Lochner Kimberly A, Kawachi Ichiro, Brennan Robert T, Buka Stephen L
Department of Health, Harvard Center for Society and Health, Harvard School of Public Health, Boston, MA, USA.
Soc Sci Med. 2003 Apr;56(8):1797-805. doi: 10.1016/s0277-9536(02)00177-6.
Several empirical studies have suggested that neighborhood characteristics influence health, with most studies having focused on neighborhood deprivation or aspects of the physical environment, such as services and amenities. However, such physical characteristics are not the only features of neighborhoods that potentially affect health. Neighborhoods also matter because of the nature of their social organization. This study examined social capital as a potential neighborhood characteristic influencing health. Using a cross-sectional study design which linked counts of death for persons 45-64 years by race and sex to neighborhood indicators of social capital and poverty for 342 Chicago neighborhoods in the USA, we tested the ecological association between neighborhood-level social capital and mortality rates, taking advantage of the community survey data collected as part of the Project on Human Development in Chicago Neighborhoods. We estimated a hierarchical generalized linear model to examine the association of race and sex specific mortality rates to social capital. Overall, neighborhood social capital-as measured by reciprocity, trust, and civic participation-was associated with lower neighborhood death rates, after adjustment for neighborhood material deprivation. Specifically, higher levels of neighborhood social capital were associated with lower neighborhood death rates for total mortality as well as death from heart disease and "other" causes for White men and women and, to a less consistent extent, for Blacks. However, there was no association between social capital and cancer mortality. Although, the findings from this study extend the state-level findings linking social capital to health to the level of neighborhoods, much work remains to be carried out before social capital can be widely applied to improve population health, including establishing standards of measurement, and exploring the potential "downsides" of social capital.
多项实证研究表明，社区特征会影响健康状况，大多数研究聚焦于社区贫困或物质环境方面，如服务设施。然而，这些物质特征并非社区中潜在影响健康的唯一因素。社区的社会组织性质也很重要。本研究将社会资本作为一种可能影响健康的社区特征进行了考察。我们采用横断面研究设计，将美国芝加哥342个社区45至64岁人群按种族和性别的死亡人数与社会资本及贫困的社区指标相联系，利用作为芝加哥社区人类发展项目一部分收集的社区调查数据，检验了社区层面社会资本与死亡率之间的生态关联。我们估计了一个分层广义线性模型，以检验种族和性别特定死亡率与社会资本之间的关联。总体而言，在对社区物质匮乏进行调整后，以互惠、信任和公民参与衡量的社区社会资本与较低的社区死亡率相关。具体来说，较高水平的社区社会资本与白人男性和女性以及在一定程度上黑人的总死亡率、心脏病死亡率和“其他”原因导致的死亡率较低相关。然而，社会资本与癌症死亡率之间没有关联。尽管本研究的结果将社会资本与健康状况之间的州层面研究结果扩展到了社区层面，但在社会资本能够广泛应用于改善人群健康之前，仍有许多工作要做，包括建立衡量标准以及探索社会资本潜在的“负面影响”。
