Association of neighbourhood and individual social capital, neighbourhood economic deprivation and self-rated health in South Africa--a multi-level analysis

Protective Role of Social Networks for the Well-Being of Persons with Disabilities: Results from a State-Wide Cross-Sectional Survey in Kerala, India

The current study presents the findings from a cross-sectional survey on social factors associated with the well-being of persons with disabilities (PWDs) in Kerala, India. We conducted a community-based survey across three geographical zones, North, Central, and South of Kerala state, between April and September 2021. We randomly selected two districts from each zone using a stratified sample method, followed by one local self-government from each of these six districts. Community health professionals identified individuals with disabilities, and researchers collected information on their social networks, service accessibility, well-being, and mental health. Overall, 244 (54.2%) participants had a physical disability, while 107 (23.78%) had an intellectual disability. The mean well-being score was 12.9 (S.D = 4.9, range = 5-20). Overall, 216 (48%) had poor social networks, 247 (55%) had issues regarding service accessibility, and 147 (33%) had depressive symptoms. Among the PWDs with issues with service access, 55% had limited social networks. A regression analysis revealed that social networks (b = 2.30, p = 0.000) and service accessibility (b = -2.09, p = 0.000) were associated with well-being. Social networks are more important than financial assistance because they facilitate better access to psycho-socioeconomic resources, a prerequisite for well-being.

Determinants of Deteriorated Self-Perceived Health Status among Informal Settlement Dwellers in South Africa

Self-perceived health (SPH) is a widely used measure of health amongst individuals that indicates an individual's overall subjective perception of their physical or mental health status. As rural to urban migration increases, the health of individuals within informal settlements becomes an increasing concern as these people are at high health and safety risk due to poor housing structures, overcrowding, poor sanitation and lack of services. This paper aimed to explore factors related to deteriorated SPH status among informal settlement dwellers in South Africa. This study used data from the first national representative Informal Settlements Survey in South Africa conducted by the Human Sciences Research Council (HSRC) in 2015. Stratified random sampling was applied to select informal settlements and households to participate in the study. Multivariate logistic regression and multinomial logistic regression analyses were performed to assess factors affecting deteriorated SPH among the informal settlement dwellers in South Africa. Informal settlement dwellers aged 30 to 39 years old (OR = 0.332 95%CI [0.131-0.840], p < 0.05), those with ZAR 5501 and more household income per month (OR = 0.365 95%CI [0.144-0.922], p < 0.05) and those who reported using drugs (OR = 0.069 95%CI [0.020-0.240], p < 0.001) were significantly less likely to believe that their SPH status had deteriorated compared to the year preceding the survey than their counterparts. Those who reported always running out of food (OR = 3.120 95%CI [1.258-7.737], p < 0.05) and those who reported having suffered from illness or injury in the past month preceding the survey (OR = 3.645 95%CI [2.147-6.186], p < 0.001) were significantly more likely to believe that their SPH status had deteriorated compared to the year preceding the survey than their counterparts. In addition, those who were employed were significantly (OR = 1.830 95%CI [1.001-3.347], p = 0.05) more likely to believe that their SPH status had deteriorated compared to the year preceding the survey than those who were unemployed with neutral SPH as a base category. Overall, the results from this study point to the importance of age, employment, income, lack of food, drug use and injury or illness as key determinants of SPH amongst informal settlement dwellers in South Africa. Given the rapid increasing number of informal settlements in the country, our findings do have implications for better understanding the drivers of deteriorating health in informal settlements. It is therefore recommended that these key factors be incorporated into future planning and policy development aimed at improving the standard of living and health of these vulnerable residents.

The Effect of Health Check-Ups on Health Among the Elderly in China: Evidence From 2011–2018 Longitudinal Data

Objectives: To assess the effect of health check-ups on health among the elderly Chinese.

Methods: The first dataset was panel data extracted from the 2011, 2014, and 2018 waves of the Chinese Longitudinal Health Longevity Survey (CLHLS). The second dataset was cross-sectional data come from CLHLS 2018 linked with the lagged term of health check-ups in CLHLS 2011. Health check-ups were measured by a binary variable annual health check-up (AHC). Health was assessed by a binary variable self-rated health (SRH). A coarsened exact matching method and individual fixed-effects models, as well as logistic regressions were employed.

