Social capital and health: a review of prospective multilevel studies

External Validation of a Machine Learning Model for Schizophrenia Classification

Background and Objective: Excellent generalizability is the precondition for the widespread practical implementation of machine learning models. In our previous study, we developed the schizophrenia classification model (SZ classifier) to identify potential schizophrenia patients in the Japanese population. The SZ classifier has exhibited impressive performance during internal validation. However, ensuring the robustness and generalizability of the SZ classifier requires external validation across independent sample sets. In this study, we aimed to present an external validation of the SZ classifier using outpatient data. Methods: The SZ classifier was trained by using online survey data, which incorporate demographic, health-related, and social comorbidity features. External validation was conducted using an outpatient sample set which is independent from the sample set during the model development phase. The model performance was assessed based on the sensitivity and misclassification rates for schizophrenia, bipolar disorder, and major depression patients. Results: The SZ classifier demonstrated a sensitivity of 0.75 when applied to schizophrenia patients. The misclassification rates were 59% and 55% for bipolar disorder and major depression patients, respectively. Conclusions: The SZ classifier currently encounters challenges in accurately determining the presence or absence of schizophrenia at the individual level. Prior to widespread practical implementation, enhancements are necessary to bolster the accuracy and diminish the misclassification rates. Despite the current limitations of the model, such as poor specificity for certain psychiatric disorders, there is potential for improvement if including multiple types of psychiatric disorders during model development.

Association between social capital and utilization of essential public health services among elderly migrants: a multilevel logistic study based on the 2017 China migrant dynamic survey (CMDS)

BACKGROUND

As the number of elderly migrants in China continues to grow, it is necessary to pay closer attention to their health and health services. Some studies have confirmed that social capital plays a significant role in the utilization of health services. Therefore, an in-depth exploration of the relationship between social capital and the utilization of essential public health services (EPHS) by elderly migrants will not only contribute to improving their overall health but also facilitate a more balanced development of public health service system in China.

METHODS

Based on the cross-sectional data from the 2017 China Migrants Dynamic Survey (CMDS), this study examined the impact of social capital on the utilization of EPHS among elderly migrants. We evaluated social capital at two distinct levels: the individual and the community, and considered two dimensions of social capital: structural social capital (SSC) and cognitive social capital (CSC). The study aimed to delve into the impact of these forms of social capital on the utilization of EPHS among elderly migrants, and whether the migration range moderates this impact by multilevel logistic regression analysis.

RESULTS

A total of 5,728 migrant elderly individuals were selected. The health records establishment rate and health education acceptance rate were approximately 33.0% and 58.6%, respectively. Social capital influenceed the utilization of EPHS among elderly migrants. Specifically, individual-level SSC and CSC have impacts on both the establishment of health records (OR = 1.598, 95%CI 1.366-1.869; OR = 1.705, 95%CI 1.433-2.028) and the acceptance of health education (OR = 1.345, 95%CI 1.154-1.567; OR = 2.297, 95%CI 1.906-2.768) among elderly migrants, while community-level SSC only affected the acceptance of health education (OR = 3.838, 95%CI 1.328-11.097). There were significant differences in individual-level SSC, health records, and health education among different migration range subgroups among elderly migrants. Migration range moderated the effect of social capital on the utilization of EPHS, crossing provinces could weaken the relationship between SSC and health education.

CONCLUSIONS

Social capital is associated with a higher utilization rate of EPHS among elderly migrants. It is necessary to encourage them to actively participate in social activities, strengthen public services and infrastructure construction in the area, and improve their sense of belonging and identity.

Regional Inequalities in Oral Frailty and Social Capital

INTRODUCTION

Oral frailty leads to poor nutritional status, which, in turn, leads to frailty. This cross-sectional study aimed to determine regional differences in the prevalence of oral frailty and to identify factors associated with oral frailty using 3-level multilevel models.

METHODS

This study comprised 165,164 participants aged ≥65 y without long-term care requirements in the Japan Gerontological Evaluation Study. The dependent variable was oral frailty, which was calculated based on age, number of teeth, difficulty in eating tough foods, and choking. The individual-level independent variables included sociodemographics, present illness, social participation, frequency of meeting friends, and social capital. The local district-level independent variable was social capital (n = 1,008) derived from exploratory factor analyses. The municipality-level independent variable was population density (n = 62). Three-level multilevel Poisson regression analysis was performed to calculate the prevalence ratios (PRs).

RESULTS

The prevalence of oral frailty in municipalities ranged from 39.9% to 77.6%. Regarding district-level factors, higher civic participation was significantly associated with a lower probability of oral frailty. At the municipality level, the PR of the rural-agricultural area was 1.17 (95% confidence interval, 1.11-1.23) (reference: metropolitan).

CONCLUSION

These results highlight the usefulness of oral frailty prevention measures in encouraging social participation in rural areas.

KNOWLEDGE TRANSFER STATEMENT

The results of the present study showed regional differences in oral frailty. In particular, rural-agricultural areas show higher prevalence rates of oral frailty than those in metropolitan cities. Promoting measures of social participation among older adults may help prevent oral frailty in rural areas.

The role of health and health systems in promoting social capital, political participation and peace: A narrative review

High levels of violence and insecurity are highly detrimental for societies. United Nations Sustainable Development Goal 16 is advocating for peaceful, accountable and inclusive institutions as one powerful channel to foster global development. Investing in health and health policies can potentially contribute achieving these objectives. After providing a conceptual framework, this article reviews the existing literature on the evidence of the role of health and health systems in promoting social capital and trust, political engagement and participation, and peace that closely relate to the objectives of Sustainable Development Goal 16. We provide evidence of a systematically positive impact of better physical and mental health on social capital, and on political participation, both contributing to the sustainability of inclusive democratic institutions. We also document that health and health systems can help supporting peace, both via the reduction of social inequality and grievances, and by reducing the disruptive effects of epidemic shocks. Overall, the study provides evidence that health and health systems can generate co-benefits outside the health domain by promoting social capital, political participation and peace.

Interdependent culture and older adults' well-being: Health and psychological happiness in Japanese communities

This review article examined perspectives on the well-being and health of older adults in Japan, a nation renowned for its longevity. We emphasized the impact of social capital and social relationships in local communities, considering both individual and societal factors. The prevailing values in Japanese culture tend to foster a sustained and stable form of interdependent happiness among older adults, suggesting that communal support systems play an important role. This article highlights the value of multi-level datasets, such as the Japan Gerontological Evaluation Study (JAGES) dataset, for understanding the influence of social participation on the health and well-being of older adults. A growing body of evidence underscores the central role of social relationships in the health and well-being of older adults.

Relationship between individual-level social capital and non-communicable diseases among adults in Honiara, Solomon Islands

Objective

Solomon Islands is experiencing a change in disease burden, from communicable to non-communicable diseases (NCDs). Urgent action is necessary to reduce the risk of high economic and personal costs associated with NCDs. Social capital refers to the trust, norms and networks that provide social benefits and it is related to health. Despite the strong social bonds among Solomon Islanders, research on the association between social capital and health is lacking. Therefore, this study examines the state of individual social capital and its connection to NCD-related factors in the capital of the Solomon Islands.

Method

In 2019, we conducted a cross-sectional study on 200 adults aged 20-80 years in urban and periurban settlements of the capital. Anthropometric measurements, questionnaires and interview surveys were conducted.

Results

This study identified higher prevalence of obesity, blood glucose levels and blood pressure compared with previous studies in both study areas. Multiple linear regression analysis reported that in the periurban area, cognitive social capital was negatively associated with body mass index (BMI) (p=0.005), whereas joining a group was positively associated with BMI (p=0.01). In the urban area, social support from individuals and cognitive social capital were negatively associated with blood glucose levels (p=0.03, p=0.007). Moreover, cognitive social capital was negatively associated with systolic blood pressure and diastolic blood pressure (p=0.03, p=0.006). However, joining citizenship activity was positively associated with glucose levels (p=0.04).

Conclusion

This study observed that participants living with people of the same linguistic group had high trust in each other. Furthermore, higher cognitive social capital and social support may reduce the risk of NCD-related factors, unlike joining group activities.

