However, not many such studies were conducted in China. Chinese society has its special quality that many Western societies lack: people traditionally render strong value to family relations and rely heavily on strong social ties in their social life. Therefore, the purpose of this study was to examine the association between different types of social capital and health information-seeking behavior (HISB) in the Chinese context. The different types of social capital were primarily bonding and bridging, as well as cognitive and structural ones.

Methods

Our analysis is based on a total of 3090 cases taken from the Health Information National Trends Survey (HINTS) – China, 2017. Dataset was weighted due to the overrepresentation of female respondents and hierarchical multiple regression analyses as well as binary logistic regression tests were operated to examine the associations between people’s social capital and their HISB.

Results

Some aspects of social capital emerged as positive predictors of HISB: information support (standing in for the cognitive component of social capital) promoted health information seeking, organization memberships (standing in for the structural component) encouraged cancer information seeking, and both the use of the internet and of traditional media for gaining health information were positively linked with bridging networks and organization memberships. Bonding networks (structural component) were not correlated with any other of the key variables and emotional support (cognitive social capital) was consistently associated with all health information-seeking indicators negatively.

Conclusions

Social capital demonstrated significant and complex relationships with HISB in China. Structural social capital generally encouraged HISB in China, especially the bridging aspects including bridging networks and organization memberships. On the other hand, emotional support as cognitive social capital damaged people’s initiatives in seeking health-related information.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13895-2.

Association between social capital and frailty and the mediating effect of health-promoting lifestyles in Chinese older adults: a cross-sectional study

BACKGROUND

To explore the association between social capital and frailty and the mediating effect of health-promoting lifestyles among Chinese older adults, while providing scientific evidence for frailty intervention.

METHODS

In May 2021, a cross-sectional study was conducted among 674 Chinese older adults in Changsha city. Data was collected using the Chinese Shortened Social Capital Scale (comprising structural social capital and cognitive social capital as two subscales), a simplified version of the Health-Promoting Lifestyle Profile and the Tilburg Frailty Indicator. Linear regression analysis was used to examine the association between social capital and frailty. Structural equation modeling was used to test the mediating effect of health-promoting lifestyles.

RESULTS

Cognitive social capital was significantly negatively associated with frailty and its three dimensions (physical, psychological, and social frailty), but structural social capital was not. Health-promoting lifestyles played a mediating role in the associations of cognitive social capital with frailty, physical and psychological frailty, but not with social frailty.

CONCLUSIONS

Higher cognitive social capital was associated with a reduced likelihood of frailty. The health-promoting lifestyles partially mediated the association between cognitive social capital and frailty. The use of health-promoting lifestyles or appropriate cognitive social capital interventions may reduce frailty among older adults.

Correlations of external social capital in social organizations providing integrated eldercare services with medical care in China

Background

This study aimed to explore the external social capital of social organizations (SOs) providing integrated eldercare services with medical care in Anhui Province, China. Specifically, we studied the current situation and influencing factors of external social capital and its six dimensions.

Methods

We conducted a cross-sectional study in Anhui Province, China using a multi-stage stratified random sampling method. We employed Pearson correlation analysis and a binary logistic regression model.

Results

The final analysis included 49 SOs. Most organizations had a high score in norm dimension (81.6%), participation (61.2%), trust (65.3%), common language (65.3%), and social capital (63.3%). After adjusting for all covariate variables, integrated eldercare services with medical care SOs which served more than 65 elderly people were likely to report lower score in social capital.

Conclusions

By examining the current situation of integrated eldercare services with medical care SOs in China, this study enriched the relevant evidence of integrated medical and nursing SOs and provides a certain reference value for relevant management departments when formulating policies.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-022-07508-2.

Social capital and dietary patterns in three ethnic minority groups native to Yunnan Province, Southwest China

BACKGROUND

Few studies have focused on the influencing factors of dietary practices among ethnic minority groups in China, particularly from a social capital perspective.

METHODS

Between May and September 2019, we conducted a cross-sectional survey among adults (n = 1,813) from three ethnic minority communities (A Chang, De Ang and Jing Po) in Yunnan Province, Southwest China. Dietary intakes during the past 12 months were measured with a 100-item Food Frequency Questionnaire (FFQ), and two forms of social capital (bonding and bridging) were measured using the validated Personal Social Capital Scale 16 (PSCS-16). Principal component factor analysis was used to derive dietary patterns from 20 food groups. Multivariate linear regressions were used to examine the associations between social capital and dietary patterns.