Results: AHC attendance among the elderly increased from 2011 to 2018, with higher utilization of AHC also detected in the rural group. AHC had positive effects on SRH among rural respondents (short-term effect: OR = 1.567, p < 0.05; long-term effect: OR = 3.385, p < 0.001).

Conclusion: This study highlights a higher utilization of AHC in rural area, and the effectiveness of AHC in SRH improvement among rural participants. It indicates enhanced access to public healthcare services in rural area and underlying implications of health check-ups for reducing urban–rural health inequalities.

High Social Capital is Associated with Decreased Mental Health Problem Among In-School Adolescents in Eastern Ethiopia: A Cross-Sectional Study

Purpose

The importance of social capital for adolescent mental health has not been explored in low resource settings like Ethiopia. In this study, we examined the association between social capital and mental health problems among in-school adolescents in Harari Regional State, eastern Ethiopia.

Methods

A cross-sectional study was conducted among 3227 in-school adolescents of 13-19 years. A multistage sampling was used to select participants. Guided self-administered questionnaire was used to collect data. Mental health problem was measured using a self-administered version of the strength and difficulty questionnaire (SDQ), while social capital questionnaire for adolescent students (SCQ-AS) was used to collect data about the condition of social capital. The data were double entered, validated, and cleaned using EpiData 3.1 and analyzed using STATA 14.1. The association between the outcome variable and predictors was analyzed using an ordinal logistic regression model. The result was reported using an odds ratio along with 95% confidence interval (CI) and a p-value <0.05 was considered statistically significant association.

Results

A total of 740 (22.93%) students had mental health problem, of which 9.7% (95% CI, 8.7-10.8) and 13.20% (95% CI, 12-14) were classified as "abnormal" and "borderline", respectively. Factors associated with decreased mental health problem were increased network of friends at school (AOR = 0.75, 95% CI: 0.58-0.99), increased trust in school or neighborhood (AOR = 0.52, 95% CI: 0.44-0.63), and high social cohesion in the community (AOR = 0.75, 95% CI: 0.62-0.89).

Conclusion

Higher social capital is associated with a decreased mental health problem among in-school adolescents. Prevention and treatment of mental health problems require strengthening social capital at school, household, and in the neighborhood.

Relationship between social capital and quality of life among adult stroke patients: a cross-sectional study in Anhui Province, China

Objectives

Few studies have investigated the association between social capital and quality of life (QoL) among stroke patients. To address this research gap, we aimed to explore the association between social capital and QoL among stroke patients in Anhui Province, China.

Study design

Cross-sectional study.

Methods

This cross-sectional study was conducted using a multi-stage stratified random sampling method. The following data including demographic characteristics, health-related conditions, five dimensions of social capital status, and quality of life (QoL) were collected using a questionnaire. Generalized linear models were then used to determine the relationship between social capital and QoL after adjusting for confounding factors.

Results

A total of 390 participants were included for the final analysis in this study. Our results indicated that subjects with higher social capital including social connection (coefficient: 28.28, 95% CI: 19.39–37.16), social support (coefficient: 21.17, 95% CI: 10.63–31.71), trust (coefficient: 13.46, 95% CI: 2.73–24.19), reciprocity (coefficient: 25.56, 95% CI: 15.97–35.15), and cohesion (coefficient: 19.30, 95% CI: 9.90–28.70) had increased odds of reporting poor QoL when compared with lower social capital group. We also observed that the association between social capital and QoL varied across cities.

Conclusions

Our findings show that social capital is associated with QoL in adult stroke patients, suggesting that social capital may be significant for enhancing QoL among adults with stroke.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12955-022-01925-x.

An investigation of cancer survival inequalities associated with individual-level socio-economic status, area-level deprivation, and contextual effects, in a cancer patient cohort in England and Wales

BACKGROUND

People living in more deprived areas of high-income countries have lower cancer survival than those in less deprived areas. However, associations between individual-level socio-economic circumstances and cancer survival are relatively poorly understood. Moreover, few studies have addressed contextual effects, where associations between individual-level socio-economic status and cancer survival vary depending on area-based deprivation.