Public health implications

Findings suggest that health professionals should consider the influence of social capital on health promotion and interventions to be effective.

Are Depression and Anxiety Underdiagnosed in Socially Vulnerable Patients With Inflammatory Bowel Disease?

INTRODUCTION

Depression and anxiety are highly prevalent among individuals with inflammatory bowel disease (IBD); however, little is understood about how social determinants of health (SDOH) may impact mental health diagnoses in this population. The social vulnerability index (SVI) is a publicly available tool that can be used to study SDOH in IBD patients.

METHODS

Home addresses from a retrospective cohort of IBD patients at a single center were used to geocode patients to their individual census tract and corresponding SVI. We used multivariable logistic regression to examine the relationship between SVI and comorbid mental health diagnoses in patients with IBD. Secondarily, data from standardized health questionnaires were then used to determine if patients were adequately screened for depression and anxiety.

RESULTS

In all, 9644 patients were included; 18% had a diagnosis of depression, 21% anxiety, and 32% had a composite of "any mental health diagnosis." Depression (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.02-1.56) but not anxiety (OR, 0.87; 95% CI, 0.71-1.06) nor "any mental health diagnosis" (OR, 1.09; 95% CI, 0.92-1.30) was associated with higher levels of social vulnerability. However, overall rates of screening for depression and anxiety were low (15% and 8%, respectively), with the lowest screening rates among the most socially vulnerable (depression 8.2%, anxiety 6.3%).

CONCLUSIONS

Disparities in the diagnoses of depression and anxiety for socially vulnerable patients with IBD exist. Awareness of these inequities is the first step toward developing interventions to improve mental health screening, eliminate barriers and bias, and promote referrals for appropriate mental health management.

Cognitive social capital as a health-enabling factor for STI testing among young men in Stockholm, Sweden: A cross-sectional population-based study

Objective

To assess whether different forms of cognitive social capital increased the relative probability of testing for sexually transmitted infections (STIs) among young men living in Stockholm, Sweden.

Methods

A population-based cross-sectional study was conducted in 2017 with men aged 20-29 years living in Stockholm County, Sweden (n = 523). The main outcome was STI testing patterns (never tested, tested only within a12-monthperiod, tested only beyond a12-monthperiod, repeatedly tested). The main exposure were two forms of cognitive social capital: social support (having received help, having someone to share inner feelings with) and institutionalized trust (in school, healthcare, media). Data were analyzed using weighted multivariable multinomial logistic regression to obtain adjusted weighted relative probability ratio (aRPR).

Results

After adjusting for confounding factors, receiving help (aRPR: 5.2, 95% CI: 1.7-16.2) and having someone to share inner feelings with (aRPR: 3.1, 95% CI: 1.2-7.7) increased the relative probabilities of young men testing for STIs, but only for those testing beyond a 12-month period. Trust in media increased the relative probability of STI testing for those testing only within a 12-month period (aRPR: 2.6, 95% CI: 1.1-6.1) and for those testing repeatedly (aRPR: 3.6, 95% CI: 1.5-8.8).

Conclusion

Young men in Stockholm County exhibit distinct STI testing patterns. Social support and trust in media were factors that increased the probability of being tested for STIs, with this effect varying according to the young men's STI testing pattern. Further studies are required to explore how trust in media might promote STI testing in this population.

Number of Siblings and Social Capital Among Parents Rearing Schoolchildren: Results From the A-CHILD Study

BACKGROUND

Having siblings may foster sociality; however, little is known about whether sibling number determines social capital, the resources obtained through social networks. We examined the association between sibling number and social capital among Japanese parents rearing schoolchildren.

METHODS

We used cross-sectional data from the 2018 and 2019 Adachi Child Health Impact of Living Difficulty (A-CHILD) study, targeting all primary and junior high school students and their parents in Adachi, Tokyo, Japan (n = 8,082). Individual-level social capital was evaluated by assessing caregivers' social cohesion, social support, and group affiliation. All analyses were adjusted for age and sex.

RESULTS

An inverse U-shaped association was found between sibling number and social capital. Adults who grew up with one or two, but not three or more siblings had greater social support (coefficient = 0.23; 95% confidence interval [CI], 0.06-0.40 and coefficient = 0.46; 95% CI, 0.29-0.64, respectively) than those who grew up as an only child, after covariate adjustment. Adults who grew up with two or three, but not one or four or more siblings had greater group affiliation (coefficient = 0.09; 95% CI, 0.03-0.16 and coefficient = 0.09; 95% CI, 0.01-0.18, respectively) than those who grew up as an only child, after covariate adjustment. Sibling number was not associated with social cohesion.

CONCLUSION

Growing up with one to three siblings was associated with higher social capital in adulthood than being an only child. Having siblings may provide an opportunity to foster social capital.

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.

Effects of social activity participation and trust in the community on the transition of frailty classification in late-stage older adults: a 4-year prospective cohort study

OBJECTIVES

In Japan, frailty is a major risk factor for requiring long-term care, especially among older adults aged 75 years or older (ie, late-stage older adults). Both physical and social factors (eg, social activities, social support and community trust) are protective factors against frailty. However, few longitudinal studies have examined reversible change or stage improvement in frailty. This study investigated social activity participation and trust in the community that may affect the transition of late-stage older adults' frailty status.

DESIGN

A mail-based survey was used to analyse the improvement or deterioration of frailty status (categorised as frailty, pre-frailty and robust) over a 4-year period. Binomial and multinomial logistic regression analyses were conducted; the transition in frailty classification was the dependent variable, while a change in social activity participation and the degree of trust in the community were the independent variables.

SETTING

Ikoma City, Nara Prefecture, Japan.

PARTICIPANTS

4249 community-dwelling older adults, aged ≥75 years, not requiring long-term care who completed a follow-up questionnaire from April to May 2016.

RESULTS

Adjusting for confounding factors, no significant social factors were detected regarding improvement in frailty. However, an increase in exercise-based social participation was an improvement factor in the pre-frailty group (OR 2.43 (95% CI 1.08 to 5.45)). Conversely, a decrease in community-based social activity was a risk factor in the deterioration from pre-frailty to frailty (OR 0.46 (95% CI 0.22 to 0.93)). In the robust group, increased community-based social activity (OR 1.38 (95% CI 1.00 to 1.90)) was a protective factor against frailty, whereas decreased community trust was a risk factor (OR 1.87 (95% CI 1.38 to 2.52)).

CONCLUSIONS

No social factors had a significant influence on the improvement of frailty in late-stage older adults. However, the promotion of exercise-based social participation was found to be important for improvement in the pre-frailty state.

TRIAL REGISTRATION NUMBER

UMIN000025621.

Community-Level Social Support to Mitigate the Impact of Combined Frailty and Multimorbidity on Psychological Distress Among Rural Chinese Older Adults During the COVID-19 Pandemic: Multilevel Modeling Study

BACKGROUND

Accumulating research provides evidence that the psychological health of older people deteriorated from before to during the COVID-19 pandemic. Unlike robust individuals, coexisting frailty and multimorbidity expose older adults to more complicated and wide-ranging stressors. Community-level social support (CSS) is also an important impetus for age-friendly interventions, and it is 1 of the components of social capital that is seen as an ecological-level property. To date, we have not found research that examines whether CSS buffered the adverse impacts of combined frailty and multimorbidity on psychological distress in a rural setting during COVID-19 in China.

OBJECTIVE

This study explores the combined effect of frailty and multimorbidity on psychological distress in rural Chinese older adults during the COVID-19 pandemic and examines whether CSS would buffer the aforementioned association.

METHODS

Data used in this study were extracted from 2 waves of the Shandong Rural Elderly Health Cohort (SREHC), and the final analytic sample included 2785 respondents who participated in both baseline and follow-up surveys. Multilevel linear mixed effects models were used to quantify the strength of the longitudinal association between frailty and multimorbidity combinations and psychological distress using 2 waves of data for each participant, and then, cross-level interactions between CSS and combined frailty and multimorbidity were included to test whether CSS would buffer the adverse impact of coexisting frailty and multimorbidity on psychological distress.

