Social Capital in Epidemiology

Martin Lindström explores the link between religion, social capital and health.

Early studies in epidemiology followed Putnam’s (1993) method in his study of social capital effects in Italy. With contextual methods, which he generally used, effects were measured as the degree of trust in other people, reciprocity in personal relations, and social and civic participation in areas such as communities, cities, states or countries.  The social capital benefits to health were seen as reductions in psychosocial stress which derived initially for the individual, but they also fit the context approach as well. The sociology model of networks emphasizes the individual contacts with others, each of which draws benefits from the group. An early stage of epidemiology developed a focus on bonding, bridging, and linking social groups. Ecological studies focused on the relations of social capital, income inequality, and mortality, though Lindstrom explains how this poses risks, in that risk results for the individual associations with health may differ from the ecology measured effects: the ecological fallacy.

Prof. Lindstrom reasons that multilevel studies improve on these approaches and address many of their problems in epidemiology. These take two or more measures, for contextual effects and individual effects and study them jointly at different levels of analysis. Contextual properties of an area are often measured in two ways: as an average individual item, such as aspects of trust, social participation and reciprocity; the second has been to use measures more directly from whole area variables such as voting, migration turnover, and high population turnover. For example, voting and high area election participation may indicate more area concern for the community (Islam et al. 2008). Like many researchers Lindstrom emphasizes longitudinal versus cross-section studies, as models with many observations over time may clarify issues of causality. Prior social capital can help to identify how it improves health, but prior health may also improve social capital. This reverse causality can derive when healthier people have better mobility and visit friends and join social groups more often (Rocco et al, 2014). Often other studies have used the Petris Index which measures area wide social capital by average attendance in social groups, which has been found associated with better health, for example indicated by acute coronary symptoms in low income people.

Martin Lindstrom, who has contributed much social capital research from its early years to the present day, explains the methodological improvements over time to the development of multilevel studies in epidemiology. He also explains how the contextual approach and individual methods have been handled over time with the needed understanding and improvements in methods. Read more in his chapter Social capital in epidemiology in the Elgar Companion to Social Capital and Health

Professor Lindstrom is Professor of Social Medicine and Health Policy, Department of Clinical Sciences in Malmo, Lund University, Sweden.

Elgar Companion to Social Capital and Health edited by Sherman Folland and Eric Nauenberg is out now.

Read chapter one free on Elgaronline

Also on ElgarBlog:

Why Trust is Good for your Health by Martin Ljunge. Read Martin Ljunge’s chapter Trust promotes health: addressing reverse causality by studying children of immigrants 

The Importance of being Social –Sherman Folland investigates the influential role social capital plays in mental health and physical wellbeing.

Religious Capital, Social Capital and Health Ephraim Shapiro and Chen Sharony explore the link between religion and health

Does Health Affect Social Capital Hope Corman, Kelly Noonan, and Nancy E. Reichman examine the relationship between health and social capital.