Social determinants of health – A question of social or economic capital? Interaction effects of socioeconomic factors on health outcomes
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.
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): 74 (2012)
Issue (Month): 6 ()
|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.:
- Fritzell, Sara & Burstrom, Bo, 2006. "Economic strain and self-rated health among lone and couple mothers in Sweden during the 1990s compared to the 1980s," Health Policy, Elsevier, vol. 79(2-3), pages 253-264, December.
- 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.
- 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.
- 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.
- Sen, Amartya, 1999. "Commodities and Capabilities," OUP Catalogue, Oxford University Press, number 9780195650389.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- Frederick J. Zimmerman & Wayne Katon, 2005. "Socioeconomic status, depression disparities, and financial strain: what lies behind the income-depression relationship?," Health Economics, John Wiley & Sons, Ltd., vol. 14(12), pages 1197-1215.