Social capital, trust in the health-care system and self-rated health: The role of access to health care in a population-based study
This paper investigates the relationship between institutional trust in the health-care system, i.e. an institutional aspect of social capital, and self-rated health, and whether the strength of this association is affected by access to health-care services. The 2004 public health survey in the Scania region of Sweden is a cross-sectional study; a total of 27,963 respondents aged 18-80 years answered a postal questionnaire, which represents 59% of the random sample. Logistic regression model was used to investigate the association between institutional trust and self-rated health. Multivariate analyses of self-rated health were performed in order to investigate the importance of possible confounders (age, country of origin, education, economic stress, generalized trust in other people, and care-seeking behaviour) on this association. A 28.7% proportion of the men and 33.2% of the women reported poor self-rated health. A total of 15.0% and 58.3% of the respondents reported "very high" and "rather high" trust in the health-care system, respectively. Almost one-third of all respondents reported low institutional trust. Respondents born outside Sweden, with low/medium education, low generalized trust and low institutional trust had significantly higher odds ratios of poor self-rated health. Multiple adjustments for age, country of origin, education, economic stress, and horizontal trust had some effect on the significant relationship between institutional trust and poor self-rated health, for both men and women, but the additional introduction of care-seeking behaviour in the model substantially reduced the odds ratios. In conclusion, low trust in the health-care system is associated with poor self-rated health. This association may be partly mediated by "not seeking health care when needed". However, this is a cross-sectional exploratory study and the causality may go in both directions.
If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Volume (Year): 64 (2007)
Issue (Month): 7 (April)
|Contact details of provider:|| Web page: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description|
|Order Information:|| Postal: http://www.elsevier.com/wps/find/supportfaq.cws_home/regional|
References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- 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.
- Mechanic, David & Meyer, Sharon, 2000. "Concepts of trust among patients with serious illness," Social Science & Medicine, Elsevier, vol. 51(5), pages 657-668, September.
- Gilson, Lucy, 2005. "Editorial: building trust and value in health systems in low- and middle-income countries," Social Science & Medicine, Elsevier, vol. 61(7), pages 1381-1384, October.
- Thiede, Michael, 2005. "Information and access to health care: is there a role for trust?," Social Science & Medicine, Elsevier, vol. 61(7), pages 1452-1462, October.
- Perry, Henry & Robison, Nathan & Chavez, Dardo & Taja, Orlando & Carolina Hilari & Shanklin, David & Wyon, John, 1999. "Attaining health for all through community partnerships: principles of the census-based, impact-oriented (CBIO) approach to primary health care developed in Bolivia, South America," Social Science & Medicine, Elsevier, vol. 48(8), pages 1053-1067, April.
- Russell, Steven, 2005. "Treatment-seeking behaviour in urban Sri Lanka: Trusting the state, trusting private providers," Social Science & Medicine, Elsevier, vol. 61(7), pages 1396-1407, October.
- Ali, Sadiq M. & Merlo, Juan & Rosvall, Maria & Lithman, Thor & Lindström, Martin, 2006. "Social capital, the miniaturisation of community, traditionalism and first time acute myocardial infarction: A prospective cohort study in southern Sweden," Social Science & Medicine, Elsevier, vol. 63(8), pages 2204-2217, October.
- Tibandebage, Paula & Mackintosh, Maureen, 2005. "The market shaping of charges, trust and abuse: health care transactions in Tanzania," Social Science & Medicine, Elsevier, vol. 61(7), pages 1385-1395, October.
- Birungi, Harriet, 1998. "Injections and self-help: risk and trust in Ugandan health care," Social Science & Medicine, Elsevier, vol. 47(10), pages 1455-1462, November.
- Franks, Peter & Gold, Marthe R. & Fiscella, Kevin, 2003. "Sociodemographics, self-rated health, and mortality in the US," Social Science & Medicine, Elsevier, vol. 56(12), pages 2505-2514, June.
- Straten, G. F. M. & Friele, R. D. & Groenewegen, P. P., 2002. "Public trust in Dutch health care," Social Science & Medicine, Elsevier, vol. 55(2), pages 227-234, July.
- Gilson, Lucy, 2003. "Trust and the development of health care as a social institution," Social Science & Medicine, Elsevier, vol. 56(7), pages 1453-1468, April.
- Kennedy, Bruce P. & Kawachi, Ichiro & Prothrow-Stith, Deborah & Lochner, Kimberly & Gupta, Vanita, 1998. "Social capital, income inequality, and firearm violent crime," Social Science & Medicine, Elsevier, vol. 47(1), pages 7-17, July.
When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:64:y:2007:i:7:p:1373-1383. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Shamier, Wendy)
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.