RESULTS

Frail older adults with multimorbidity reported the most psychological distress compared to individuals with only 1 or none of the conditions (β=.68, 95% CI 0.60-0.77, P<.001), and baseline coexisting frailty and multimorbidity predicted the most psychological distress during the COVID-19 pandemic (β=.32, 95% CI 0.22-0.43, P<.001). Further, CSS moderated the aforementioned association (β=-.16, 95% CI -0.23 to -0.09, P<.001), and increased CSS buffered the adverse effect of coexisting frailty and multimorbidity on psychological distress during the COVID-19 pandemic (β=-.11, 95% CI -0.22 to -0.01, P=.035).

CONCLUSIONS

Our findings suggest that more public health and clinical attention should be paid to psychological distress among multimorbid older adults with frailty when facing public health emergencies. This research also suggests that community-level interventions prioritizing social support mechanisms, specifically improving the average levels of social support within communities, may be an effective approach to alleviate psychological distress for rural older adults who concurrently manifest frailty and multimorbidity.

Associations of Cooking Skill with Social Relationships and Social Capital among Older Men and Women in Japan: Results from the JAGES

The health benefits of social relationships and social capital are well known. However, little research has examined the determinants of social relationships and social capital. We examined whether cooking skill was associated with social relationships and social capital in older Japanese people. We used 2016 Japan Gerontological Evaluation Study data on a population-based sample of men and women aged ≥ 65 years (n = 21,061). Cooking skill was assessed using a scale with good validity. Social relationships were evaluated by assessing neighborhood ties, frequency and number of meetings with friends, and frequent meals with friends. Individual-level social capital was evaluated by assessing civic participation, social cohesion, and reciprocity. Among women, high-level cooking skill was positively associated with all components of social relationships and social capital. Women with high-level cooking skill were 2.27 times (95% CI: 1.77-2.91) more likely to have high levels of neighborhood ties and 1.65 (95% CI: 1.20-2.27) times more likely to eat with friends, compared with those with middle/low-level cooking skill. Cooking skills explained 26.2% of the gender difference in social relationships. Improving cooking skills may be key to boosting social relationships and social capital, which would prevent social isolation.

Building social capital with elders' leadership through a community hub "Ibasho" in the Philippines and Nepal

We quantitatively study the Ibasho project-a unique, innovative community-based project that involves co-creating a building as a social hub. Ibasho's decision-making undertakes a bottom-up approach, differentiating itself from the conventional top-down decision-making process. Using sui generis data, we find that Ibasho projects in the Philippines and Nepal contributed to enhancing social capital among elders in both cases. Yet there are differences between the two communities. In the Philippines, participation in Ibasho increased the number of a participant's friends, or "strong ties," indicating that it is on the intensive margin of human relationships. In contrast, joining Nepal's Ibasho broadened weak ties rather than strong ones. This contrast may stem from the difference in pre-existing social and built infrastructures in the two communities, which were strengthened through the building-human interactions.

Employment Outcomes for People With Autism Spectrum Disorder: A Theory Mapping of the Evidence

Background:People with autism spectrum disorder (ASD) are three to four times less largely to be with employment compared to neurotypical others. Theory based studies may provide helpful indicators for the design and implementation of employment supports for people with ASD.

Objective:This critical review examined the extent of the evidence for theory in studies on employment outcomes for people with ASD and taking into account social inequality. For the evidence, 35 studies were selected for review if they were published in the period 2000–2016 and assessed for the association between work participation with ASD applying descriptive survey or quasi-experimental design.

Methods:Studies were examined for use of any theory, including four predetermined theory types: social liminality, psychosocial, behavioral, and structural-infrastructural. They were also content-analyzed to determine if they cited any evidence of social inequality influences on employment outcomes with ASD.

Findings:Results indicated that none of the studies explicitly applied and tested a theory on work participation with ASD. Rather, the majority of the studies were implicitly framed on predominantly behavioral type theory with minor elements of workplace psychosocial support theory-oriented interventions. Regard of structural-infrastructural type theory addressing social inequality is incidentally addressed by a few of the studies (n= 3) that examined family income status influences.

Conclusion:In conclusion, extant studies on the association between employment outcomes and ASD are seriously limited in their explanatory value by a lack of theoretical grounding. They also neglect influences of antecedent social inequality in employment outcomes with ASD. Future studies should apply specific theory to questions on employment outcomes with ASD to provide usable evidence to inform employment support policy instruments and interventions for people with ASD.

Disentangling the complexities of modelling when high social capital contributes to indicating good health

The association between social capital and health is under continuous research. Based both on theoretical frameworks and previous empirical studies, the magnitude and sign of this association are ambiguous. Our main goal is to empirically investigate under which conditions is social capital relevant to obtain good or very good self-rated health, while acknowledging that different paths can lead to this outcome. The data used in this study come from the European Social Survey 2018 (47,423 observations for 29 European countries) and fuzzy-set qualitative comparative analysis was adopted. Our results show that neither the presence of social capital (as measured in this study - 'Generalised trust' and/or 'Informal social connections'), nor its absence, is a necessary condition for good or very good self-rated health. While not being necessary, there are contexts where social capital is relevant for health and, whenever it is present, it positively contributes to good or very good self-rated health. However, our results further suggest that social capital alone is not sufficient to be healthy. The relevance of social capital is contingent on the presence, or absence, of other conditions. What works for some individuals does not work for others. And for any given individual, rarely there is only one way to be healthy. Additionally, our findings suggest that the impact of belonging to a minority ethnic group on health might be stronger than what has been hitherto recognised.

Are trajectories of social isolation from childhood to mid-adulthood associated with adult depression or suicide outcomes

PURPOSE

Social isolation has been shown to have negative effects on mental health outcomes though little is known about trajectories across the life course. We examined the relationship between trajectory groups and selected mental health outcomes in mid-adulthood.

METHODS

We previously created a typology of social isolation based on onset during the life course and persistence into adulthood, using group-based trajectory analysis of longitudinal data from a New Zealand birth cohort. The typology comprises four groups: 'never-isolated', 'adult-only', 'child-only', and 'persistent (child-adult) isolation'. We undertook logistic regression analyses of three mental health outcomes with trajectory group as the predictor, adjusting for sex and a range of familial and child-behavioural factors.

RESULTS

Lifetime suicide attempt, and depression and suicide ideation in mid-adulthood were each associated with adult-only but not child-only social isolation. Depression in mid-adulthood was also associated with persistent child-adult social isolation.

CONCLUSION

Although our findings are associational and not causal, they indicate that interrupting persistent social isolation may help to prevent adult depression whereas halting adult social isolation may ameliorate both depression and suicide outcomes.

Physical, Psychiatric, and Social Comorbidities of Individuals with Schizophrenia Living in the Community in Japan

The physical, psychiatric, and social comorbidities interfere with the everyday activities of community-dwelling individuals with schizophrenia and increase the risk of their readmission. However, these comorbidities have not been investigated comprehensively in Japan. We conducted a self-reported internet survey in February 2022 to identify individuals aged 20-75 years with and without schizophrenia using a prevalence case-control study. The survey compared physical comorbidities such as being overweight, hypertension, and diabetes; psychiatric comorbidities such as depressive symptoms and sleep disturbances; social comorbidities such as employment status, household income, and social support between participants with and without schizophrenia. A total of 223 participants with schizophrenia and 1776 participants without schizophrenia were identified. Participants with schizophrenia were more likely to be overweight and had a higher prevalence of hypertension, diabetes, and dyslipidemia than participants without schizophrenia. Additionally, depressive symptoms, unemployment, and non-regular employment were more prevalent in participants with schizophrenia than those without schizophrenia. These results highlight the necessity of comprehensive support and interventions addressing physical, psychiatric, and social comorbidities in individuals with schizophrenia in the community. In conclusion, effective interventions for managing comorbidities in individuals with schizophrenia are necessary to enable them to continue to live in the community.