METHODS

Using 9276 individual-level observations from a longitudinal study in England and Wales, we examined the association with cancer survival of area-level deprivation and individual-level occupation, education, and income, for colorectal, prostate and breast cancer patients aged 20-99 at diagnosis. With flexible parametric excess hazard models, we estimated excess mortality across individual-level and area-level socio-economic variables and investigated contextual effects.

RESULTS

For colorectal cancers, we found evidence of an association between education and cancer survival in men with Excess Hazard Ratio (EHR) = 0.80, 95% Confidence Interval (CI) = 0.60;1.08 comparing "degree-level qualification and higher" to "no qualification" and EHR = 0.74 [0.56;0.97] comparing "apprenticeships and vocational qualification" to "no qualification", adjusted on occupation and income; and between occupation and cancer survival for women with EHR = 0.77 [0.54;1.10] comparing "managerial/professional occupations" to "manual/technical," and EHR = 0.81 [0.63;1.06] comparing "intermediate" to "manual/technical", adjusted on education and income. For breast cancer in women, we found evidence of an association with income (EHR = 0.52 [0.29;0.95] for the highest income quintile compared to the lowest, adjusted on education and occupation), while for prostate cancer, all three individual-level socio-economic variables were associated to some extent with cancer survival. We found contextual effects of area-level deprivation on survival inequalities between occupation types for breast and prostate cancers, suggesting wider individual-level inequalities in more deprived areas compared to least deprived areas. Individual-level income inequalities for breast cancer were more evident than an area-level differential, suggesting that area-level deprivation might not be the most effective measure of inequality for this cancer. For colorectal cancer in both sexes, we found evidence suggesting area- and individual-level inequalities, but no evidence of contextual effects.

CONCLUSIONS

Findings highlight that both individual and contextual effects contribute to inequalities in cancer outcomes. These insights provide potential avenues for more effective policy and practice.

Socioenvironmental factors and behaviors associated with negative self-rated health in Brazil

The purpose of this study is to determine the factors associated with negative self-rated health in Brazil. The sample consisted of 5,259 adults from five representative capitals of the five regions of Brazil. Data collection was achieved in the following municipalities: Palmas (North Region), João Pessoa (Northeast Region), Goiânia (Central-West Region), Vitória (Southeast Region) and Florianópolis (South Region). For the analysis of the data, Binary Logistic Regression for determine the factors associated with negative self-rated health was used. Negative self-rated health was identified in 31.43% of Brazilians. The factors that were significantly associated were bad air quality, does not have public spaces for leisure, older age group, insufficient salary to cover expenses, a rare practice of physical exercises, does not perform healthy eating, active commuting for study or employment and commuting time for above 30 minutes, dissatisfaction with health services and still, not working, not looking for a job and finally, reside in some Brazilian regions. The study presents the importance of socioenvironmental and behavioral factors for the self-rated health of Brazilian adults, as well as it shows high rates of negative self-rated health compared to other studies.

Residents living in communities with higher civic participation report higher self-rated health

It has been shown that community-level social capital may affect residents' health. The present mixed ecological study assesses the evidence for an association between the community-level social capital and the individual level of self-rated health. The Hakui City Health Interview Survey targeted 15,242 people aged 40 years and older from 11 communities. Among them, 6578 residents responded to the questionnaire (response rate, 43.2%). We examined whether the community-level social capital (general trust, norm, and civic participation) was associated with the individual level of self-rated health. Overall, 1919 (29.1%) answers of self-rated poor health were identified. Community-level civic participation was negatively associated with poor self-rated health after adjusting for individual demographic factors, individual social capitals, and community-level economic status, whereas community-level general trust, and norm were not significant. The findings suggest the importance of fostering communities with high civic participation to reduce the poor health status of residents.

Association between social capital and depression among older people: evidence from Anhui Province, China

BACKGROUND

To examine the relationship between social capital and depression among community-dwelling older adults in Anhui Province, China.

