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


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


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.

Suggested Citation

  • Ahnquist, Johanna & Wamala, Sarah P. & Lindstrom, Martin, 2012. "Social determinants of health – A question of social or economic capital? Interaction effects of socioeconomic factors on health outcomes," Social Science & Medicine, Elsevier, vol. 74(6), pages 930-939.
  • Handle: RePEc:eee:socmed:v:74:y:2012:i:6:p:930-939
    DOI: 10.1016/j.socscimed.2011.11.026

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    References listed on IDEAS

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    1. Atuoye, Kilian Nasung & Luginaah, Isaac, 2017. "Food as a social determinant of mental health among household heads in the Upper West Region of Ghana," Social Science & Medicine, Elsevier, vol. 180(C), pages 170-180.
    2. 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.
    3. Rung, Ariane L. & Gaston, Symielle & Robinson, William T. & Trapido, Edward J. & Peters, Edward S., 2017. "Untangling the disaster-depression knot: The role of social ties after Deepwater Horizon," Social Science & Medicine, Elsevier, vol. 177(C), pages 19-26.
    4. 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.
    5. Fiorillo, Damiano & Lubrano Lavadera, Giuseppe & Nappo, Nunzia, 2016. "Social participation and self-rated psychological health," MPRA Paper 72879, University Library of Munich, Germany.
    6. Lafferty, Lise & Treloar, Carla & Chambers, Georgina M. & Butler, Tony & Guthrie, Jill, 2016. "Contextualising the social capital of Australian Aboriginal and non-Aboriginal men in prison," Social Science & Medicine, Elsevier, vol. 167(C), pages 29-36.


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