Promoting a culture of reciprocity to build social capital in advanced practice nursing students

ABSTRACT

A virtual activity integrating the evidence-based Reciprocity Ring model was designed to enhance confidence and skills for building social capital for advanced practice registered nursing (APRN) students. The central objective of the activity was to reduce the stigma of asking for help by providing a framework for the balanced exchange of favors, thus supporting new connections and feelings of trust among APRN students. Students from two APRN practice tracks ( N = 44) participated in a virtual Reciprocity Ring activity where they could post and respond to requests for help. On average, students posted 2.5 requests and received three offers for assistance; 220 connections were made overall with the major theme requests related to stress management. A retrospective survey was administered at the conclusion of the activity. Questions inquired about student confidence before, and then after, the activity for identifying resources, providing help to others, finding personal support when needed, accessing resources related to academic success, and finding solutions to problems. Student mean confidence scores were significantly higher after the activity compared with mean confidence scores before the activity ( p = .01). Additionally, the effect size was large (Cohen d = 0.89). Therefore, we suggest that integrating Reciprocity Ring exercises into nursing curricula and practice can be a useful tool for promoting skills related to productive help-seeking that will support APRN students' academic and professional success.

Developing a Theory of Community Caring for Public Health Nursing

Nursing theories focus on individual and community care and human relationships in unique contexts. One of these contexts is the community in which a theory-based systematic nursing practice process is warranted. This article describes a theory of Community Caring for Public Health Nursing (CCPHN), which is grounded in four nursing metaparadigms by Fawcett: persons, environment, health, and nursing. This theory has three assumptions: (1) community caring fosters care demonstrations in nursing, (2) caring communities comprise members with community attachments united by their common values rather than rigid customs, and (3) community caring is expressed competently in mutual-care practices. From these assumptions, a nursing perspective supporting the community caring process is exhibited as the expression of caring by public health nurses toward supportive and promotive nursing processes that enhance a caring community. Nurses play critical roles in leading the establishment of caring communities. In future research, it is critical to verify whether building a caring community by public health nursing practices based on this theory of CCPHN contributes to the health and well-being of the people in the community.

Individual-level social capital is associated with depressive symptoms among middle-aged community dwellers in rural Vietnam: a cross-sectional study

OBJECTIVES

There has been comparatively little research on the association between social capital and depressive symptoms in low- and middle-income countries. To address this deficit this study examined the association among middle-aged adults in rural Vietnam.

DESIGN

A cross-sectional study.

SETTING

Data came from the baseline survey of the Khánh Hòa Cardiovascular Study, which is an ongoing prospective cohort study aiming to elucidate the determinants of cardiovascular diseases.

PARTICIPANTS

A total of 3000 people aged 40-60 years old residing in rural communes in Khánh Hòa province, Vietnam.

EXPOSURE OF INTEREST

Cognitive social capital (ie, low, middle and high) and structural social capital (in terms of social participation; yes or no) were assessed via a questionnaire.

PRIMARY OUTCOME MEASURE

Depressive symptoms were assessed with the 11-item Center for Epidemiologic Studies Depression Scale.

RESULTS

A robust Poisson regression model revealed that adults in the highest versus lowest cognitive social capital tertile had a 61% lower prevalence of depressive symptoms (prevalence ratio (PR)=0.39, 95% CI=0.31 to 0.49). Individuals with higher structural social capital were also significantly less likely to experience depressive symptoms (PR=0.74, 95% CI=0.61 to 0.90).

CONCLUSION

In a cohort of 3000 middle-aged rural residents in Vietnam, both cognitive and structural social capital assessed at the individual level were inversely associated with the prevalence of depressive symptoms.

Community social capital and the health-related quality of life among empty-nest elderly in western China: moderating effect of living arrangements

BACKGROUND

At present, the empty nest phenomenon is becoming more and more serious in the world, especially in China, and its health problems deserve attention. Therefore, the purpose of this study is to explore the impact of community social capital on the health-related quality of life of empty-nest elderly.

METHODS

The study used data collected from a survey study conducted between 2018 and 2019 in Sichuan province, China, with 638 empty-nest elderly meeting our criteria. SF-12 scale and self-made social capital scale were used to evaluate the health-related quality of life and community social capital of empty-nest elderly. Through descriptive statistical analysis, bivariate analysis and hierarchical multiple regression model, this study analyzes the relationship between community social capital and health-related quality of life of empty-nest elderly. Considering the role of living arrangements, this study further uses the simple effect analysis method to explore the moderating role of living arrangements.

RESULTS

After controlling the relevant variables, the cognitive social capital (CSC) of empty-nest elderly had a positive relationship with the physical health summary (PCS) (β = 0.188, p＜0.001) and mental health summary (MCS) (β = 0.205, p＜0.001). No effect of structural social capital on quality of life was found as a result. Living arrangements played a moderation effect on the relationship between CSC and MCS (β=-2.018, p＜0.05). The MCS score of high CSC group (55.516 ± 0.757) was significantly higher than that of low CSC group (49.383 ± 0.722).

CONCLUSION

The results suggest empty-nest elderly has poorer physical health and weaker structural social capital, while the cognitive social capital has a greater positive impact on their quality of life. Targeted interventions to enhance community social capital may be beneficial to improve health status of this vulnerable population.

Relationship of social isolation with mental distress among older Korean Americans: The moderating role of social cohesion

Social isolation has been associated with poor mental health outcomes, particularly for older immigrants who do not have a protective social environment. The purpose of this study was to investigate the relationship of social isolation (living alone, marginal family ties and marginal friend ties) with mental distress and to examine the moderating role of social cohesion (family cohesion and community cohesion). We hypothesised that social isolation and social cohesion would be directly associated with mental distress and that social cohesion would buffer the influence of social isolation on mental distress. Data were drawn from the Study of Older Korean Americans (SOKA), which included 2150 older Korean Americans aged 60 or over in multiple areas, collected during 2017-2018. A series of hierarchical regression models of mental distress examined the direct and interactive role of social isolation and social cohesion. Approximately one-third of the sample lived alone, 20% had marginal family ties and 27% had marginal friend ties. All three indicators of social isolation had a significant direct effect on mental health; however, living alone lost its statistical significance with the inclusion of social cohesion variables. Both indicators of family and community cohesion were significantly associated with lower levels of mental distress. In addition, family cohesion buffered the negative effects of marginal ties to family and friends on mental distress. The significant role of a positive social environment must be considered when addressing the needs of older immigrants who are socially isolated.

Race-related differences in the economic, healthcare-access, and psychological impact of COVID-19: personal resources associated with resilience

Background

The impact of the coronavirus disease 2019 (COVID) is worse among those with fewer financial resources, in jobs not amenable to remote work, and in denser living conditions. People of color are more likely to be among these vulnerable groups. Although race itself is a social construction and not based on underlying genetic/biological differences, this study investigated race/ethnicity differences in the negative repercussions of COVID and in the benefits of psychological and social resources.

Methods

This cross-sectional, web-based study (n = 4817) was administered to a heterogeneous United States sample in Spring/Summer 2020. Information was gathered on the following COVID-specific variables: Infection Status, Coping with Lockdown, Social Support, Post-traumatic Growth, Interpersonal Conflict, Worry about Self, Financial Impact on Family, Lack of Money, Inadequate Access to Healthcare, and Housing Instability. Resilience was operationalized as the ability to maintain a sense of wellness in the face of the pandemic, using the DeltaQuest Wellness measure. Multivariate linear regression (adjusting for demographics) and propensity-matched cohort analysis (matched on demographics) evaluated the impact of COVID-specific variables on Wellness in separate models for Whites and Non-Whites.

Findings

Both sets of models retained the same COVID-specific variables and explained about half of the variance in wellness. Coping with Lockdown, Social Support, and Post-traumatic Growth were associated with higher levels of Wellness in both Whites and Non-Whites, while Interpersonal Conflict and Worry about Self were associated with lower levels of Wellness. While these associations are similar, Non-Whites reported worse levels of some positive resources (e.g., social support) and more challenging levels of negative stressors (e.g., interpersonal, worry, financial). Non-Whites also reported much higher levels of post-traumatic growth.