METHODS

A cross-sectional study was conducted among older people selected from three cities of Anhui Province, China using a multi-stage stratified cluster random sampling method. Data were collected through questionnaire interviews and information on demographic characteristics, social capital, and depression was collected. The generalized linear model and classification and regression tree model were employed to assess the association between social capital and depression.

RESULTS

Totally, 1810 older people aged ≥60 years were included in the final analysis. Overall, all of the social capital dimensions were positively associated with depression: social participation (coefficient: 0.35, 95% CI: 0.22-0.48), social support (coefficient:0.18, 95% CI:0.07-0.28), social connection (coefficient: 0.76, 95% CI:0.53-1.00), trust (coefficient:0.62, 95% CI:0.33-0.92), cohesion (coefficient:0.31, 95% CI:0.17-0.44) and reciprocity (coefficient:0.30, 95% CI:0.11-0.48), which suggested that older people with higher social capital had a smaller chance to develop depression. A complex joint effect of certain social capital dimensions on depression was also observed. The association with depression and the combinative effect of social capital varied among older adults across the cities.

CONCLUSIONS

Our study suggests that improving social capital could aid in the prevention of depression among older adults.

Assessing health impacts of an environmental pan-African development project: A migration perspective

The general objective of this article is to analyze to what extent the implementation of the Great Green Wall project is likely to disrupt migratory movements towards the rural environment and, consequently, the socio-economic structures and health status of local populations. This study was carried out in 2015 on a population sample of 500 individuals living in the municipality of Tessekere, constructed using the quota method. Socioeconomic and demographic characteristics, migratory status and self-rated health of individuals were collected during face-to-face interviews. Statistical analyses used were Chi-square tests, student and binary logistic regressions. Results show that internal migrants in the municipality of Tessekere represent 13.40% of the study population. Migrants more often work as civil servants, artisans, craft workers or traders than the region's native population, who are generally livestock breeders or jobless. While place of birth does not play a significant role, it appears that the length of residence of migrants in rural areas influences health status: migrants residing in the municipality of Tessekere for less than 10 years are less likely to report poor health, regardless of their sex, age, occupation, material well-being and perceived stress. In conclusion, an environmental requirement (combating desertification), addressed by an international political project - the Great Green Wall - and then applied at the national level, has transformed the demographic, economic and health structure of a local population. In conclusion, our study showed that (1) an examination of migration can offer a means of interpreting the impact of development projects and the local changes they entail, and (2) migration is a unique prism through which one can study how exposure to a new physical and social environment influences the health of populations.

Effect of self-rated health status on functioning difficulties among older adults in Ghana: Coarsened exact matching method of analysis of the World Health Organization's study on global AGEing and adult health, Wave 2

BACKGROUND

Functional difficulty assessment has been proven as a key factor in the health evaluation of adults. Previous studies have shown a reduction in health and functional difficulties with increasing age. This analysis was conducted to quantify the effect of poor self-rated health on functional difficulty among older adults in Ghana.

METHOD

This analysis was based on the World Health Organization Study on Global AGEing and Adult Health in Ghana for older adults 50 years and above. Fifteen standard functioning difficulty tools were extracted and used for the analysis. Three predictive models with the Coarsened Exact Matching method involving Negative Binomial, Logistics and Ordered logistic regression were performed using Stata 14.

RESULTS

Overall, the prevalence of poor Self-rated health was 34.9% and that of functional difficulties among older adults in Ghana was 69.4%. Female sex, increasing age, being separated, having no religious affiliation, not currently working and being underweight were associated with and significantly influence poor Self-rated health [AOR(95%CI)p-value = 1.41(1.08-1.83)0.011, 3.85(2.62-5.64)0.000, 1.45(1.08-1.94)0.013, 2.62(1.68-4.07)0.000, 2.4(1.85-3.12)0.000 and 1.39(1.06-1.81)0.017 respectively]. In addition, poor Self-rated health and geographical location (rural vs. urban)significantly influence functioning difficulties among older adults in Ghana as predicted by the three models [Negative Binomial: PR(95%CI) = 1.62(1.43-1.82), Binary logistic: AOR(95%CI) = 3.67(2.79-4.81) and ordered logistic: AOR(95%CI) = 2.53(1.14-2.03)].

