Folland Sherman
Department of Economics, Oakland University, Rochester, MI 48309, USA.
Soc Sci Med. 2007 Jun;64(11):2342-54. doi: 10.1016/j.socscimed.2007.03.003. Epub 2007 Apr 11.
Robert Putnam showed that a social capital index, created as a weighted sum of 14 variables chosen to describe the civic degree of sociability and community mindedness, is correlated with many community outcomes, such as education, child well-being, crime, and the total mortality rate. Although correlation does not establish causation, we can find that in a large number of studies this index, a selection of its elements, or similar measures register as significantly correlated with health variables, virtually always in a direction consistent with the hypothesis that social capital improves health. The potential benefit of this relationship is substantial, especially if it proves to be robust to differences in time and place, statistical contexts, and ultimately if the relation can be supported to be causal. This paper subjects the social capital and health hypothesis to an expanded set of rigorous tests, which, by surviving, it becomes stronger or, by failing, its weaknesses are better revealed. The paper seeks to extend this body of research by a combination of study characteristics that are each relatively unusual in social capital and health research. Though causality cannot be established by these tests, the work shows that the association of social capital with health is quite robust when challenged in the following ways: (1) seven different health measures are studied, including five mortality rates; (2) the 48 contiguous states are observed at six points in time covering the years from 1978 to 1998 over four year intervals, thus forming a panel; (3) the multivariate tests feature economic variables from the production of health literature; and (4) a statistical method (instrumental variables) is applied to account for the possibility that omitted variables are confounding the social capital estimates. The results and the discussion find cases for which the social capital and health hypothesis performs only weakly, but, on the whole, the hypothesis is remarkably robust to these variations.
罗伯特·帕特南表明，一个社会资本指数与许多社区成果相关，该指数是由14个变量的加权总和构成，这些变量旨在描述社交的公民程度和社区意识，比如教育、儿童福祉、犯罪率以及总死亡率等。虽然相关性并不能确立因果关系，但我们可以发现，在大量研究中，这个指数、其部分要素或类似指标与健康变量显著相关，而且几乎总是与社会资本改善健康这一假设方向一致。这种关系的潜在益处是巨大的，尤其是如果它在时间和地点差异、统计背景方面都能成立，最终如果这种关系能被证明具有因果性的话。本文对社会资本与健康假设进行了一系列更严格的检验，若检验通过，该假设就会更有力，若未通过，则其弱点会更明显地暴露出来。本文试图通过结合一些在社会资本和健康研究中相对不常见的研究特征来扩展这一研究领域。虽然这些检验无法确立因果关系，但研究表明，当以以下方式进行挑战时，社会资本与健康之间的关联相当稳固：（1）研究了七种不同的健康指标，包括五种死亡率；（2）观察了48个相邻州在1978年至1998年期间每四年一个时间点的情况，共六个时间点，从而形成一个面板数据；（3）多变量检验纳入了健康文献中涉及的经济变量；（4）应用了一种统计方法（工具变量法）来考虑遗漏变量可能混淆社会资本估计值的可能性。结果和讨论发现，在某些情况下，社会资本与健康假设的表现较弱，但总体而言，该假设对这些变化具有显著的稳健性。
