Social Capital and Health Interventions: Enhancing Social Capital to Improve Health

Jean Guo, Setti Raïs Ali, and Lise Rochaix demonstrate how improvements in community social capital cause better community health.

Jean Guo[i], Setti Raïs Ali[ii], and Lise Rochaix[iii]

These authors demonstrate how improvements in community social capital cause better community health. There are 40 examples where stimulation of social capital, in careful measured with interviewed groups compared with controls illustrate these effects. These examples are grouped in five categories: environment improvements; behavior changes; behavior of specific patients; psychosocial support; support to caregivers. The summary below provides a few selected examples of these interventions.

Environmental Interventions Foster Social Exchange at the Community Level

Sunnyside Piazza began as a busy intersection. It was converted by the community to a gathering place, including a giant sunflower painting. The project improved social interaction and resulted in better self-reported health compared to a control site, Semenza (2003, American Journal of Public Health). A community garden developed in Denver provides an example of a widely effective social capital intervention. Gardeners reported an improved sense of community and more consumption of healthy fruits and vegetables, Hale et al (2011, Social Science and Medicine).

Behavior Interventions for Health Promotion and Prevention

Christakis and Fowler (2007, New England Journal of Medicine) and Fowler and Christakis (2008, Journal of Health Economics) describe social capital intervention directed at public health goals. Here are two examples from our selected chapters. The Department of Agriculture developed a program for rural Mississippi where coaches were trained to lead walking groups. Average walking time for participants after six months increased from 49 minutes to 60 minutes, Zoellner et al (2007, Progress in Community Health Partnerships). A diet program provided guidance by phone for the individual for nine months and to the spouse for 11 months. Participants improved both the perceptions of spouse support and improved self-efficacy, Voils et al (2013, Preventative Medicine).

Behavioral Interventions to Impact Health Outcomes of Specific Patient Populations

Participants of the Bridges to a Better Life program received a 12-month in-person training program as well as phoned help for managing their diabetes. Individuals in the treatment group experienced better blood test results than the controls, Zhong et al (2015, Annals of Family Medicine). Salmen et al (2015, SS&M) studied the effectiveness of microclinic interventions for HIV-infected individuals in neighborhoods in Kenya. These microclinic interventions benefited from the participation of both family and neighbors. The interventions resulted in better treatment literacy and support, reductions in stigma, and safer environments.

Psychosocial Support Interventions

Ruland et al (2013, Cancer Nursing) studied a 12-month internet intervention called WebChoice, to assist breast and prostate cancer survivors. This included support group forums and discussions with health professionals. Results showed a significant reduction in symptoms. Verduin et al (2014, Social Science and Medicine) analyzed the effects of a psychosocial group intervention, community-based, which involved group sessions. Self-Reporting Questionnaire (SAQ-20) scores were increased as well as indicated by elective activity involvement. An internet-based intervention to assist African American young, first-time mothers, provided care information and discussion groups with peers and nurses. Self esteem and psychological outcomes were clearly higher in the intervention group than in the controls.

Interventions to Reduce Caregiver and Family Burden

Caregivers for long-term patients of diseases such as cancers often face very difficult burdens. This is recognized by social capital groups who seek to lessen these caregiver burdens. For example, DuBenske et al (2014, Health Psychology) studied a 24-month intervention called the Copenhagen Health Enhancement Support System (CHESS) for caregivers of lung cancer patients. The program provided information on cancer and discussion groups with peers and experts. The caregivers benefited from lower levels of burden and better mood states.

Conclusions

Clearly such interventions as these rely on the benefits of substantial human contact as well as expert medical knowledge. These are the essential elements of social capital. Each of the profiled interventions includes the basic scientific standard of comparing a treatment group with a control group. The selected examples in this summary describe only a small sample of the 40 cases described in the original Chapter 11 of the Elgar Companion to Social Capital and Health.

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[i] Jean Guo is pursuing a joint master’s degree at the Howard Kennedy School and The Harvard Business School, USA.

[ii] Setti Raïs Ali is in the PhD program at the Paris School of Economics, France.

[iii] Lise Rochaix is full professor in the Economics Department of the University of Paris 1 Panthéon-Sorbonne and the chair in health economics at the Paris School of Economics, France. Her PhD in Economics is from York University, UK.

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