CONCLUSION

Poor SRH is more pronounced among older adult females in Ghana. Some determinants of poor SRH include; age, geographical location (urban vs. rural), marital status, religion, and employment status. This provides pointers to important socio-demographic determinants with implications on the social function of older adults in line with the theme of the national aging policy of 2010, 'ageing with security and dignity' and ultimately in the national quest to achieve the Sustainable Development Goals by 2030.

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.

Particularized trust, generalized trust, and immigrant self-rated health: cross-national analysis of World Values Survey

OBJECTIVES

This research examined the associations between two types of trust, generalized and particularized, and self-rated health among immigrants.

STUDY DESIGN

Data were drawn from the World Values Survey (WVS6), the latest wave of cross-sectional surveys based on face-to-face interviews.

METHODS

The immigrant subsample analyzed herein contains 3108 foreign-born individuals clustered from 51 countries. Given the hierarchically nested data, two-level logistic regressions models were estimated using HLM (Hierarchical Linear Modeling) 7.1.

RESULTS

At the individual level, net of socio-economic and demographic factors (age, gender, marital status, education, income, neighborhood security, and subjective well-being), particularized trust was positively related to physical health (odds ratio [OR] = 1.11, P < .001). Generalized trust, however, was not a significant predictor. At the country level, based on alternative models, the aggregate measure of particularized trust was negatively associated with subjective health. The odds of being healthy were on average about 30% lower.

CONCLUSION

The interdisciplinary literature on social determinants of health has largely focused on the salubrious impact of trust and other forms of social capital on physical well-being. Many previous studies based on general, not immigrant, populations also did not differentiate between generalized and particularized types of trust. Results from this study suggest that this conceptual distinction is critical in understanding how and to what extent the two are differentially related to immigrant well-being across multiple levels of analysis.

Work and family transitions and the self-rated health of young women in South Africa

Understanding the transition to adulthood has important implications for supporting young adults and understanding the roots of diversity in wellbeing later in life. In South Africa, the end of Apartheid means today's youth are experiencing their transition to adulthood in a changed social and political context which offers opportunities compared to the past but also threats. This paper presents the first national level analysis of the patterning of key transitions (completion of education, entry into the labour force, motherhood and marriage or cohabitation), and the association between the different pathways and health amongst young women. With the use of longitudinal data from the South African National Income Dynamics Study (2008-2015), this paper employs sequence analysis to identify common pathways to adulthood amongst women aged 15-17 years at baseline (n = 429) and logistic regression modelling to examine the association between these pathways and self-rated health. The sequence analysis identified five pathways: 1. 'Non-activity commonly followed by motherhood', 2. 'Pathway from school, motherhood then work', 3. 'Motherhood combined with schooling', 4. 'Motherhood after schooling', and 5. 'Schooling to non-activity'. After controlling for baseline socio-economic and demographic characteristics and health, the regression results show young women who followed pathways characterised by early motherhood and economic inactivity (1, 3 and 4) had poorer self-rated health compared to women whose pathways were characterised by combining motherhood and economic activity (2) and young women who were yet to become economically active or mothers (5). Therefore, policies should seek to prevent adolescent childbearing, support young mothers to continue their educational careers and enable mothers in work and seeking work to balance their work and care responsibilities. Further, the findings highlight the value of taking a holistic approach to health and provide further evidence for the need to consider work-family balance in the development agenda.

Investigating the Associations between Ethnic Networks, Community Social Capital, and Physical Health among Marriage Migrants in Korea

This study examines factors associated with the physical health of Korea's growing immigrant population. Specifically, it focuses on the associations between ethnic networks, community social capital, and self-rated health (SRH) among female marriage migrants. For empirical testing, secondary analysis of a large nationally representative sample (NSMF 2009) is conducted. Given the clustered data structure (individuals nested in communities), a series of two-level random intercepts and slopes models are fitted to probe the relationships between SRH and interpersonal (bonding and bridging) networks among foreign-born wives in Korea. In addition to direct effects, cross-level interaction effects are investigated using hierarchical linear modeling. While adjusting for confounders, bridging (inter-ethnic) networks are significantly linked with better health. Bonding (co-ethnic) networks, to the contrary, are negatively associated with immigrant health. Net of individual-level covariates, living in a commuijnity with more aggregate bridging social capital is positively linked with health. Community-level bonding social capital, however, is not a significant predictor. Lastly, two cross-level interaction terms are found. First, the positive relationship between bridging network and health is stronger in residential contexts with more aggregate bridging social capital. Second, it is weaker in communities with more aggregate bonding social capital.

