Econometrics and Applied Statistics Unit, Joint Research Centre, European Commission, Italy.
J Epidemiol Community Health. 2011 Jan;65(1):44-50. doi: 10.1136/jech.2009.097592. Epub 2009 Oct 26.
Previous research has identified the role of social capital in explaining variations in health in the countries of the former Soviet Union. This study explores whether the benefits of social capital vary among these countries and why.
The impact of micro social capital (trust, membership and social isolation) on individual health was estimated in each of eight former Soviet republics using instrumental variables to overcome methodological hazards such as endogeneity and reverse causality. Interactions with institutional variables (voice and accountability, effectiveness of the legal system, informal economy) and social protection variables (employment protection, old age and disability benefits, sickness and health benefits) were examined.
Most social capital indicators, in most countries, are associated with better health but the magnitude and significance of the impact differ between countries. Some of this variation can be explained by interacting social capital indicators with measures of institutional quality, with membership of organisations bringing greater benefit for health in countries where civil liberties are stronger, whereas social isolation has more adverse consequences where there is a large informal economy. A lesser amount is explained by the interaction of social capital indicators with selected measures of social protection.
When considering interventions to improve social capital as a means of improving population health, it seems advisable to take into account the influence of macrocontextual variables, in order not to overstate or understate the likely impact of the intervention.
先前的研究已经确定了社会资本在解释前苏联国家健康差异方面的作用。本研究探讨了社会资本的益处是否因这些国家而异，以及原因是什么。
使用工具变量来克服内生性和反向因果关系等方法学陷阱，估计了微观社会资本（信任、成员资格和社会隔离）对每个前苏联共和国个体健康的影响。还检验了与制度变量（发言权和问责制、法律制度的有效性、非正规经济）和社会保护变量（就业保护、老年和残疾津贴、疾病和健康津贴）的相互作用。
在大多数国家，大多数社会资本指标与更好的健康状况相关，但影响的大小和显著性在国家之间存在差异。这种差异的一部分可以通过将社会资本指标与制度质量的衡量指标进行交互来解释，在公民自由更强的国家，组织成员资格对健康有更大的好处，而在非正规经济较大的国家，社会隔离则带来更多的不利后果。与社会保护的一些特定衡量指标的相互作用解释了较少的差异。
在考虑通过改善社会资本来改善人口健康的干预措施时，似乎需要考虑宏观背景变量的影响，以免夸大或低估干预措施的可能影响。
