Department of Clinical Sciences in Malmö, Lund University, Sweden; Centre of Economic Demography, Lund University, Sweden.
Soc Sci Med. 2010 Mar;70(5):700-10. doi: 10.1016/j.socscimed.2009.10.044. Epub 2009 Dec 21.
Individual aspects of social capital have been shown to have significant associations with health outcomes. However, research has seldom tested different elements of social capital simultaneously, whilst also adjusting for other well-known health determinants over time. This longitudinal individual-level study investigates how temporal changes in social capital, together with changes in material conditions and other health determinants affect associations with self-rated health over a six year period. We use data from the British Household Panel Survey, a randomly selected cohort which is considered representative of the United Kingdom's population, with the same individuals (N=9303) providing responses to identical questions in 1999 and 2005. Four measures of social capital were used: interpersonal trust, social participation, civic participation and informal social networks. Material conditions were measured by total income (both individual and weighted household income), net of taxation. Other health determinants included age, gender, smoking, marital status and social class. After the baseline sample was stratified by health status, associations were examined between changes in health status and changes in all other considered variables. Simultaneous adjustment revealed that inability to trust demonstrated a significant association with deteriorating self-rated health, whereas increased levels of social participation were significantly associated with improved health status over time. Low levels of household and individual income also demonstrated significant associations with deteriorating self-rated health. In conclusion, it seems that interpersonal trust and social participation, considered valid indicators of social capital, appear to be independent predictors of self-rated health, even after adjusting for other well-known health determinants. Understandably, how trust and social participation influence health outcomes may help resolve the debate surrounding the role of social capital within the field of public health.
个体层面的社会资本的各个方面都与健康结果有着显著的关联。然而，研究很少同时测试社会资本的不同要素，同时随着时间的推移调整其他已知的健康决定因素。本纵向个体水平研究调查了社会资本的时间变化，以及物质条件和其他健康决定因素的变化，如何在六年的时间内影响与自我评估健康的关联。我们使用了英国家庭面板调查的数据，这是一个随机选择的队列，被认为代表了英国的人口，相同的个体（N=9303）在 1999 年和 2005 年对相同的问题提供了答复。使用了四种社会资本衡量指标：人际信任、社会参与、公民参与和非正式社交网络。物质条件由个人和加权家庭收入减去税收后的总收入来衡量。其他健康决定因素包括年龄、性别、吸烟、婚姻状况和社会阶层。在根据健康状况对基线样本进行分层后，我们研究了健康状况变化与所有其他考虑因素的变化之间的关联。同时调整显示，无法信任与自我评估健康状况恶化有显著关联，而社会参与水平的提高与随着时间的推移健康状况的改善有显著关联。家庭和个人收入水平较低也与自我评估健康状况恶化有显著关联。总之，人际信任和社会参与似乎是社会资本的有效指标，它们似乎是自我评估健康的独立预测因素，即使在调整了其他已知的健康决定因素后也是如此。可以理解的是，信任和社会参与如何影响健康结果可能有助于解决公共卫生领域社会资本作用的争论。