Conclusion

COVID was a source of worry and even conflict, but also unlocked people’s resources in use of health-enhancing behavioral strategies, social support, and renewed gratitude for sources of personal meaning and value. The similar relationships between Whites and Non-Whites on wellness and COVID-specific stressors across racial groups underscore that race is a social construction, not a biological fact. Focusing on a renewed appreciation for sources of personal meaning, and particularly faith, seemed to buffer much of the COVID-related stress for Non-Whites.

Supplementary Information

The online version contains supplementary material available at 10.1186/s41687-022-00514-2.

Effects of intergenerational contact on social capital in community-dwelling adults aged 25–84 years: a non-randomized community-based intervention

Background

Accumulating social capital in urban areas is essential to improve community health. Previous studies suggested that intergenerational contact may be effective for enhancing social capital. However, no study has examined the effect of intergenerational contact on social capital through a population-based evaluation. This study aimed to investigate the effects of a community-based intervention to increase the frequency of intergenerational contact on social capital among adults aged 25–84 years.

Methods

This study used a non-randomized controlled trial design to conduct a community-based intervention (from March 2016 to March 2019). The study area was Tama ward, Kawasaki city, Kanagawa, Japan. The area comprises five districts; one district was assigned as the intervention group and the other four districts as the control group. We provided the intervention to residents in the intervention group. The intervention comprised three phases: Phase 1 was the preparation term (organizing the project committee); Phase 2 was the implementation term (trained volunteer staff members, conducted the intergenerational greeting campaign, and held intergenerational contact events); and Phase 3 was the transition term (surrendering the lead role of the project to the city hall field workers). In the control group, field workers provided public health services as usual. We conducted mail surveys in September 2016 and November 2018 to assess the effects of the intervention on social capital during Phase 2. Eligible participants were randomly selected from community-dwelling adults aged 25–84 years according to age (10,620 control group individuals and 4479 intervention group individuals). We evaluated social trust, norm of reciprocity, and social support as outcome variables.

Results

In total, 2518 participants completed both surveys and were analyzed (control group: 1727; intervention group: 791). We found that social trust (coefficient = 0.065; 95% confidence interval [CI]: 0.006, 0.125) and norm of reciprocity (coefficient = 0.084; 95% CI: 0.020, 0.149) positively changed in the intervention group compared with the control group.

Conclusions

This community-based intervention may contribute to sustaining and improving social capital among community-dwelling adults.

Trial registration: UMIN000046769 (UMIN-CTR); first registered on January 28, 2022 (retrospectively registered).

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14205-6.

Exploring the Role of Community Social Capital in Not-for-profit Hospitals’ Decision to Engage Community Partners in the Community Health Needs Assessment Process

Not-for-profit hospitals (NFPs) frequently partner with community organizations to conduct internal revenue service-mandated community health needs assessment (CHNA), yet little is known about the number of partnerships that hospitals enter into for this purpose. This article uses “American Hospital Associations’ 2020 Annual Survey” data to examine hospital-community partnerships around the CHNA and the role that community social capital defined as, “the networks that cross various professional, political and social boundaries to reflect community level trust needed to pursue shared objectives” plays in hospitals’ choices to partner with community organizations for the CHNA. After controlling for a set of hospital, community, and state characteristics, we found that hospitals present in communities with higher social capital were likely to partner with more community organizations to conduct CHNA. Greater social capital may thus promote community health by facilitating the partnerships NFPs develop with community organizations to conduct the CHNA.

The Association Between Family Social Capital and Female Entrepreneurship

Background

Following the new line of research on Family Social Capital, this work focused on the adaptation and application of the Family Social Capital questionnaire to studying the association between Family Social Capital (FSC) and the intention of Russian females to start a business.

Objective

This study investigated the relationship between three dimensions of Family Social Capital (Structural, Cognitive, and Bonding) and components of Entrepreneurial Intention (EI) operationalized via Ajzen's Theory of Planned Behavior among females in Russia.

Design

Online survey participants (N=222) were assessed with 1) an adapted version of the FSC questionnaire (Álvarez et al., 2019); and 2) the EI questionnaire previously verified on a large Russian sample within Social Capital research (Tatarko & Schmidt, 2015).

Results

The study confirmed the positive relationship of EI with two dimensions of FSC: Structural FSC (namely, the frequency of time spent with significant family members) and Bonding FSC (namely, family resources that can be activated in various life situations). Both positive relationships are mediated by Perceived Behavioral Control (PBC) - one's feeling of being capable to act upon one's intentions. The third dimension of FSC - Cognitive FSC (namely, family cohesion and intra-family trust) - showed no association with the intention to start a business among Russian females.

Conclusion

Russian women with higher levels of EI demonstrated higher investment in family time with significant family members (Structural FSC) and reported exposure to larger intra-family resources (Bonding FSC). These two factors, even though not strengthened with a supportive and trustworthy family atmosphere (Cognitive FSC), provided the sense of confidence and control, which empowered the women with the courage to take preliminary actions with the intention of starting their own businesses.

Adaptation of the personal social capital brief scale for the measurement of the offline and online social capital in Italy

Social Capital refers to the resources associated with durable and trustworthy social connections. Social Capital can be developed through offline and online relationships. It can be distinguished between cognitive Social Capital (perception of trustworthiness, reciprocity, and support) and structural Social Capital (density of social networks and membership, and participation in groups and associations). It can also be distinguished between bonding Social Capital (resources associated with informal networks; i.e., neighbors, friends, colleagues) and bridging Social Capital (resources associated with formal networks; i.e., community service, cultural, religious or political groups/associations). The different forms and dimensions of Social Capital may have distinct effects on health outcomes and self-rated health. Therefore, public health researchers need valid and reliable instruments to investigate Social Capital. However, valid instruments including the measurement of online Social Capital are not available. The Personal Social Capital Scale aims to assess bonding and bridging Social Capital by means of cognitive and structural items. In the present investigation, three studies were carried out (N = 1149) to adapt the Personal Social Capital Scale to develop the Personal On-Offline Social Capital Brief Scale, a brief scale for measuring online and offline bonding and bridging Social Capital in Italy. Factorial structure and convergent/divergent validity in relation to scales measuring constructs with different patterns of relationships with bonding and bridging Social Capital (i.e., social support and stress; sense of community and health) were also investigated. Overall, these studies provide evidence of reliability and validity related to the internal structure of the Personal On-Offline Social Capital Brief Scale in measuring online and offline bonding and bridging Social Capital and discriminating them from similar constructs. This scale is a useful instrument for planning public health interventions.

Comparing proxy and formal measures of county-level racial isolation in race-stratified models: A case study in Tennessee, 2005-2014

The purpose of this study was to understand whether proxy measures of county-level racial isolation (based on racial compositions) would yield similar results as the formal measures of county-level racial isolation (derived from the isolation index of P*). White (non-Hispanic White) and Black (non-Hispanic Black or African American) women residing in the State of Tennessee, USA, and diagnosed with a non-invasive or invasive breast cancer were considered as the study population. Individual-level variables were obtained from the Tennessee Cancer Registry data for the period between 2005 and 2014 (46,983 White women and 7,967 Black women), and county-level variables were obtained from the American Community Survey data for the periods of 2005–2009 and 2010–2014 (95 counties). Using breast cancer condition (non-invasive versus invasive) as the binary outcome of interest, a series of multilevel logistic regression analyses was conducted separately by race. After controlling for individual-level socio-demographic characteristics, proxy measure of county-level White isolation and county-level median household income were not associated with breast cancer condition, but formal measure of county-level White isolation was associated with lower odds of having an invasive breast cancer among White women. On the other hand, neither proxy nor formal measure of county-level Black isolation was associated with breast cancer condition, but county-level median household income was associated with lower odds of having an invasive breast cancer among Black women. These results suggest that using a proxy and formal measure of racial isolation may yield different results, and race-stratified analyses would be helpful for understanding a differential effect of racial isolation on Whites and Blacks. While more detailed examinations are needed in future studies, possible explanations on and reasons behind these findings are discussed.

