The impact of social capital and social support on the health of female-headed households: a systematic review

Bridging the gap or widening the divide? Exploring the dual role of social capital in healthcare financing in rural Uttar Pradesh, India

Social capital, defined as the nature of the social relationship and the resources embedded within the social network of an individual or community, influences how individuals within a group interact and collaborate within their communities or organizations. While it is acknowledged that social capital can be drawn from as a coping strategy to mitigate financial stress, there is a notable absence of the lived experience in the literature on how social capital influences households to tap resources from their social network. We have investigated the role of social capital in healthcare financing in rural Uttar Pradesh, India, highlighting the challenges faced by households in managing healthcare expenses. We took a qualitative research approach, conducting in-depth interviews with 24 households in the Hardoi District of Uttar Pradesh in August 2017 to explore participants' lived experience of accruing support from their community during their healthcare crisis. Data analysis followed a thematic content analysis approach. The study finds that households leverage social capital for both financial and non-financial support during health crises. Social networks, trust, and community cohesion play critical roles in resource acquisition. However, overreliance on social capital can be coercive, leading to inequity, privacy invasion, and dependency. Though social capital serves as a crucial resource of support in healthcare emergencies, its unequal distribution and potential for misuse highlight the need for more structured health financing policies in India. The findings underscore the importance of integrating community-driven resources into broader health financing strategies, considering local social structures and community dynamics.

Gender-based adjustment problems of divorcees in Hazara Division, Pakistan

INTRODUCTION

Divorce is one of the harshest realities in Eastern societies worldwide because it is an intact component of the elementary social institution of the family. Grievously, divorce rates are escalating with profound ramifications for divorcees in Asia, including Pakistan. Therefore, exploring the challenges after divorce with gender-based dimensions in the Pakistani context was necessary, particularly in Hazara Division.

RESEARCH METHODOLOGY

The study followed a pragmatic approach through snowball sampling and recruited 75 respondents. The data were collected through a semi-structured questionnaire and analysed using IBM SPSS 25. For descriptive statistics, frequencies of quantitative responses were determined using percentages, means, and standard deviations. Then Chi-Square Test of Independence, Principal Component Analysis, and Multivariate Analysis of Covariance were performed to find an association between the dependent and independent variables.

RESULTS

Results demonstrated that most divorcees face children-related issues followed by economic, social, and psychological issues that impede post-divorce adjustment of divorcees. Results showed that the immaturity of divorcees and gender-specific violence specifically for women make it challenging for them to cope with the situation and impede their growth after divorce. Results revealed that more than half of women and a few of men have custody of children after divorce; however, fight over custody of children is another major cause of delayed adjustment. Results presented that gender significantly influences women's intensity of post-divorce adjustment constraints.

CONCLUSION

Therefore, it is concluded that regardless of gender, ongoing conflicts with ex-spouses or in-laws made the post-divorce adjustment of divorcees difficult. Divorcees are in a constant tug-of-war between fighting internal dilemmas, pursuing individualistic ideals, and fulfilling societal norms, values, and expectations. This battle complicates and prolongs their adjustments after divorce. The study suggests that institutional, psychosocial, and family support is critical to proactively relieve divorcees from resources and their children.

Perceived mental health impacts of the COVID-19 pandemic: The roles of social support and social engagement for working age adults in the United States

In this paper we assess if two protective mechanisms for mental health - social support and social engagement - are associated with lower risk of reporting worsening mental health as a result of the pandemic. Using a demographically representative sample of working age adults in the United States (N = 4014) collected in February and March of 2021, we use logistic regression models to predict self-reported worsening mental health as a result of the pandemic using social support - measured as instrumental and emotional support - and social engagement. We use additional stratified models to determine if these relationships are consistent across rural-urban areas. Results indicate that among urban working age adults, emotional support, high levels of instrumental support, and some types of social engagement were associated with significantly lower risk of worsening mental health. However, among rural working age adults, only emotional support and high levels of instrumental support were significantly associated with lower odds of worsening mental health. Findings suggest that while emotional support may be effective for working age adults in lowering risk of worsening mental health from the pandemic, social engagement may not be for rural residents. The results support use of mental health promotion and prevention approaches that bolster emotional support through familial and local social networks, and raises caution about the efficacy of social engagement approaches in rural contexts.