RESULTS

Two distinct dietary patterns were identified: the traditional and the modern. The traditional pattern was characterized by high consumptions of tubers, poultry, rice, fruits, vegetables and low consumptions of oil and salt, whereas the modern pattern was highly correlated with egg, nut, beverage, snack and oil consumptions. After adjusted for potential confounders, the modern pattern was positively associated with bonding capital (β = 0.066; 95%CI: 0.058, 0.075) and negatively associated with bridging capital (β = -0.017; 95%CI: -0.024, -0.010).

CONCLUSION

In conclusion, an unhealthy dietary pattern was identified among the ethnic minority groups in Southwest China. The influences of people's social connections on dietary behaviors should be considered in designing and implementing nutrition intervention programs for the population.

Are both individual-level and county-level social capital associated with individual health? A serial cross-sectional analysis in China, 2010-2015

OBJECTIVES

We aimed to examine the associations of both individual-level and county-level social capital with individual health in China during a period of rapid economic growth.

DESIGN AND SETTING

A serial cross-sectional study in China.

PARTICIPANTS AND METHODS

The participants were 42 829 Chinese adults (aged ≥18 years) from the 2010, 2012, 2013 and 2015 Chinese General Social Survey. The outcomes were self-rated physical and mental health in all time points. We assessed social capital by the individual-level and county-level indicators, including frequency of socialising, civic participation and trust. We conducted multilevel binary logistic regression models to examine the associations of individual-level and county-level social capital with self-rated physical and mental health.

RESULTS

At the individual level, high frequency of socialising (2010-OR: 1.49, 95% CI: 1.33 to 1.66; 2012-OR: 1.39, 95% CI: 1.26 to 1.54; 2013-OR: 1.28, 95% CI: 1.15 to 1.42; 2015-OR: 1.36, 95% CI: 1.23 to 1.50) and high trust (2010-OR: 1.34, 95% CI: 1.22 to 1.47; 2012-OR: 1.30, 95% CI: 1.18 to 1.42; 2013-OR: 1.21, 95% CI: 1.10 to 1.33; 2015-OR: 1.41, 95% CI: 1.28 to 1.55) was significantly associated with good physical health in all years. At the individual level, high frequency of socialising (2010-OR: 1.27, 95% CI: 1.14 to 1.42; 2012-OR: 1.21, 95% CI: 1.09 to 1.34; 2013-OR: 1.30, 95% CI: 1.17 to 1.45; 2015-OR: 1.35, 95% CI: 1.22 to 1.50) and high trust (2010-OR: 1.47, 95% CI: 1.34 to 1.61; 2012-OR: 1.42, 95% CI: 1.30 to 1.56; 2013-OR: 1.36, 95% CI: 1.24 to 1.49; 2015-OR: 1.43, 95% CI: 1.30 to 1.57) was also significantly associated with good mental health in all years. No evidence showed that the associations of individual-level frequency of socialising and trust with physical and mental health changed over time. There were no consistent associations of individual-level civic participation or any county-level social capital indicators with physical or mental health.

CONCLUSION

The positive associations of individual-level social capital in terms of socialising and trust with physical and mental health were robust during a period of rapid economic growth. Improving individual-level socialising and trust for health promotion could be a long-term strategy even within a rapidly developing society.

The prevalence of depressive symptoms and its determinants among adults in mainland China: Results from a national household survey

BACKGROUND

Depression have become a widespread health concern in Chinese society.

METHODS

We analyzed the factors influencing the risk of depression among residents aged 16 and over using data from the 2016 China Family Panel Studies (CFPS), in which depression was measured using the Center for Epidemiologic Studies Depression (CES-D20) scale. A total of 26,464 individuals were sampled in a weighted manner to represent the entire country. Univariate and multivariate analysis were used to explore the risk factors for depression and the odds of depression in people with different characteristics.

