Social EpidemiologySocial capital: An individual or collective resource for health?
Introduction
The last decade has seen a surge in interest in the beneficial properties of social capital. Social capital has been linked to, amongst others, economic development, a well-functioning democracy, good education, and safe and productive neighbourhoods (see e.g., Cook, 2000; Fukuyama, 1995; Putnam (1993), Putnam (2000)). One of the domains that attracted considerable attention in recent years is in health and well-being (Putnam, 2000). There is increasing evidence that social capital has a positive influence on various aspects of people's physical and psychological health (see e.g., Hawe & Schiell, 2000; Kawachi, Kennedy, Lochner and Prothrow-Stith, 1997; Kawachi, Kennedy and Glass, 1999; Lomas, 1998; Veenstra, 2000).
Although it is now widely acknowledged that the social environment is important for people's health and well-being, there is less agreement about the specific nature of this relationship. For example, there is still considerable disagreement about whether social capital is a collective attribute of communities or societies, or whether its beneficial properties are associated with individuals and their social relationships (Kawachi, Kim, Coutts and Subramanian, 2004). The conventional notion of social capital is as an ecological societal construct rather than a characteristic of individuals. Putnam (1993), Putnam (2000) defines social capital as the features of social organisation—such as civic participation, norms of reciprocity, and trust in others—that helps facilitate cooperation for mutual benefit. Social capital in this sense is a resource of a group of people working together in order to achieve collective goals that could not be accomplished by individuals themselves (Macinko & Starfield, 2001). According to Fukuyama (1995), social capital can be embodied in the smallest and most basic of groups, the family, as well as the largest of all groups, the nation. However, not all agree that social capital is a collective resource. Others have argued that individuals benefit directly from their own social networks. For example, Portes (1998) defines social capital as the capacity of individuals to command scarce resources by virtue of their membership in networks or broader social structures. Lochner, Kawachi and Kennedy (1999) make a useful distinction between social capital, and social networks and support. Whereas social capital is part of a societal structure, social networks and support refers to the social embeddedness of individuals. It is important to distinguish between the two, because the specific social mechanism that contributes to public health will have important implications for health policy. Whether the health benefits of social capital are individual or collective indicates whether interventions should be targeted at ‘people’ or ‘places’ (Subramanian, Lochner & Kawachi, 2003).
Section snippets
Social capital: An individual or collective resource?
Ecological studies have found some support for social capital being a collective resource. Kawachi, Kennedy, Lochner, & Prothrow-Stith (1997), Kawachi, Kennedy, & Glass (1999) were among the first to empirically explore the relationship between social capital and health at the contextual level. Based on the definition of Putnam they assessed social capital at the US state level with aggregated measures of social trust and reciprocity, as well as with the per capita number of memberships of a
Aims of this study
This paper reports data from the European Social Survey (ESS) (Jowell et al., 2003) with the aim to investigate the importance of social capital for people's self-rated health status. More specifically, this study further explores whether the health benefits of social capital are individual or collective at the national level. As argued before it is important to distinguish between individual and collective effects, as they point to different policies and interventions to improve public health.
The European Social Survey
The ESS is a pan-European initiative to examine the interaction between Europe's changing institutions, its political and economic structures and the attitudes, beliefs and behaviour patterns of its diverse populations, and is funded by the European Commission, the European Science Foundation and academic funding bodies in each participating country (Jowell et al., 2003). Data for ESS round 1 were collected between 1 September 2002 and 30 June 2003 in the 22 participating European countries.
Results
Table 1 presents the average social trust and civic participation scores for each of the 22 participating countries. The table shows that Scandinavian countries (Denmark, Norway, Finland and Sweden) report the highest level of social trust, followed by Northern and Mid European countries, like Ireland, Switzerland, the Netherlands and the United Kingdom. Southern and Eastern European countries tend to have lower levels of social trust (Greece, Poland, Hungary, Slovenia, Italy and Portugal). A
Discussion
The current study investigated the importance of social capital for people's self-rated health using the first round of the ESS (Jowell et al., 2003). It was specifically aimed at investigating whether the health benefits of social capital are individual or collective at the national level. The association between social capital and health is typically examined at either the aggregate (e.g., Kawachi et al., 1999; Lynch et al., 2001) or the individual level (e.g., Barefoot et al., 1998;
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