Elsevier

Social Science & Medicine

Volume 51, Issue 9, 1 November 2000, Pages 1421-1435
Social Science & Medicine

How much does social capital add to individual health?A survey study of Russians

https://doi.org/10.1016/S0277-9536(00)00106-4Get rights and content

Abstract

Some Russians are healthier than others. To what extent does their health vary with involvement or exclusion from social capital networks? The first section reviews alternative theories: human capital as the primary determinant; social capital, whether generic, situation-specific or simply a new label for old measures of social integration; or a composite theory — both human and social capital are major determinants of health. The evidence to test hypotheses consists of individual-level data about self-assessed physical and emotional health from the special-purpose social capital questionnaire used in the 1998 New Russia Barometer survey, a nationwide representative sample of the adult Russian population. Multiple regression analysis shows that on their own human capital and social capital each account for a notable amount of variance in health. When both forms of capital are combined in a composite model, each retains major influence, demonstrating that social capital does make an independent contribution to health. Significant social capital influences include involvement or exclusion from formal and informal networks; friends to rely on when ill; control over one’s own life; and trust. Significant human capital influences besides age include subjective social status, gender and income. Regression-based estimates of impact show that social capital increases physical and emotional health more than human capital; together they can easily raise an individual’s self-reported health from just below average on a five-point scale to approaching good health.

Section snippets

Applying social capital theories to health

Generically, capital is a stock of resources used to produce goods and services. Manufacturing and financial capital are central in economic analysis. Natural resource capital, such as the stock of oil and minerals, is a second important form of capital. Human capital describes an individual’s productive resources, for example, education. Conventional economic analysis has yet to give recognition to the concept of social capital, but arguments are increasingly made that it is a distinctive

Russian evidence

The Soviet Union’s record in health was positive — up to a point. Although Soviet health statistics raise many questions of validity and interpretation (see e.g. Meslé et al., 1992, Lutz et al., 1994; Part III), in the first decades after 1945 life expectancy undoubtedly rose and infant mortality fell greatly. But by 1965 progress was slowing down and evidence of a deterioration in health began to emerge. Between 1965 and 1985 the reported life expectancy of female Russians rose by only 1.2

Analyzing the evidence

Classic OLS multiple regression is appropriate for testing how much or how little support hypothesized influences have, net of other influences on physical and emotional health, each assessed on five-point scales. Having multiple indicators of human and of social capital makes it possible to identify which specific forms have a strong influence on Russian health — and which do not. Three regression models are presented for physical and for emotional health. The first tests Hypothesis 1,

Implications

To determine how much human and social capital influence health, we must turn to the unstandardized coefficient (b), which estimates how much change in health occurs as the result of one unit of change in an independent variable. Significant influences are, except for gender, ordinal or continuous variables, but their scales differ in length from rouble income to the four-point scale measuring trust in other people (for details, see Appendix A). Therefore, impact is here shown by calculating

Acknowledgements

This paper is part of a project on Coping with Organizations: Networks of Russian Social Capital, financed by the Leverhulme Trust, London. The survey data were collected with help from a grant to the World Bank Social Capital Initiative, from the development fund of the Danish government. I am indebted to Professor Sir Michael Marmot, Professor Martin McKee and Dr. Martin Bobak for encouraging my interest in the health of Russians, and to Ismail Serageldin and Christian Grootaert of the World

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