RESULTS

A total of 76.6% of adult residents were mentally healthy. Females had higher rates of depression than males (OR=1.515). There was an "inverted U-shaped" distribution between age and risk of depression. Higher levels of education and better physiological health were associated with a lower risk of depression. Self-evaluated income and social status were not linearly related to the risk of depression but rather had a "U-shaped" distribution. For social capital, better social relationships and a higher level of social trust were associated with a lower risk of depression. Nonsmokers had a lower risk of depression than smokers (OR=0.818).

LIMITATIONS

All items were self-reported and some results depend on single item responses. This is a cross-sectional survey so that causative interpretations cannot be drawn.

CONCLUSION

These findings suggest potential public health measures whose efficacy needs to be tested and confirmed.

Individual Social Capital and Life Satisfaction among Mainland Chinese Adults: Based on the 2016 China Family Panel Studies

Background: At present, most Chinese adults are under great psychological pressure, which seriously affects the improvement of life satisfaction. The purpose of this study was to shed light on the associations between individual social capital and life satisfaction among mainland Chinese adults. Methods: We used a nationally representative dataset called 2016 China Family Panel Studies, and a total of 26,009 people suited our study requirements. Chi-squared test and binary regression analysis were used to determine the relationship between individual social capital and life satisfaction among mainland Chinese adults. Results: The results indicated that cognitive social capital had significant effects on life satisfaction (p < 0.05), but the impact of structural social capital on life satisfaction became less significant when combined with sociodemographic variables and socioeconomic status (SES) (p > 0.05). Moreover, we also found that life satisfaction was better in married/cohabited (p < 0.05) and in over 65 age group people (p < 0.05). Self-rated income level, self-rated social status, and self-rated health all had positive effects on life satisfaction (p < 0.001). Conclusions: Given the stabilizing effect of cognitive social capital at the individual level on life satisfaction, the government should attach great importance to this aspect when trying to improve adults’ life satisfaction.

The relationship among social capital, eHealth literacy and health behaviours in Chinese elderly people: a cross-sectional study

Background

Social capital has been linked to health behaviours, but the underlying mechanism is unclear. Previous studies have found that health literacy played the role of a mediator in the relationships among social capital, individual physical activity and nutrition. But it is not clear whether eHealth literacy mediates the impact of social capital on health behaviours. Therefore, our research aimed to explore the relationships among social capital (structural and cognitive social capital), eHealth literacy, and the health behaviours of elderly people, and to analyse the mediating effect of eHealth literacy, while providing a theoretical basis for a health behaviour intervention for elderly people.

Methods

From January to February 2019, we conducted a cross-sectional survey of 1201 Chinese people aged over 60 years using the Chinese Shortened Social Capital Scale (contains two subscales of structural social capital and cognitive social capital), eHealth Literacy Scale, and Health-Promoting Lifestyle Profile. We used structural equation modelling to test a hypothetical mediation model.

Results

The mean scores of social capital was 72.07 (SD = 13.03), 17.24 (SD = 9.34) for eHealth literacy, and 112.23 (SD = 23.25) for health behaviours. Social capital and eHealth literacy were significantly correlated with health behaviours, and social capital and structural social capital were significantly correlated with eHealth literacy. Lastly, eHealth literacy mediated the relationship between structural social capital and health behaviours.

Conclusions

eHealth literacy was an important mediating factor for elderly people’s structural social capital and health behaviours. Therefore, social capital and eHealth literacy must be considered when designing and implementing health behaviour intervention programmes for elderly people.

Correlates of Domain-Specific Physical Activity Among Older Adults in Six Low- to Middle-Income Countries: Analysis of Nationally Representative Samples From Study of Global Aging and Adult Health (SAGE) (Wave 1)

The correlates of physical activity differ across domains. The authors explored the contribution of domain-specific physical activity to total physical activity and examined how different sociodemographic and social capital-related variables are associated with different physical activity domains in older adults, using nationally representative samples from six low- to middle-income countries. Activity at work and home combined plays an important role in contributing to total physical activity, while leisure-time physical activity accounted for an extremely small proportion. Some correlates of physical activity were similar across countries, such as working status and structural social capital, while other associations were country specific. Promoting structural social capital, trust, and perceived safety may confer positive benefits on older adults' activity.

