Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, SE-901 87 Umeå, Sweden.
Soc Sci Med. 2011 Jul;73(2):264-73. doi: 10.1016/j.socscimed.2011.05.013. Epub 2011 May 30.
Growing research on social capital and health has fuelled the debate on whether there is a place effect on health. A central question is whether health inequality between places is due to differences in the composition of people living in these places (compositional effect) or differences in the local social and physical environments (contextual effects). Despite extensive use of multilevel approaches that allows controlling for whether the effects of collective social capital are confounded by access to social capital at the individual level, the picture remains unclear. Recent studies indicate that contextual effects on health may vary for different population subgroups and measuring "average" contextual effects on health for a whole population might therefore be inappropriate. In this study from northern Sweden, we investigated the associations between collective social capital and self-rated health for men and women separately, to understand if health effects of collective social capital are gendered. Two measures of collective social capital were used: one conventional measure (aggregated measures of trust, participation and voting) and one specific place-related (neighbourhood) measure. The results show a positive association between collective social capital and self-rated health for women but not for men. Regardless of the measure used, women who live in very high social capital neighbourhoods are more likely to rate their health as good-fair, compared to women who live in very low social capital neighbourhoods. The health effects of collective social capital might thus be gendered in favour for women. However, a more equal involvement of men and women in the domestic sphere would potentially benefit men in this matter. When controlling for socioeconomic, sociodemographic and social capital attributes at the individual level, the relationship between women's health and collective social capital remained statistically significant when using the neighbourhood-related measure but not when using the conventional measure. Our results support the view that a neighbourhood-related measure provides a clearer picture of the health effects of collective social capital, at least for women.
关于社会资本与健康的研究不断增加，这也推动了关于健康是否存在地方效应的争论。一个核心问题是，地方之间的健康不平等是由于居住在这些地方的人群构成差异（构成效应），还是由于当地的社会和物质环境差异（情境效应）造成的。尽管广泛使用了多水平方法，可以控制集体社会资本的影响是否因个人层面的社会资本获取而混淆，但情况仍然不清楚。最近的研究表明，情境效应对健康的影响可能因不同的人口亚组而异，因此为整个人口衡量“平均”情境效应对健康的影响可能并不合适。在这项来自瑞典北部的研究中，我们分别研究了集体社会资本与男性和女性自评健康之间的关系，以了解集体社会资本对健康的影响是否存在性别差异。我们使用了两种集体社会资本的衡量指标：一种是常规指标（信任、参与和投票的综合衡量），另一种是特定的与地方相关的指标（邻里）。结果表明，集体社会资本与女性自评健康呈正相关，但与男性无关。无论使用哪种衡量指标，与居住在社会资本非常低的邻里的女性相比，居住在社会资本非常高的邻里的女性更有可能将自己的健康评为良好或一般。因此，集体社会资本对健康的影响可能对女性有利，但如果男性和女性在家庭领域的参与更加平等，那么男性在这方面可能会受益。当在个体层面上控制社会经济、社会人口统计学和社会资本属性时，使用邻里相关指标时，女性健康与集体社会资本之间的关系仍然具有统计学意义，但使用常规指标时则没有。我们的研究结果支持这样一种观点，即邻里相关的衡量标准提供了一个更清晰的集体社会资本对健康影响的图景，至少对女性来说是这样。