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County-level White isolation may have a protective effect on White women.

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County-level Black isolation may have no effect on Black women.

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County-level racial isolation may have differential effects on races.

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Measurement may matters for a study of residential segregation and health.

Combined psychosocial work factors and risk of long-term sickness absence in the general working population: Prospective cohort with register follow-up among 69 371 workers

OBJECTIVE

This study aimed to investigate the importance of combined psychosocial work factors for the risk of long-term sickness absence (LTSA).

METHODS

We followed 69 371 employees in the general working population (Work Environment and Health in Denmark study 2012-2018), without LTSA during the preceding year, for up to two years in the Danish Register for Evaluation of Marginalization. Using k-means cluster analyses and weighted Cox-regression controlling for age, gender, survey year, education, health-behaviors, and physical work demands, we determined the prospective association of 11 identified clusters - based on the combination of nine psychosocial work factors (recognition, quantitative demands, work pace, emotional demands, influence, justice, role clarity, role conflicts, and support from colleagues) - with the risk of LTSA.

RESULTS

During 124 045 person-years of follow-up, 6197 employees developed LTSA (weighted 8.5%). Using the cluster with the most favorable psychosocial scores as reference, clusters scoring poorly on several combined psychosocial factors had increased risk of LTSA. The cluster scoring poor on all nine psychosocial factors exhibited the highest risk [hazard ratio (HR) 1.68, 95% confidence interval (CI) 1.45-1.94]. Scoring poorly on one or two psychosocial factors did not increase the risk of LTSA when combined with favorable scores on the other psychosocial factors. Interaction analyses showed that gender, but not age and education, modified the association between cluster and LTSA.

CONCLUSION

Scoring poorly on several combined psychosocial work factors plays an important role in the risk of LTSA. Scoring favorably on several psychosocial factors outweighed the potentially adverse effects of scoring poorly on one or two factors.

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.

Did States With More Social Capital Pre-pandemic Offer Mental Health Protection During the COVID-19 Pandemic? A Cross-Sectional View

Background

Social capital is a well-known health determinant with both relational and geographic aspects. It can help mitigate adverse events and has been shown to impact behaviors and responses during the COVID-19 pandemic. Mental health has declined during the COVID-19 pandemic, and social capital, may serve to buffer those declines.

Methods

Building from this, we assessed whether pre-pandemic social capital and contemporaneous social policy, which included indicators of social trust, civic participation, and presence of mask mandates, affected pandemic mental health, measured as the percent of the population experiencing symptoms of depression and anxiety at the state level.

Results

Generalized social trust and state mask mandates were significantly associated with lower levels of depression and anxiety. Conversely, states with greater civic engagement prior to the pandemic experienced more anxiety and depression.

Conclusions

Findings suggest that existing social capital, particularly social trust, may protect against anxiety and depression and contribute to community resilience during times of adversity. States should invest in policies and programs that increase social trust.

Les attendus d’une approche d’économie comportementale pour les décisions individuelles face à la pandémie de COVID-19 : succès et déceptions

Dans le cadre du premier appel à projet « Flash-COVID-19 » de l’Agence nationale de la recherche, nous avons mobilisé des méthodes récentes de l’économie comportementale afin de mieux comprendre les décisions des individus face à la crise sanitaire due à la pandémie de COVID-19 (coronavirus disease 2019) et d’identifier les paramètres pouvant influencer le respect des mesures sanitaires. Cet article introduit brièvement l’économie comportementale, présente un compte rendu des attendus du projet CONFINOBS (Observance et observation des mesures barrières et du confinement : une approche d’économie comportementale) et de ses méthodes, puis il propose une synthèse des résultats obtenus.

Social Capital and Lifestyle Impacts on Mental Health in University Students in Colombia: An Observational Study

Introduction

For young adults, the first year of higher education represents a transition period into adulthood associated with an increased risk of developing depression, anxiety, and stress, contributing to deteriorating physical and mental health. The present study aimed to analyze the relationship between depressive symptoms and social capital and lifestyles among Colombian university students.

Methods

In 2020, a longitudinal repeated measures study was conducted on first year students at Universidad de los Andes in Bogota, Colombia. The study was conceptualized and approved by the university before the COVID-19 pandemic appeared. Each student completed a self-administered questionnaire including questions on sociodemographic characteristics, depressive symptoms, perceived stress, social capital, and lifestyles. The study's pilot was conducted in November 2019, and the two measurement points were in January 2020 (wave 1, before the COVID-19 pandemic was declared) and in August 2020 (wave 2, during the COVID-19 pandemic). A binary logistic regression analysis was performed to assess the relationship between depressive symptoms, perceived stress, social capital, and lifestyles.

Findings

A total of 609 first year students (response rate = 58.11%) participated in wave 1, and 42% of the participants showed signs of clinically relevant depressive symptoms. In wave 2, despite the difficulties encountered in collecting data due to the COVID-19 pandemic, 216 students from wave 1 participated (35.47%). An increase in a sedentary lifestyle was observed (31.49%). We found that cognitive and behavioral social capital levels decreased by 12.03 and 24.54%, respectively. In addition, we observed a 6.5% increase in students with clinically relevant depressive symptoms compared to wave 1. A low level of behavioral [OR: 1.88; 95% CI (1.16, 3.04)] social capital was associated with clinically relevant depressive symptoms.

Conclusion

The health of university students continues to be a public health concern. The study suggests that social capital may play an important role in preventing depressive symptoms. Therefore, universities should put effort into programs that bring students together and promote the creation of social capital.

Mediating role of social capital in the association between socioeconomic status and childcare practices in rural Malawi: a cross-sectional study

OBJECTIVES

Childcare practices determine the child nutritional outcomes, but resources for good practices are unequally distributed across socioeconomic status (SES). This study first examined the associations between social capital and childcare practices separately across SES groups. It then investigated the mediation effect of social capital between SES and childcare practices.

DESIGN

This cross-sectional study used the Short Version of the Adapted Social Capital Assessment Tool to measure structural social capital (group membership, social support and citizenship activities) and cognitive social capital of mothers. Data were analysed using multilevel logistic regressions with random intercepts and mediation modellings.

SETTING

Rural Lilongwe, Malawi.

PARTICIPANTS

A total of 320 mothers with a child aged between 12 months and 23 months.

PRIMARY OUTCOME MEASURES

Childcare practice outcomes included were minimum dietary diversity, handwashing and complete vaccination.

RESULTS

Among structural social capital dimensions, social support was found to be positively associated with minimum dietary diversity (adjusted OR (AOR)=1.44, 95% CI 1.22 to 1.71; p<0.001) and handwashing for all mothers (AOR=1.42, 95% CI 1.23 to 1.64; p<0.001). In the subgroup analysis, the higher SES group had higher odds of meeting the minimum dietary diversity (AOR=1.63, 95% CI 1.18 to 2.26; p=0.01) and handwashing with increased social support (AOR=1.53, 95% CI 1.13 to 2.08; p=0.01) than the lower SES. The mediation effect of social support accounted for 27.3% of the total effect between SES and minimum dietary diversity. Cognitive social capital was negatively associated with vaccination for the lower SES group (AOR=0.07, 95% CI 0.01 to 0.68; p=0.03).

CONCLUSIONS

To improve feeding and handwashing practices and to reduce health inequalities in rural Malawi, governments and organisations should consider promoting the value of social support and health. Future research is needed to explain the negative association between cognitive social capital and vaccination among the lower SES group.

The Predictors of Psychological Well-Being in Lithuanian Adolescents after the Second Prolonged Lockdown Due to COVID-19 Pandemic

Recent research highlights the impact of prolonged pandemics and lockdown on the mental health of youngsters. The second wave of COVID-19 brought an increase in mental health problems among young people. Therefore, this study aims to analyze the main factors arising from intra-individual, inter-individual, and environmental contexts that predict good psychological well-being in a group of adolescents after a second prolonged period of social restrictions and distance education. The study included 1483 school students from 11 to 19 years old. The survey assessed self-reported students’ psychological well-being (WHO-5 index), physical activity, sedentary behavior, school social capital, communication with peers and relationships with parents, existing emotional and behavioral problems. The results indicated that 58% of adolescents were of good psychological well-being in spring 2021, after half a year in lockdown. Almost 19% of adolescents had depression risk. The study revealed that during a period of prolonged isolation, male gender, better relationships between young people and their parents, the absence of serious emotional and behavioral problems, less sedentary behavior, and higher school social capital were found to be significant factors predicting adolescents’ psychological well-being. Lower physical activity is an important contributor to students’ poor well-being. Finally, the lack of face-to-face communication with peers was revealed as a specific factor in predicting adolescents with depression risk.