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

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

Effects of physical activity and stress on the relationship between social capital and quality of life among breast cancer survivors

This study aims to investigate the serial multiple mediation of physical activity and perceived stress in the relationship between individual social capital and quality of life (QOL) in breast cancer survivors (BCSs). This study was conducted among 520 BCSs between March and April 2017 in Shanghai, China. Data were collected using the Individual Social Capital Scale, the Health-Promoting Lifestyle Profile-II, the Perceived Stress Scale-14 and the EORTC QLQ-C30. Ordinary least-squares regression and the bootstrap method was used to test the significance of the serial multiple mediation model. The serial-multiple mediations of physical activity and perceived stress were found significant in the relationship of QOL with all five dimensions of individual social capital. The separate mediations of two single mediating variables were found significant in the relationship of QOL with control over life and feeling about the community. In the relationship of QOL with social participation, social network and social support, the separate mediation of physical activity was significant, while the separate mediation of perceived stress was not significant. A multidisciplinary team approach and a variety of delivery systems are needed to address the social, physical and psychological issues for improving QOL among BCSs.

Individual Capital Structure and Health Behaviors among Chinese Middle-Aged and Older Adults: A Cross-Sectional Analysis Using Bourdieu's Theory of Capitals

This study draws on Bourdieu’s theory of capitals to analyze the relative importance of economic, cultural, and social capital on health behaviors in Chinese middle-aged and older adults. Based on data from the China Family Panel Studies of 2016 (N = 15,147), we first harnessed a binary logistic regression model to discuss the associations between the three capitals and four types of health behaviors (i.e., physical exercise, smoking, binge drinking and stay-up). Using the sheaf coefficients technique, we then compared the relative effects of three of the capitals on health behaviors. The results suggest that cultural capital is the most influential one, which would significantly increase physical exercise and stay-up behaviors, and reduce smoking and binge drinking behaviors. Economic capital is also an important predictor, that may reduce smoking behavior but increase binge drinking and stay-up behaviors. Social capital has shown the least importance, although it would still be saliently associated with physical exercise, smoking and stay-up behaviors. In addition, some significant group disparities are also identified. This article is one of the first to explain health behavior inequalities through a Bourdieusian capital-based approach in Chinese contexts.

Association between Social Trust and Metabolic Syndrome in a Previously Healthy Population-A Longitudinal Cohort Study in South Korea

Background: Social trust, assessed by the trustworthiness of one another in a community, is known to have beneficial effects on health outcomes. However, the impact of social trust on metabolic syndrome (MetS) is unclear. Methods: The study subjects were extracted from the Korean National Health Insurance Service, and social trust was obtained from the Korean Community Health Survey (KCHS). Previously healthy participants were followed up from 1 January 2010 to 31 December 2011, and again from 1 January 2012 to 31 December 2013 for waist circumference, blood pressure, fasting blood glucose, triglycerides and high-density lipoprotein cholesterol (HDL-C). Multivariate logistic regression was used to calculate the adjusted odds ratios (aORs) with 95% confidence intervals (CIs) for newly developed MetS according to social trust quintiles. Stratified analyses were performed to determine the relationship between lifestyle behaviors and social trust. Results: Compared to the participants within the first quintile of social trust, those in the remaining quintiles had lower risks of developing MetS. The aOR with the 95% CI was 0.88 (0.79–0.98) in the 5th quintile group of social trust. Among the diagnostic criteria for MetS, waist circumference and HDL-C were statistically significant with aORs of 0.91 (0.84–0.99) and 0.88 (0.80–0.95) in the 5th quintile group. The stratified analyses showed protective effects of positive lifestyle behaviors. The aORs with 95% CIs were 0.85 (0.74–0.99) in never smokers, 0.82 (0.70–0.95) in non-drinkers and 0.87 (0.76–1.00) in the physically active in the highest level of social trust. Conclusions: Higher social trust was associated with a lower incidence of MetS. Therefore, building community with psychosocial support may be helpful in improving public health.

