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Social determinants of health – A question of social or economic capital? Interaction effects of socioeconomic factors on health outcomes

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  • Ahnquist, Johanna
  • Wamala, Sarah P.
  • Lindstrom, Martin
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    Abstract

    Social structures and socioeconomic patterns are the major determinants of population health. However, very few previous studies have simultaneously analysed the “social” and the “economic” indicators when addressing social determinants of health. We focus on the relevance of economic and social capital as health determinants by analysing various indicators. The aim of this paper was to analyse independent associations, and interactions, of lack of economic capital (economic hardships) and social capital (social participation, interpersonal and political/institutional trust) on various health outcomes. Data was derived from the 2009 Swedish National Survey of Public Health, based on a randomly selected representative sample of 23,153 men and 28,261 women aged 16–84 year, with a participation rate of 53.8%. Economic hardships were measured by a combined economic hardships measure including low household income, inability to meet expenses and lacking cash reserves. Social capital was measured by social participation, interpersonal (horizontal) trust and political (vertical/institutional trust) trust in parliament. Health outcomes included; (i) self-rated health, (i) psychological distress (GHQ-12) and (iii) musculoskeletal disorders. Results from multivariate logistic regression show that both measures of economic capital and low social capital were significantly associated with poor health status, with only a few exceptions. Significant interactive effects measured as synergy index were observed between economic hardships and all various types of social capital. The synergy indices ranged from 1.4 to 2.3. The present study adds to the evidence that both economic hardships and social capital contribute to a range of different health outcomes. Furthermore, when combined they potentiate the risk of poor health.

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    Bibliographic Info

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

    Volume (Year): 74 (2012)
    Issue (Month): 6 ()
    Pages: 930-939

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    Handle: RePEc:eee:socmed:v:74:y:2012:i:6:p:930-939

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    Keywords: Social determinants; Social capital; Economic hardships; Self-rated health; Sweden;

    References

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    1. Lindström, Martin, 2004. "Social capital, the miniaturisation of community and self-reported global and psychological health," Social Science & Medicine, Elsevier, vol. 59(3), pages 595-607, August.
    2. Rose, Richard, 2000. "How much does social capital add to individual health?A survey study of Russians," Social Science & Medicine, Elsevier, vol. 51(9), pages 1421-1435, November.
    3. Wildman, John, 2003. "Income related inequalities in mental health in Great Britain: analysing the causes of health inequality over time," Journal of Health Economics, Elsevier, vol. 22(2), pages 295-312, March.
    4. Stafford, M. & Cummins, S. & Macintyre, S. & Ellaway, A. & Marmot, M., 2005. "Gender differences in the associations between health and neighbourhood environment," Social Science & Medicine, Elsevier, vol. 60(8), pages 1681-1692, April.
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    7. Veenstra, Gerry, 2002. "Social capital and health (plus wealth, income inequality and regional health governance)," Social Science & Medicine, Elsevier, vol. 54(6), pages 849-868, March.
    8. Sen, Amartya, 1999. "Commodities and Capabilities," OUP Catalogue, Oxford University Press, number 9780195650389, September.
    9. Carlson, Per, 2004. "The European health divide: a matter of financial or social capital?," Social Science & Medicine, Elsevier, vol. 59(9), pages 1985-1992, November.
    10. Cattell, Vicky, 2001. "Poor people, poor places, and poor health: the mediating role of social networks and social capital," Social Science & Medicine, Elsevier, vol. 52(10), pages 1501-1516, May.
    11. Sundquist, Kristina & Lindström, Martin & Malmström, Marianne & Johansson, Sven-Erik & Sundquist, Jan, 2004. "Social participation and coronary heart disease: a follow-up study of 6900 women and men in Sweden," Social Science & Medicine, Elsevier, vol. 58(3), pages 615-622, February.
    12. Lindstrom, Martin & Mohseni, Mohabbat, 2009. "Social capital, political trust and self-reported psychological health: A population-based study," Social Science & Medicine, Elsevier, vol. 68(3), pages 436-443, February.
    13. Giordano, Giuseppe N. & Lindstrom, Martin, 2010. "The impact of changes in different aspects of social capital and material conditions on self-rated health over time: A longitudinal cohort study," Social Science & Medicine, Elsevier, vol. 70(5), pages 700-710, March.
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    Cited by:
    1. Farmer, Jane & Prior, Maria & Taylor, Judy, 2012. "A theory of how rural health services contribute to community sustainability," Social Science & Medicine, Elsevier, vol. 75(10), pages 1903-1911.
    2. Van Cauwenberg, Jelle & De Donder, Liesbeth & Clarys, Peter & De Bourdeaudhuij, Ilse & Buffel, Tine & De Witte, Nico & Dury, Sarah & Verté, Dominique & Deforche, Benedicte, 2014. "Relationships between the perceived neighborhood social environment and walking for transportation among older adults," Social Science & Medicine, Elsevier, vol. 104(C), pages 23-30.

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