Continuance Intention of Online Healthcare Communities- The Mediation Mechanism of Social Interaction Ties

The purpose of this research is to evaluate the continuance usage intention on online healthcare community (OHC) platform for patients and examine the "doctor-OHC-patient" relationship. The proposed model attempted to integrate social interaction ties, shared value, trust with the indirect effects on the relationship between the determinants and continuous usage intention of the OHC platform. The empirical results showed that perceived critical mass, social identity, and para-social interaction would strengthen continuance intention via the social interaction ties. In addition, this study found that the shared values and trust increase users' willingness to continue usage of OHC. This study provides OHC platform managers with an in-depth understanding of the "doctor-OHC-patient" online social interaction. The results of this study may also help hospitals, health policy makers, and related healthcare practitioners to improve the way they use the web for advocacy and guidance, and provide insight into the intent of promoting the ongoing use of OHC platforms.

Associations of social capital and health at a city with high aging rate and low population density

Maintaining physical and mental health of older people is one of the important issues to be addressed in the aging society. Social capital, defined as the resources available to members of social groups, has recently attracted attention as a factor influencing public health. Most of the previous studies targeted various communities having different aging rates or population densities at once to examine the associations of social capital and health outcomes. However, the results of those studies are not always consistent. Moreover, because few studies have targeted a particular advanced aging society, associations of social capital and health at such societies have remained unknown. This study examined how social capital associates with health at a particular city having a very high aging rate and low population density. We targeted Iwamizawa city, Hokkaido, Japan, which is one of the most advanced aging areas, with an aging rate of 36.6% and a population density of 165/km². We analyzed self-administered questionnaire data obtained from “HELLO (HEalth, Lifestyle, and LOcal community of Iwamizawa citizen) Study” in 2018. The sample comprised 1237 individuals aged 65 and older. Following previous studies, we regarded three items—social cohesion, reciprocity, and civic participation—as social capital indices, and targeted two health outcomes: self-rated health (SRH) and degree of depression. Multilevel Poisson regression analyses were used to calculate prevalence ratios (PRs). We found that at the individual-level, the PR (95% confidence interval) of having poor SRH among those with more civic participation was 0.81 (0.71–0.93), and that of being depressed among those with more social cohesion was 0.32 (0.21–0.51), even after adjusting for compositional factors. We also found that the community-level civic participation significantly correlated with aging rate. Our findings indicate that social capital positively associates with older people's health at the advanced aging city.

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Examined the relationship between social capital and health at an advanced aging city.

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Multilevel Poisson regression analyses were used to calculate prevalence ratios.

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Individuals with less social capital had poor self-rated health and were depressed.

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Community-level social capital had no effect on individual-level health outcomes.

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Community-level civic participation significantly correlated with aging rate.

Direct and Indirect Effects of Social Support and School Social Capital on the Academic Success of 11–19-Year-Old Students Using Distance Learning

In the context of current changes in the education process due to the pandemic, the main aims of this study were to highlight social capital factors within the school community that are associated with better students’ outcomes in the context of distance learning. This study was a cross-sectional population-based study. The research sample consisted of 1483 students, whose ages varied from 11 to 19 years old (56.9% were girls). Academic success in this study was measured in terms of average grade and students’ perception of their learning process or outcomes by six single items. A Five-item WHO-5 questionnaire was used to measure students’ psychological well-being. Social capital was measured in terms of relationship, trust, reciprocity, and communication within different social contexts in the school community in total by 16 items. School social capital and social support scales were developed from these items. Students’ gender and age were also taken into consideration. The research results show that although social capital from parents and peers also matters, the relationship with teachers emerges as the main and the most important resource in supporting positive attitudes and outcomes in to learning (std.β varied from 0.116 to 0.439). The results also show that higher psychological wellbeing is associated with higher perceived school social capital (std.β 0.260) and social support (std.β 0.326) and mediates the effects of the latter two for better academic success outcomes. The findings also highlight the importance of close and trusting social ties, especially between students and their teachers as well as parents for better learning outcomes in times of crises and in the context of distance learning. The study results prove that social support and social capital at school are essential factors for sustainable psychological development. The results presumably support the idea that the school is sustainable if it is developing as an ecosystem not solely aimed at academic outcomes. The results of the current study may aid policymakers and practitioners in developing interventions, policies and practices that focus resources where they will have the greatest benefit.

Social Determinants of Remaining Life Expectancy at Age 60: A District-Level Analysis in Germany

Remaining life expectancy at age 60 (in short: RLE) is an important indicator of the health status of a population's elders. Until now, RLE has not been thoroughly investigated at the district level in Germany. In this study we analyzed, based on recent publicly available data (2015-2017), and for men and women separately, how large the RLE differences were in Germany across the 401 districts. Furthermore, we examined a wide range of potential social determinants in terms of their bivariate and multivariate (i.e., partial) impact on men's and women's RLE. Men's district-level RLE ranged between 19.89 and 24.32 years, women's district-level RLE between 23.67 and 27.16 years. The best single predictor both for men's and women's RLE at district level was 'proportion of employees with academic degree' with standardized partial regression coefficients of 0.42 (men) and 0.51 (women). Second and third in rank were classic economic predictors, such as 'household income' (men), 'proportion of elder with financial elder support' (women), and 'unemployment' (men and women). Indicators expressing the availability of medical services and staffing levels of nursing homes and services had at best a marginal partial impact. This study contributes to the growing body of evidence that a population's educational level is a decisive determinant of population health resp. life expectancy in contemporary industrialized societies.

The Promotional Effect of Health Education on the Medical Service Utilization of Migrants: Evidence From China

There were 376 million migrants in China by 2020, who made significant contributions to urban development. However, they used limited medical services and had lower self-reported health status than inflow city residents. Based on this, this study uses the cross-sectional data of the 2017 China Migrants Dynamic Survey (CMDS) to construct a multiple linear regression model to empirically study the role of health education in improving medical services utilization for migrants. It finds that compared to migrants without health education, the probability of the medical service utilization for migrants with health education has increased significantly, and counseling is more effective than other methods for health education. This promotion effect of health education has been established after a series of robustness tests. Furthermore, this study finds that the closer the migrants are to medical service resources, the greater the effect of health education on medical services utilization for migrants. The heterogeneity test shows that the effect of health education on medical services utilization for migrants is greater among the non-elderly and those with lower education levels. From the perspective of health education, the findings in this study provide empirical evidence to support the government in formulating policies to improve the utilization of medical services for migrants and reduce health inequality.

Relationships among mental health, social capital and life satisfaction in rural senior older adults: a structural equation model

BACKGROUND

Literature about life satisfaction in rural senior older adults is scarce. The aim of this research was to examine the relationships among mental health, social capital and life satisfaction in rural senior older adults.

METHODS

This was a cross-sectional study. From July to October 2017, 245 senior older adults from 14 villages of Jinhua City in China were recruited. The Satisfaction with Life Scale (SWLS), the Chinese Version of the 12-item General Health Questionnaire (GHQ-12), the Social Capital Questionnaire (SCQ) and a self-designed questionnaire was administered to the participants. Structural equation modelling was implemented to analyse the relationships between mental health, social capital and life satisfaction in rural senior older adults.

