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Not belonging where others do: a cross-sectional analysis of multi-level social capital interactions on health and mental well-being in Wales
  1. Christopher W N Saville
  1. School of Psychology, Bangor University, Bangor, UK
  1. Correspondence to Chris Saville, North Wales Clinical Psychology Programme, School of Psychology, Brigantia Building, Penrallt Road, Bangor University, Gwynedd, Wales, Bangor LL57 2AS UK; c.saville{at}


Background Social capital may be a social good in health terms, but it is not necessarily a universal good. Several studies have shown that while there is a positive association between ecological social capital and health in people with high individual-level social capital, this relationship is weaker or even reversed in those with low individual-level social capital. Such studies, however, have used relatively coarse levels of geography for quantifying ecological social capital. The present study looks at this relationship at a more fine-grained spatial scale.

Methods Data from the National Survey for Wales (n=27 828, weighted mean age=48.4) were linked to previously published small-area estimates (n=410) of ecological social capital for Wales. Mixed effects models were then used to assess whether the relationship between mental well-being and self-reported health on one hand, and ecological social capital (sense of belonging) on the other, was moderated by individual-level social capital.

Results The models found the same moderation of the relationship that has been demonstrated previously: Although ecological social capital is positively associated with health in respondents with high individual-level social capital, the relationship is negative in those with low individual-level social capital.

Conclusion This study replicates this association at a spatial scale orders of magnitude more fine-grained than had been shown previously. Ecological social capital is not an unambiguously positive factor for public health, and may be a risk factor for marginalised people.

  • Social capital
  • self-rated health
  • multilevel modelling
  • mental health
  • geography

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  • Twitter Chris Saville @cwnsaville.

  • Acknowledgements I am very grateful to the survey team at the Welsh Government for providing access to data, and to two anonymous reviewers for their helpful comments. This article is dedicated to the memory of my mother, Jenny Saville (1948–2020).

  • Contributors All analyses and writing are my own work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Map disclaimer The depiction of boundaries on the map(s) in this article does not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. The map(s) are provided without any warranty of any kind, either express or implied.

  • Competing interests No, there are no competing interests for any author.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public, open access repository. Data may be obtained from a third party and are not publicly available.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.