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Social capital and health: Implications for public health and epidemiology

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  • Lomas, Jonathan
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    Abstract

    Public health and its "basic science", epidemiology, have become colonised by the individualistic ethic of medicine and economics. Despite a history in public health dating back to John Snow that underlined the importance of social systems for health, an imbalance has developed in the attention given to generating "social capital" compared to such things as modification of individual's risk factors. In an illustrative analysis comparing the potential of six progressively less individualised and more community-focused interventions to prevent deaths from heart disease, social support and measures to increase social cohesion fared well against more individual medical care approaches. In the face of such evidence public health professionals and epidemiologists have an ethical and strategic decision concerning the relative effort they give to increasing social cohesion in communities vs expanding access for individuals to traditional public health programs. Practitioners' relative efforts will be influenced by the kind of research that is being produced by epidemiologists and by the political climate of acceptability for voluntary individual "treatment" approaches vs universal policies to build "social capital". For epidemiologists to further our emerging understanding of the link between social capital and health they must confront issues in measurement, study design and analysis. For public health advocates to sensitise the political environment to the potential dividend from building social capital, they must confront the values that focus on individual-level causal models rather than models of social structure (dis)integration. The evolution of explanations for inequalities in health is used to illustrate the nature of the change in values.

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    Bibliographic Info

    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 47 (1998)
    Issue (Month): 9 (November)
    Pages: 1181-1188

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    Handle: RePEc:eee:socmed:v:47:y:1998:i:9:p:1181-1188

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    Keywords: social capital public health epidemiology;

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    Cited by:
    1. Jennifer M. Mellor & Jeffrey Milyo, 2003. "State Social Capital and Individual Health Status," Working Papers 0310, Harris School of Public Policy Studies, University of Chicago.
    2. Glenn Stalker, 2008. "Measuring Diversity in Daily Social Contact: The Contribution of Social Context, Work and Leisure on the Opportunity for Engagement," Social Indicators Research, Springer, vol. 86(2), pages 275-295, April.
    3. Nauenberg, Eric & Laporte, Audrey & Shen, Leilei, 2011. "Social capital, community size and utilization of health services: A lagged analysis," Health Policy, Elsevier, vol. 103(1), pages 38-46.
    4. Shortt, S. E. D., 2004. "Making sense of social capital, health and policy," Health Policy, Elsevier, vol. 70(1), pages 11-22, October.
    5. Muennig, Peter & Cohen, Alison K. & Palmer, Aileen & Zhu, Wenyi, 2013. "The relationship between five different measures of structural social capital, medical examination outcomes, and mortality," Social Science & Medicine, Elsevier, vol. 85(C), pages 18-26.
    6. TITTENBRUN Jacek, 2013. "Social Capital. Trust and Ideology," European Journal of Interdisciplinary Studies, Bucharest Economic Academy, issue 01, March.
    7. Eriksson, Malin & Emmelin, Maria, 2013. "What constitutes a health-enabling neighborhood? A grounded theory situational analysis addressing the significance of social capital and gender," Social Science & Medicine, Elsevier, vol. 97(C), pages 112-123.

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