High social trust associated with increased depressive symptoms in a longitudinal South African sample

Several studies have documented a protective association between social trust and mental and physical health, but gaps in knowledge remain. Debates regarding the contextual versus individual nature of social trust are ongoing; research from low- and middle-income countries is lacking, and study designs have been limited for causal inference. To address these gaps, we examined the association between social trust and depressive symptoms using three waves of the National Income Dynamics Study, a longitudinal South African survey. We used individual fixed-effects models to assess the association between changes in scores on the Center for Epidemiological Studies Depression Scale Short Form (CES-D-10) and in individual-level and district-level personalized and generalized trust among 15,670 individuals completing at least two waves of the NIDS adult questionnaire. High individual-level generalized trust was unexpectedly associated with increased depressive symptoms scores while district generalized trust did not show an association. We also found a cross-level interaction between individual and district-level personalized trust. High individual trust was associated with increased depressive symptoms scores when district trust was low; however, as district-level trust increased, higher individual trust was associated with reduced depressive symptoms. Our unexpected results suggest that trust may not always be beneficial for depressive symptoms, but rather, that its effects may depend on context. In the South African setting where social trust is low, being very likely to trust may be associated with worse depressive symptoms in some circumstances.

Self-rated health in Senegal: A comparison between urban and rural areas

Introduction

Although the relationship between mortality and self-rated health has been demonstrated in sub-Saharan Africa, information in this area is rudimentary. In Senegal, no study has been undertaken comparing self-rated health between urban and rural areas. The objective of this study is therefore to compare self-rated health and its main predictors in Dakar and in a rural isolated area, Tessekere municipality, taking into account socio-demographic and economic factors, social relations, as well as measures of physical and mental health.

Material and methods

This study was carried out in 2015 on a population sample of 1000 individuals living in Dakar and 500 individuals living in the municipality of Tessekere, constructed using the quota method. Self-rated health, health variables, psychosocial, sociodemographic and economic characteristics were collected during face-to-face interviews. Statistical analyses used were Chi-square tests and binary logistic regressions.

Results

Results show that self-rated health in Senegalese urban area (Dakar) is better than in rural area (Tessekere), but the determinants of self-rated health partly differ between these two environments. Age and gender play a fundamental role in self-rated health as much in Dakar as in Tessekere but diabetes and social support play a role in self-rated health only in urban environment, whereas economic well-being is associated to self-rated health only in rural area.

Conclusion

The analyses carried out in these two environments show that despite the existence of common determinants (age, gender, stress), the determinants for formulating an answer to the question of self-rated health differ. People’s social and cultural environments thus play a fundamental role in the process of rating one’s health and, in the short and long term, in the mortality rate.

[Factor structure validity of the social capital scale used at baseline in the ELSA-Brasil study]

This study aims to analyze the factor structure of the Brazilian version of the Resource Generator (RG) scale, using baseline data from the Brazilian Longitudinal Health Study in Adults (ELSA-Brasil). Cross-validation was performed in three random subsamples. Exploratory factor analysis using exploratory structural equation models was conducted in the first two subsamples to diagnose the factor structure, and confirmatory factor analysis was used in the third to corroborate the model defined by the exploratory analyses. Based on the 31 initial items, the model with the best fit included 25 items distributed across three dimensions. They all presented satisfactory convergent validity (values greater than 0.50 for the extracted variance) and precision (values greater than 0.70 for compound reliability). All factor correlations were below 0.85, indicating full discriminative factor validity. The RG scale presents acceptable psychometric properties and can be used in populations with similar characteristics.