Exploring the Role of Social Networks in Facilitating Health Service Access Among Low-Income Women in the Philippines: A Qualitative Study

Despite efforts to implement universal health care coverage (UHC) in the Philippines, income poor households continue to face barriers to health care access and use. In light of recent UHC legislation, the aim of this study was to explore how gender and social networks shape health care access and use among women experiencing poverty in Negros Occidental, Philippines. Semi-structured interviews were conducted with women (n = 35) and health care providers (n = 15). Descriptive statistical analyses were performed to report demographic information. Interview data were analyzed thematically using a hybrid deductive-inductive approach and guided by the Patient-Centred Access to Health Care framework. Women’s decisions regarding health care access were influenced by their perceptions of illness severity, their trust in health care facilities, and their available financial resources. Experiences of health care use were shaped by interactions with health professionals, resource availability at facilities, health care costs, and health insurance acquisition. Women drew upon social networks throughout their lifespan for social and financial support to facilitate healthcare access and use. These findings indicate that social networks may be an important complement to formal supports (eg, UHC) in improving access to health care for women experiencing poverty in the Philippines.

The relationship of supportive roles with mental health and satisfaction with life in female household heads in Karaj, Iran: a structural equations model

Background

Female household heads are faced with more problems than men due to their multiple concurrent roles. The present study was conducted to determine the relationship of supportive roles with mental health and satisfaction with life in female household heads in Karaj, Iran using a structural equations model.

Methods

The present descriptive-analytical study was conducted on 286 eligible female household heads in Karaj, Iran, in 2020, who were selected by convenience sampling. Data were collected using Vaux’s Social Support, the perceived social support scale, the general health questionnaire (GHQ), and the satisfaction with life questionnaire plus a socio-demographic checklist, and were analyzed in SPSS-16 and Lisrel-8.8.

Results

The participants’ mean age was 43.1 ± 1.7 years. According to the path analysis results, satisfaction with life had the highest direct positive relationship with perceived social support (B = 0.33) and the highest indirect positive relationship with age (B = 0.13) and the highest direct and indirect positive relationship with education and social support (B = 0.13). Also, mental health had a direct negative relationship with satisfaction with life (B = -0.29), an indirect negative relationship with social support, and both a direct and indirect negative relationship with perceived support (B = -0.26).

Conclusion

Based on the results, supportive roles had a negative relationship with mental health; in other words, mental health problems increase as supportive roles decrease. They also had a positive relationship with satisfaction with life in female household heads.

Accordingly, given the status and role of women in the health of family members and the community and their greater vulnerability, further attention and support should be directed toward these women by the government and relevant organizations like establishment of counseling-support centers.

The relationship between social support and mental health problems during pregnancy: a systematic review and meta-analysis

Background

Pregnancy is a time of profound physical and emotional change as well as an increased risk of mental illness. While strengthening social support is a common recommendation to reduce such mental health risk, no systematic review or meta-analysis has yet examined the relationship between social support and mental problems during pregnancy.

Methods

The PRISMA checklist was used as a guide to systematically review relevant peer-reviewed literature reporting primary data analyses. PubMed, Psych Info, MIDIRS, SCOPUS, and CINAHL database searches were conducted to retrieve research articles published between the years 2000 to 2019. The Newcastle–Ottawa Scale tool was used for quality appraisal and the meta-analysis was conducted using STATA. The Q and the I² statistics were used to evaluate heterogeneity. A random-effects model was used to pool estimates. Publication bias was assessed using a funnel plot and Egger’s regression test and adjusted using trim and Fill analysis.

Result

From the identified 3760 articles, 67 articles with 64,449 pregnant women were part of the current systematic review and meta-analysis. From the total 67 articles, 22 and 45 articles included in the narrative analysis and meta-analysis, respectively. From the total articles included in the narrative analysis, 20 articles reported a significant relationship between low social support and the risk of developing mental health problems (i.e. depression, anxiety, and self-harm) during pregnancy. After adjusting for publication bias, based on the results of the random-effect model, the pooled odds ratio (POR) of low social support was AOR: 1.18 (95% CI: 1.01, 1.41) for studies examining the relationship between low social support and antenatal depression and AOR: 1.97 (95% CI: 1.34, 2.92) for studies examining the relationship between low social support and antenatal anxiety.

Conclusion

Low social support shows significant associations with the risk of depression, anxiety, and self-harm during pregnancy. Policy-makers and those working on maternity care should consider the development of targeted social support programs with a view to helping reduce mental health problems amongst pregnant women.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12978-021-01209-5.

Pregnancy is a significant event for reproductive-age women. It is supplemented by hormonal changes and can represent a time of increased risk for the occurrence of mental illness like depression, anxiety and self-harm. Providing good social support for the pregnant mother reduce this risk and prevent pregnancy complication and adverse birth outcome. However, no systematic review and/or meta-analysis has explored the associations between social support and mental illness (depression, anxiety, self-harm) among pregnant women. Therefore, this systematic review and meta-analysis aimed to examine the association between social support and mental illness (anxiety, depression, and self-harm) during pregnancy.