Gender Difference in Social Capital, Common Mental Disorders and Depression: ELSA-Brasil Study

Association studies between social capital and health point out that a high level of social capital can act as a protector for mental health. The growing interest in social risk factors for mental health coincides with the development of social capital research. Higher levels of social capital available through social networks can act as a protector for mental health. This study investigates gender differences in the association between social capital and common mental disorders (CMD) and depression. We analyzed 15,052 participants in the baseline of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). CMD and depression were assessed by Clinical Interview Schedule-Revised (CIS-R) and social capital by the Resource Generator scale. We used Logistic regression models stratified by sex. Women with lower social capital in the social support dimension had a greater chance of presenting CMD (OR = 1.36; CI 95%: 1.16–1.60) and depression (OR = 2.07; CI 95%: 1.57–2.72) when compared to women with higher social capital. No association was identified among men, or among women in the “prestige and education” dimension. The differences found between the dimensions of social capital support its multidimensionality, as well as the differences found between sexes, confirm the need to approach gender in its association with mental health.

Peer support in Shanghai's Commitment to diabetes and chronic disease self-management: program development, program expansion, and policy

Identifying organizational settings for sustainable, scalable implementation of peer support (PS) is a challenge. Development, initial evaluation, and community expansion of PS for populations with diabetes staged in the context of the Shanghai Integration Model integrating primary and specialty care for diabetes. Development Phase with 9 Community Health Centers (CHCs) leading to Community Expansion Phase with additional 12 communities. Development Phase peer leaders (PLs) co-led meetings on diabetes management, led neighborhood activities, and followed up with individuals and families. Among 1,284 participants, changes in HbA1c, other clinical markers, and diabetes distress were significant (ps from 0.001 to 0.041), pronounced among those with elevated levels, for example, HbA1c reduction from 9.09% to 8.50% among those ≥8% at baseline (p < 0.001). Ratings of Implementation were associated with reduced HbA1c and diabetes distress and increased neighborhood support. In particular, linking with community resources and utilization of neighborhood Residential Committees were associated with improved HbA1c, indicating the value of PS programs including community resources. Thus, the Community Expansion Phase includes district- and community-level health staff, Community Self Management Groups, and Residential Committees along with CHCs in 12 communities, all of which have implemented activities during the first 6 months. PS programs are feasible and appear to add value among populations with diabetes in community settings such as Shanghai. Recognition by the Shanghai government has included PS as a key strategy for achieving self-management of chronic disease in its 2030 health goals.

Disease causing poverty: adapting the Onyx and Bullen social capital measurement tool for China

Background

Disease-causing poverty is a serious problem in rural China, where social capital can mediate the disease—poverty relationship. However, there is no generally accepted reliable, robust and viable measure of social capital for China’s unique socio-cultural context. This study adapts for China the widely used Onyx and Bullen social capital measurement scale and tests the validity and reliability of a modified Chinese Onyx-Bullen general scale, the Chinese Onyx-Bullen health scale, for a disease-causing-poverty subpopulation in rural China.

Methods

We conducted the forward and backward translation procedure and cross-cultural adaptation process to derive the 34 item Chinese Onyx-Bullen general scale. Next we collected through face-to face interviews a sample of disease-causing poverty population in rural Shandong province in China to test a 29 item modified Chinese Onyx-Bullen general scale for a health subpopulation. Most of the rural respondents had no formal work, so 5 work-related items in the Onyx-Bullen general scale were deleted in the Chinese Onyx-Bullen health scale. Exploratory factor analysis was conducted to evaluate the structure, validity, internal consistency and reliability of the Chinese Onyx-Bullen health scale. SPSS21.0 software was used for data analysis.

Results

A total of 467 people completed the scale. For the 29-item scale, a better simple structure was found when the number of factors was limited to 8. The absolute values of inter-factor correlations were in the range of 0.004 to 0.213 and the Kaiser-Meyer-Olkin value was 0.834. All the eight factors explain a total of 59.51% of the variance. The total scale had a Cronbach’s alpha = 0.868, in which seven of the eight factors had Cronbach’s α greater than 0.5.

Conclusion

The Chinese health version of the Onyx-Bullen general social capital scale showed an adequate reliability and validity in a rural disease-causing poverty subpopulation in Shandong province, providing the first general, robust, consistent and reliable measure of social capital in China. The Chinese Onyx-Bullen general social capital scale provides a scale for testing social capital in China or for modification along the lines of the Chinese Onyx-Bullen health scale.