Social capital and health in Kenya: A multilevel analysis

Despite the acknowledgment that social capital is an important predictor of good health and overall well being in wealthy countries, little empirical research has been conducted in developing countries, particularly in Africa, to examine this relationship. This study examines the association between cognitive (trust) and structural (membership in organization) social capital on health at both the individual and contextual levels. Health was measured using answers to a subjective question on physical health and anxiety/worry suffered by individuals within the last 30 days. This study utilized Afrobarometer data collected in Kenya in 2005 to examine this relationship using multilevel logistic statistical modeling. Upon controlling for socioeconomic and demographic factors, social capital was found to be significantly associated with anxiety/worry and physical health in Kenya. Membership in organizations was associated with increased odds (OR = 1.34, 95%CI: 1.02-1.76) of physical health problems, while individual trust was associated with a 6% (OR = 0.94, 95%CI: 0.90-0.99) reduction in the likelihood of physical health problems. Conversely, generalized trust was associated with a 37% reduction in the odds (OR = 0.63, 95%CI: 0.40-0.99) of anxiety/worry, while individual trust was associated with a 5% reduction (OR = 0.95, 95%CI: 0.90-1.00) of anxiety/worry. With the exception of membership in an organization that exacerbates physical health, both individual level trust and generalized trust were associated with better health outcomes in Kenya. The availability of social organizations at the contextual level was associated with worsening anxiety/worry although the effect size was small. These results show that social capital, particularly trust, is a concept that can apply to different social and cultural contexts and can potentially be harnessed to improve health in settings that suffer from resource poverty.

Determinants of poor self-rated health among adults in urban Mozambique

Background

Self-rated health is a measure expressing the general condition of health of individuals. Self-rated health studies are common in developed countries and in some developing regions. Despite increasing proportion of adult and older population in sub-Saharan Africa and poor population health indicators, there is a dearth of studies on self-rated health in the region. This study examines factors associated with poor self-rated health among adult individuals in Maputo metropolitan area in Mozambique.

Methods

Data for this study come from a survey of 1768 individuals aged 18 years or more carried out in Maputo metropolitan area, Mozambique, in 2015. Employing multiple logistic regression, the study used a subsample of 677 female and male respondents aged 40 years or more to estimate the determinants of poor self-rated health.

Results

About 54 % of respondents aged 40 years or more believed that their health status was poor. Female respondents [Odds Ratios (OR) = 3.43, p <0.01], single (OR = 4.71, p < 0.05), widow (OR = 1.81, p < 0.05), separated or divorced (OR = 2.08, p < 0.05) and those believing that hypertension or heart problem was a major community health problem (OR = 1.56, p < 0.05) displayed higher odds of reporting poor health than their peers, net of other factors. Furthermore, individuals aged 40–49 years (OR = 0.45, p < 0.01), or 50–59 years (OR = 0.59, p < 0.05), those whose work involves intensive physical activity (OR = 0.60, p < 0.05) and those from households treating drinking water (OR = 0.49, p < 0.01) showed lower odds of reporting poor health, adjusting for other factors.

Conclusion

Overall, the results point to the importance of age, gender, marital status, socioeconomic circumstances, individuals’ health behaviors and perceived community health problems as key determinants of poor self-rated health among adults in Maputo metropolitan area. Given the growing number of adult and older people in sub-Saharan Africa, the rising importance of non-communicable diseases and the scarcity of studies on determinants of poor self-rated health among adults in the region, our findings may have implications for a better understanding of the drivers of poor health among adults in urban sub-Saharan Africa

Social Participation and Disaster Risk Reduction Behaviors in Tsunami Prone Areas

This paper examines the relationships between social participation and disaster risk reduction actions. A survey of 557 households in tsunami prone areas in Phang Nga, Thailand was conducted following the 2012 Indian Ocean earthquakes. We use a multivariate probit model to jointly estimate the likelihood of undertaking three responses to earthquake and tsunami hazards (namely, (1) following disaster-related news closely, (2) preparing emergency kits and/or having a family emergency plan, and (3) having an intention to migrate) and community participation. We find that those who experienced losses from the 2004 tsunami are more likely to participate in community activities and respond to earthquake hazards. Compared to men, women are more likely to prepare emergency kits and/or have an emergency plan and have a greater intention to migrate. Living in a community with a higher proportion of women with tertiary education increases the probability of engaging in community activities and carrying out disaster risk reduction measures. Individuals who participate in village-based activities are 5.2% more likely to undertake all three risk reduction actions compared to those not engaging in community activities. This implies that encouraging participation in community activities can have positive externalities in disaster mitigation.

