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.
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|
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.:
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
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.
If references are entirely missing, you can add them using this form.