RESULTS

The structural equation model was fitting adequately (χ2/df = 1.785, P < 0.001; RMSEA = 0.059; CFI = 0.963). Life satisfaction was positively affected by income (β = 0.243, P = 0.01). Likewise, community canteen services improved life satisfaction (β = 0.288, P = 0.001). Social capital had direct positive prediction on life satisfaction (β = 0.342, P = 0.003) and indirectly improved life satisfaction through mental health (β =0.183, P = 0.007). Life satisfaction was impaired by poor mental health among senior older adults (β = - 0.395, P < 0.026).

CONCLUSIONS

Life satisfaction among rural senior older adults is a multifaceted well-being construct affected by income, community canteen services, social capital and mental health. The presented model highlights the positive effect of income, community canteen services, social capital and mental health. Appropriate home-based aged care, programs and policies are needed.

Master-planned communities in the United States as novel contexts for individual and population-level research

It has long been known that social and physical environments can shape individual and population health, for better or worse. Master-planned communities (MPCs) in the US are custom-designed residential neighborhoods with defined boundaries planned and developed under a single, private owner or entity from their inception. Across the US, these vary greatly in scale ranging from 100 to over 50,000 homes, but broadly all provide residents with housing, infrastructure, landscaping, and purpose-built facilities to support socialization. Current research in the urban planning literature suggests that MPCs can influence the health of their residents. However, few studies have examined the use of MPCs as settings to conduct individual or population health research. In this paper, we examine the potential of MPCs as context for observational or intervention studies aimed at understanding individual and population-level health and well-being. We first summarize links between built and social environment and individual and population health research. Next, we describe the history of planned communities in the US. Then, we review specific features of MPCs related to governance, development, design, and social structure. We end by exploring how those specific features may lead to potential opportunities and challenges when using MPCs in health research. Through this discussion, we highlight MPCs as overlooked settings that may offer potential for collaborative, innovative, and socially engaged health research.

Sedentary Behavior and Happiness: The Mediation Effects of Social Capital

Background and Objectives

This study aimed to examine the associations between time spent in 6 different domains of sedentary behavior and happiness and whether social capital mediated such associations among adults and older adults living in a rural area of Japan.

Research Design and Methods

Cross-sectional data from 3,357 participants (mean age: 60 ± 16 years) were used. 6 domains of sedentary behavior, happiness, and social capital were assessed using a self-report questionnaire. Age-stratified multivariable linear regression models adjusted for covariates were used to examine the associations between 6 domains of sedentary behavior and happiness. For relationships where the direct effect was significant, we tested the mediating effects of 2 social capital measures.

Results

Among both adults and older adults, more time spent viewing television was significantly associated with lower happiness scores, and more time spent engaging in other leisure activities was significantly associated with higher happiness scores. In addition, more time spent using cell phones and computers was significantly associated with lower happiness scores among the adults. Engaging in activities with neighbors significantly mediated the relationship between other leisure activities and happiness in the adults and older adults, and between television viewing and happiness in the older adults.

Discussion and Implications

Our findings indicated that less television viewing and more mentally active sedentary behavior (e.g., talking with others and engaging in hobbies) were associated with greater happiness. One aspect of social capital, engaging in activities with neighbors, acts as a potential mediator for relationships between sedentary behavior and happiness.

Neighborhood social capital and incidence and mortality of prostate cancer: a Swedish cohort study

BACKGROUND

There is a growing interest in the contextual effect of neighborhood linking social capital on different health outcomes, including cancer.

AIMS

To examine associations between neighborhood linking social capital and incidence and mortality of prostate cancer.

METHOD

This cohort study was based on national registers. Between 2002 and 2015, we included 1,196,563 men aged 50 years and above in the analyses. Multilevel logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CI) for the association between exposure and outcome, adjusting for potential confounding factors.

RESULTS

The total incidence of prostate cancer and mortality in patients with prostate cancer were 8.22 (per 100) and 1.80 (per 100), respectively, during the follow-up period. Individuals living in neighborhoods with low (OR 0.90; 95% CI 0.88-0.93) and intermediate (OR 0.94; 95% CI 0.92-0.96) linking social capital were less likely to be diagnosed with prostate cancer than those living in neighborhoods with high linking social capital. Opposite effects were observed for mortality; prostate cancer patients living in neighborhoods with low (OR 1.15; 95% CI 1.08-1.23) and intermediate (OR 1.09; 95% CI 1.03-1.14) linking social capital were more likely to die from prostate cancer than those in neighborhoods with high linking social capital.

CONCLUSIONS

Lower neighborhood linking social capital was associated with lower incidence but higher mortality in patients with prostate cancer. These findings suggest that men living in neighborhoods with low linking social capital may need additional surveillance for prostate cancer.

Bonding social capital and health within four First Nations communities in Canada: A cross-sectional study

To date, research on social capital in Indigenous contexts has been scarce. In this quantitative study, our objectives were to (1): Describe bonding social capital within four distinct First Nations communities in Canada, and (2) Explore the associations between bonding social capital and self-rated health in these communities. With community permission, cross-sectional data were drawn from the Canadian Alliance for Healthy Hearts and Minds study. Four reserve-based First Nations communities were included in the analysis, totaling 591 participants. Descriptive statistics were computed to examine levels of social capital among communities and logistic regression analyses were performed to identify social capital predictors of good self-rated health. Age, sex, education level, and community were controlled for in all models. Across the four communities in this study, areas of common social capital included frequent socialization among friends and large and interconnected family networks. Positive self-rated health was associated with civic engagement at federal or provincial levels (OR=1.65, p<0.05) and organizational membership (OR=1.60, p<0.05), but overall, sociodemographic variables were more significantly associated with self-rated health than social capital variables. Significant differences in social capital were found across the four communities and community of residence was a significant health outcomes predictor in all logistic regression models. In conclusion, this study represents one of the first efforts to quantitatively study First Nations social capital with respect to health in Canada. The results reflect significant differences in the social capital landscape across different First Nations communities and suggest the need for social capital measurement tools that may be adapted to unique Indigenous contexts. Further, the impact of social capital on health may be better explored and interpreted with more community-specific instruments and with supplementary qualitative inquiry.

Precarious Suicide Behavior According to Housing Price Gap: A Case Study on South Korea

In 2018, the suicide rate in South Korea was the highest among the Organisation for Economic Co-operation and Development countries, and socioeconomic inequality has intensified. This study analyzes the impact relationship between suicidal impulses and economic inequality in South Korea. This study measures suicidal impulses thoughts National Health Survey Data and economic inequality based on the housing prices gap in the country. The primary analysis results were as follows: First, suicidal impulses were positively associated with the high index of housing price inequality; this correlation has become tight in recent years. Second, it was confirmed that the higher the income level, the higher the correlation between suicidal impulses with the index of housing price inequality. Third, the correlation between housing price inequality with suicidal impulse increased consistently in highly urbanized areas, but the statistical significance was low in non-urban areas.

The Association of Social Capital and Self-Rated Health Between Urban Residents and Urbanized Rural Residents in Southwest China

China has seen an accelerated process of urbanization in the past 30 years. The influence of urbanization on health is complex and primarily influenced by changes in social capital. The purpose of this research was to compare the social capital between urban residents and urbanized rural residents of southwest China and its relationship with self-rated health. It is of great significance to study the difference of social capital between urban and urbanized rural residents to help urbanized rural residents improve their social adaptability and health. Data was collected from 1,646 residents between November and December of 2017 in Chengdu. Three logistic regressions were used to investigate the association between social capital and self-rated health by controlling for demographic variables, lifestyles factors, and health status factors. We observed that urban residents' self-rated health had a higher proportion of “good” than that of urbanized rural residents (P = 0.017). After controlling for factors such as health status and demographic characteristics, participants with higher social capital had better self-rated health. Urbanized rural residents with higher community trust and belonging had better self-rated health (OR = 0.701, 95% CI = 0.503~0.978), however urban residents with higher personal social networks and family relationships had better self-rated health (OR = 0.676, 95% CI = 0.490~0.933 and OR = 0.666, 95% CI = 0.450~0.987, respectively). Different types of communities should focus on the types of social capital from different sources, so as to take more targeted measures to improve the social support of residents and improve their health. Improving residents' social trust and sense of belonging may help urbanized rural residents better adapt to the new living environment and help them complete the identity transformation.