Association between social capital and health in women of reproductive age: a population-based study

Women's health is a public health priority. The origins of health inequalities are very complex. The present study was conducted to determine the association between social capital and health status in reproductive-age women in Tehran, Iran. In this population-based, cross-sectional study, the Social Capital Integrated Questionnaire, the SF-36 and socio-demographic questionnaires were used. Analysis of data by one-way ANOVA test and stepwise multiple linear regression showed that the manifestation dimensions of social capital (groups and networks, trust and solidarity, collective action and cooperation) can potentially lead to the outcome dimensions of social capital (social cohesion and inclusion, and empowerment and political action), which in turn affect health inequities after controlling for socio-demographic differences.

Investigating the relationship between self-rated health and social capital in South Africa: a multilevel panel data analysis

Background

The relationship between social capital and self-rated health has been documented in many developed compared to developing countries. Because social capital and health play important roles in development, it may be valuable to study their relationship in the context of a developing country with poorer health status. Further, the role of social capital research for health policy has not received much attention. This paper therefore examines the relationship between social capital and health in South Africa, a country with the history of colonialism and apartheid that has contributed to the social disintegration and destruction of social capital.

Methods

This study uses data from the National Income Dynamics Study (NIDS), the first nationally representative panel study in South Africa. Two waves of the NIDS were used in this paper – Wave 1 (2008) and Wave 2 (2010). Self-rated health, social capital (individual- and contextual-level), and other covariates related to the social determinants of health (SDH) were obtained from the NIDS. Individual-level social capital included group participation, personalised trust and generalised trust while contextual-level or neighbourhood-level social capital was obtained by aggregating from the individual-level and household-level social capital variables to the neighbourhood. Mixed effects models were fitted to predict self-rated health in Wave 2, using lagged covariates (from Wave 1).

Results

Individual personalised trust, individual community service group membership and neighbourhood personalised trust were beneficial to self-rated health. Reciprocity, associational activity and other types of group memberships were not found to be significantly associated with self-rated health in South Africa. Results indicate that both individual- and contextual-level social capital are associated with self-rated health.

Conclusion

Policy makers may want to consider policies that impact socioeconomic conditions as well as social capital. Some of these policies are linked to the SDH. We contend that the significant social capital including community service membership can be encouraged through policy in a way that is in line with the values of the people. This is likely to impact on health and quality of life generally and lead to a reduction in the burden of disease in South Africa considering the historic context of the country.

A multilevel analysis of the relationship between neighborhood social disorder and depressive symptoms: evidence from the South African National Income Dynamics Study

The apartheid regime that governed South Africa from 1948-1994 established spatial segregation that is understood to have contributed to the magnitude of neighborhood social disorder in the postapartheid era. Although a number of neighborhood social disorder characteristics, such as perceived violence and crime in the community, are prominent issues in South Africa, the extent to which these perceived spatial attributes are linked to depression is unknown at the population level. Multilevel modeling of data from the second wave of the South African National Income Dynamics Study (SA-NIDS) was utilized to examine the relationship between depressive symptomatology and neighborhood social disorder as indicated by the perceived frequency of violent, criminal and illicit activities in the community. Depressive symptomatology was assessed using the 10-item version of the Center for Epidemiologic Studies Depression Scale. A cut-off score of 10 or higher was used to indicate the presence of significant depressive symptomatology. Results showed that perception of neighborhood social disorder was independently associated with significant levels of depressive symptomatology. Gender, race or ethnicity, perceived health status, and education were significant for individual-level covariates of depression. Community intervention strategies that reduce the risk of neighborhood disorganization and emphasize positive social norms in the neighborhood are warranted. Taking into account the residential deracialization of a country transitioning from apartheid to nonracial democracy, a longitudinal spatial study design assessing the dynamics between depression and the aforementioned perceptions of neighborhood attributes may also be warranted.