A Spatial Regression Analysis on the Effect of Neighborhood-Level Trust on Cooperative Behaviors: Comparison With a Multilevel Regression Analysis

There is no reason to suppose that neighborhood effects based on residents' trust vary according to administrative boundaries. We examined the relationship between neighborhood trust and cooperative behaviors using the spatial Durbin model which assumed that people are influenced by closer neighbors regardless of administrative boundaries, comparing the results with those of the multilevel model. We used data from 476 residents in Arakawa Ward, Tokyo, Japan. For each respondent, we assigned a unique 'neighborhood trust' value weighted by the inverse distance between the respondent and all other respondents as an independent variable. The dependent variables were perceived neighbors' cooperative behaviors and respondents' own cooperative behaviors. The spatial Durbin model showed that spatially weighted neighborhood trust was positively associated with cooperative behaviors. Meanwhile, the multilevel models did not show the statistically significant effect of neighborhood trust. We concluded that the spatial model might model the neighborhood effects in society more precisely.

The impact of social capital on physical activity and nutrition in China: the mediating effect of health literacy

Background

Physical activity and good nutrition are important behavioral factors in promoting health and preventing disease. It is important to understand the factors affecting physical activity and nutrition. The purpose of this study was to explore whether social capital has an effect on physical activity and nutrition, and whether health literacy plays a mediating role between social capital and physical activity as well as nutrition.

Methods

This cross-sectional study was performed in a certain district of Shanghai in March and April 2017. Data was collected using a self-reported questionnaire, which included questions on sociodemographic characteristics, social capital, health literacy and health-promoting lifestyle profile-II. Health-promoting lifestyle profile-II measures the behaviours or habits of physical activity and healthy nutrition. An explore factor analysis of the principal components with varimax rotation was carried out on the social capital scale. Descriptive statistics was used to summarize the sociodemographic of participants. Mediation analysis was performed using the bootstrapping tests to examine whether health literacy mediate the relationship between social capital and physical activity as well as nutrition.

Results

The explore factor analysis results showed that social capital has five dimensions, namely social participation, social support, social network, control over life and feelings about the community. There is a positive correlation between social capital, health literacy, physical activity and nutrition. The correlation coefficient varied from 0.135 to 0.594. Mediation analysis demonstrated health literacy played a partial mediating effect between social capital and physical activity as well as nutrition. In the relationship between physical activity and social capital, the indirect effect of health literacy accounted for 8.20 to 12.65% of the total effect. In the relationship between nutrition and social capital, the mediation effect of health literacy accounted for 4.93 to 12.71% of the total effect.

Conclusion

Social capital can promote physical activity and nutrition by disseminating health information. Enhancing the social capital of residents will help increase physical activity and develop healthy eating habits. Attention should also be paid to the improvement of residents’ health literacy.

Social capital and physical health: An updated review of the literature for 2007-2018

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.

Analysis of Factors Affecting the High Subjective Well-Being of Chinese Residents Based on the 2014 China Family Panel Study

(1) Purpose: The purpose of our research is to understand the subjective well-being (SWB) of Chinese adult residents and its influencing factors and to identify the key groups and areas to provide a basis for the formulation of relevant policies to improve residents' happiness. (2) Methods: In this study, we analyzed the influencing factors of SWB of individuals older than 16 years of age, according to the 2014 China Family Panel Study (CFPS). We weighted 27,706 samples in the database to achieve the purpose of representing the whole country. Finally, descriptive statistics were used for the population distribution, chi-square tests were used for univariable analysis, and binary logistic models were used for multivariable analysis. (3) Results: The response rate of SWB was 74.58%. Of the respondents, 71.2% had high SWB (7-10), with a U-shaped distribution between age and SWB. Females are more likely than males to rate themselves as happy. There is a positive ratio between years of education and SWB. Residents who have better self-evaluated income, self-rated health (SRH), psychological well-being (PWB), Body Mass Index (BMI), social trust, social relationships, and physical exercise have higher SWB. (4) Conclusion: The results of the present study indicate that to improve residents' SWB, we should focus more attention on middle-aged and low-income groups, particularly men in agriculture. The promotion of SWB should be facilitated by improvements in residents' education, health status, and social support as well as by the promotion of smoking bans and physical exercise.