van Hooijdonk Carolien, Droomers Mariël, Deerenberg Ingeborg M, Mackenbach Johan P, Kunst Anton E
Centre for Prevention and Health Services Research, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
Int J Epidemiol. 2008 Dec;37(6):1384-92. doi: 10.1093/ije/dyn181. Epub 2008 Sep 9.
Literature on the effect of community social capital on health is inconsistent and could be related to differences in social capital measures, health outcomes, population groups and locations studied. Therefore this study examines the diversity in associations between community social capital and health by investigating different diseases, populations groups and locations.
Mortality records and individual data on sex, age, marital status, ethnic origin and place of residence were available for 6 years (1995-2000). Neighbourhood data, i.e. community social capital, socio-economic level and urbanicity, were linked through postcode information. Community social capital was indicated by measures of community interaction, belongingness, satisfaction and involvement. Variations in all-cause and cause-specific mortality across low and high social capital neighbourhoods were estimated through Poisson regression. In addition, analyses were stratified according to population group and to urbanization level.
In the total population, community social capital was not related to all-cause mortality (RR = 1.00; CI: 0.99-1.01). However, residents of high social capital neighbourhoods had lower mortality risks for cancer [especially lung cancer (RR = 0.92; CI: 0.89-0.96)] and for suicide (RR = 0.90; CI: 0.83-0.98). Slightly lower mortality risks were also found for men (RR = 0.98; CI: 0.97-0.99), married individuals (RR = 0.96; CI: 0.94-0.97) and for residents living in socially strong neighbourhoods located in large cities (RR = 0.95; CI: 0.91-0.99).
The association between community social capital and health differs per health outcome, study population and location studied. This underlines the need to take such diversity into account when aiming to conceptualize the relation between community social capital and health.
关于社区社会资本对健康影响的文献并不一致，这可能与社会资本测量方法、健康结果、研究的人群组和地点的差异有关。因此，本研究通过调查不同疾病、人群组和地点，考察社区社会资本与健康之间关联的多样性。
可获取6年（1995 - 2000年）的死亡率记录以及关于性别、年龄、婚姻状况、种族出身和居住地点的个人数据。通过邮政编码信息将邻里数据，即社区社会资本、社会经济水平和城市化程度相联系。社区社会资本通过社区互动、归属感、满意度和参与度的测量指标来表示。通过泊松回归估计低社会资本邻里和高社会资本邻里之间全因死亡率和特定病因死亡率的差异。此外，分析按人群组和城市化水平进行分层。
在总人口中，社区社会资本与全因死亡率无关（相对风险 = 1.00；置信区间：0.99 - 1.01）。然而，高社会资本邻里的居民患癌症[尤其是肺癌（相对风险 = 0.92；置信区间：0.89 - 0.96）]和自杀的死亡风险较低（相对风险 = 0.90；置信区间：0.83 - 0.98）。男性（相对风险 = 0.98；置信区间：0.97 - 0.99）、已婚个体（相对风险 = 0.96；置信区间：0.94 - 0.97）以及居住在大城市社会凝聚力强的邻里中的居民（相对风险 = 0.95；置信区间：0.91 - 0.99）的死亡风险也略低。
社区社会资本与健康之间的关联因健康结果、研究人群和研究地点而异。这凸显了在试图概念化社区社会资本与健康之间的关系时考虑这种多样性的必要性。