The review identified 67 relevant articles with 64,449 pregnant women, from PubMed, Psych Info, MIDIRS, SCOPUS, and CINAHL database. Of the total 67 articles, 22 articles included in the narrative review and 45 articles included in the meta-analysis. Among studies included in the narrative synthesis, a majority of them reported significant positive associations between low social support and antenatal depression, antenatal anxiety and self-harm during pregnancy. Further, the pooled estimates of the meta-analysis show that low social support had a significant positive association with antenatal depression (AOR: 1.18 (95% CI: 1.01, 1.41)) and antenatal anxiety (AOR: 1.97 (95% CI: 1.34, 2.92)). Therefore, maternal health professionals need to have discussions with pregnant women regarding the level and source of social support they receive. Maternal health professionals may also need to consider encouraging the social network of pregnant women to improve social support being given. Policy-makers and those working on maternity care should consider the development of targeted social support programs with a view to helping reduce mental health problems amongst pregnant women.

Social capital and sleep disorders in Tibet, China

Objective

Sleep plays an important role in the health and well-being of middle aged and elderly people, and social capital may be one of the important factors for sleep disorders. This study aimed to understand the relationship between social capital and sleep disorders in a unique region of China –Tibet that generally has the disadvantaged economic status compared to other parts of China.

Methods

The study was based on Tibetan data from The China Multi-Ethnic Cohort (CMEC) and was conducted from May 2018 to September 2019. A total of 3194 Tibetans aged > 50 were selected from the community population by multi-stage stratified cluster sampling. Social capital was measured using two validated health-related social capital scales, family/community and society.. Sleep disorders were measured as the presence of disorders of initiating and maintaining sleep, early morning awakening, or daytime dysfunction. Logistic regression models were applied to examine the association between social capital and sleep disorders.

Results

39.9% (1271/3194) of the participants had sleep disorders. In addition, after controlling for all potential variables, family social capital was significantly negatively associated with sleep disorders (OR = 0.95, P < 0.05), while community and society social capital was not associated with sleep disorders. Then, when we did all the sex-stratified analyses, the significant association between social capital and sleep disorders was found only in women (OR = 0.94, P < 0.05), while no association was found in males; neither males nor females showed any association with community and society social capital.

Conclusion

Our study would help to better understand the extent of health inequality in China, and guide future interventions, strategies and policies to promote sleep quality in low-income areas, taking into account both the role of Tibetan specific cultural traditions, lifestyles and religious beliefs in social capital and the gender differences in social capital.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10626-x.

Psychological Well-Being of Female-Headed Households Based on Age Stratification: A Nationwide Cross-Sectional Study in South Korea

The female-headed household is a new vulnerable group associated with health inequality. The purpose of this study was to analyze psychological well-being and related factors among Korean female-headed households based on age stratification. This was a secondary analysis of data extracted from the fifth Korean Working Conditions Survey (2017), which included a total of 9084 female-headed households. Their psychological well-being was measured by the WHO-5 well-being index. A total of 39.8% of female-headed household workers were psychologically unhealthy. Among them, 2.2% of those aged 15-30 years old, 8.1% aged 30-50 years old, and 29.5% over aged 50 years old were unhealthy. In the age group of 15-30 years old, depression/anxiety was negatively associated with psychological well-being. In the age group of 30-50 years old, living alone, musculoskeletal pain, fatigue, and depression/anxiety were negatively associated with psychological well-being. In the age group over 50 years old, low education level, living alone, low income, musculoskeletal pain, fatigue, and depression/anxiety were negatively associated with psychological well-being. The psychological well-being perceived by female households is complex and goes beyond economic poverty and dependent burdens. Therefore, a multidimensional support strategy should be included in the concept of social deprivation, and a preventive approach is needed to establish a support system.

Challenges and opportunities confronting female-headed households in Iran: a qualitative study

Background

Female-headed households are one of the most vulnerable groups of society that confront many problems and challenges. Therefore, the present study aimed to explore the challenges and opportunities confronting female-headed households in Iran.

Methods

This qualitative study was conducted among female-headed households in Kermanshah, West of Iran, in 2019. The data were collected through Semi-structured interviews with 26 female-headed households who were selected by purposeful and theoretical sampling. Data analysis was done through conventional qualitative content analysis, and the software MAXQDA-12 was used for the management of data. The four criteria of Goba and Lincon, including credibility, confirmability, dependability, and transferability, were observed to evaluate the quality of research results.

Results

After analyzing the data, 4 main categories and 13 subcategories were obtained as follows: individual problems (role overload, role conflict, end of love, psychological problems), intra-family problems (declined independence, intra-family tension, poverty reproduction and family disability), social problems (stigma of being unattended, social insecurity, social isolation, social exclusion), positive outcomes (positive self-concept, social maturity).

Conclusion

Female-headed households face many challenges that can become a big threat or an opportunity. Therefore, their health improvement can be achieved through training and helping them to adapt to new and multifaceted roles, providing more economic support and helping them raise their social status.

