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Social capital and geographical variation in the incidence of COVID-19: an ecological study

Abstract

Background The new behavioural norms needed to reduce the spread of COVID-19 are likely scaffolded by social capital. Research on social capital and COVID-19 has yielded mixed results, with some studies finding it to be protective while others identifying it as a risk factor. We examined the association between social capital and COVID-19 at a finer spatial scale than previous research, and examined changes in the relationship over the course of the pandemic.

Methods Routine COVID-19 surveillance data from Wales were linked to estimates of social capital at a small area level. Generalised linear mixed effects models predicting COVID-19 case rates across areas using social capital estimates and possible confounding variables were fitted to the data. A moving window version of the analysis explored whether this relationship varied across time.

Results Areas with higher levels of social capital had lower rates of COVID-19 (rate ratio for trust=0.94, 95% CI 0.92 to 0.96; rate ratio for belonging=0.94, 95% CI 0.92 to 0.96). These associations were strongest during periods of lockdown, with evidence that social capital was less protective, and potentially even a risk factor, during periods when restrictions were eased. Trust, but not belonging, remained protective after adjusting for deprivation, population density, ethnicity and proportion population aged over 65 years.

Conclusions Social capital is an important public health resource, which should be considered in future pandemic preparedness. Its importance may be greatest during times when social activity is most restricted.

  • COVID-19
  • social capital
  • communicable disease control
  • public health
  • geography

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. COVID-19 case data were weekly versions of data available from the Public Health Wales dashboard (https://public.tableau.com/profile/public.health.wales.health.protection%23!/vizhome/RapidCOVID-19virology-Public/Headlinesummary). Please contact Public Health Wales to discuss the access to the weekly data. Social capital estimates are available at https://osf.io/cd83q/

This article is made freely available for personal use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

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