Older Men With Living Spouses Versus Men Without Spouses: An Example From the Arab World-Kuwait

This research is concentrated on elderly Kuwait men and the effect that losing wife, a major determinant of social support, has on their general health. A sample of 472 older male adults aged 60 years and older have been included in this study. A questionnaire was the major tool of the study. The questionnaire included sociocultural information and social support scales (Degree of Religiosity, Social Support Scale, Frequency of Contact, and Strength of Relation scales). Health measurements also were used: two, one-item self-reported health scales in the current year and last year and a Somatic Symptoms Inventory (SSI) were used. Systolic and diastolic blood pressure and glucose levels were taken. Statistical Package for Social Sciences (SPSS, version 21) was used for data entry and analysis. t-test and regression were the major statistical procedures. Data show that there are differences between elderly men with a living wife compared to those without a living wife. Having a living wife was positively associated with better social support and health in Kuwaiti elderly men. Data show that a living wife is an important factor of men's health and well-being in general and that a wife is one of the major social support elements of elderly men.

Factors Associated with Metabolic Syndrome among Middle-Aged Women in their 50s: Based on National Health Screening Data

This study aimed to identify the risk factors associated with metabolic syndrome among middle-aged women in their 50s to provide a strategy for managing the metabolic syndrome of those whose prevalence is rapidly increasing. Secondary data from the 2012 Korean National Health Insurance Service Medical check-up cohort database were analyzed. Participants included 36,582 middle-aged women in their 50s from the cohort who received a general medical check-up. The risk factors were estimated using logistic regression analysis. Metabolic syndrome was identified in 14.6% of the surveyed persons among middle-aged women in their 50s. Working women, low household income levels, country residents, high body mass index (BMI), total cholesterol of over 240 mg/dL, non-drinker, non-exerciser, history of diabetes or hypertension, and family history of diabetes were associated with increased risk of metabolic syndrome. It is necessary to prepare a strategy to increase access to health care services so that socioeconomic vulnerability does not lead to negative health behavior such as obesity and lack of physical activity. In particular, we recommend active interventions at workplaces for the working women who have a higher risk of metabolic syndrome.

Social Capital and Sleep Quality in Individuals Who Self-Isolated for 14 Days During the Coronavirus Disease 2019 (COVID-19) Outbreak in January 2020 in China

Background

From the end of December 2019, coronavirus disease 2019 (COVID-19) began to spread in central China. Social capital is a measure of social trust, belonging, and participation. This study aimed to investigate the effects of social capital on sleep quality and the mechanisms involved in people who self-isolated at home for 14 days in January 2020 during the COVID-19 epidemic in central China.

Methods

Individuals (n=170) who self-isolated at home for 14 days in central China, completed self-reported questionnaires on the third day of isolation. Individual social capital was assessed using the Personal Social Capital Scale 16 (PSCI-16) questionnaire. Anxiety was assessed using the Self-Rating Anxiety Scale (SAS) questionnaire, stress was assessed using the Stanford Acute Stress Reaction (SASR) questionnaire, and sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Path analysis was performed to evaluate the relationships between a dependent variable (social capital) and two or more independent variables, using Pearson’s correlation analysis and structural equation modeling (SEM).

Results

Low levels of social capital were associated with increased levels of anxiety and stress, but increased levels of social capital were positively associated with increased quality of sleep. Anxiety was associated with stress and reduced sleep quality, and the combination of anxiety and stress reduced the positive effects of social capital on sleep quality.

Conclusion

During a period of individual self-isolation during the COVID-19 virus epidemic in central China, increased social capital improved sleep quality by reducing anxiety and stress.

Social capital and health: A systematic review of systematic reviews

There are many systematic reviews on social capital (SC) and various health outcomes, but each of these reviews shows one piece of the larger SC and health puzzle. The aim of this research was to systematically review systematic reviews on SC and health, in order to provide an overview of existing evidence and to identify strategies for future research. Nine databases were searched for key words that could fall under the broad umbrella of SC and health outcomes. We screened 4941 titles and abstracts and read 187 reviews before retaining 20 of them. A critical appraisal of each review was conducted. The reviews show there is good evidence to suggest that SC predicts better mental and physical health, and indicators of SC are protective against mortality. At the same time, many reviews also found numerous non-significant and negative relationships that are important to consider. It was unclear whether SC interventions for health were really improving SC, or other aspects of the social environment. Overall, this research shows that evidence on how various aspects of SC affect different health outcomes for different actors remains unclear. Intergroup and lifecourse perspectives could help clarify this link. Future research could benefit from conceptualizing the link between SC and health in a what, who, where, when, why and how framework.

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Social capital predicts better health.

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Other aspects of social capital should also be considered in health research.

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Recommendations on how to improve social capital and health research are made.