Chen He, Meng Tianguang
Department of Global Health, School of Public Health, Peking University, Beijing, China.
Department of Political Science, School of Social Sciences, Tsinghua University, Beijing, China.
PLoS One. 2015 Nov 16;10(11):e0142300. doi: 10.1371/journal.pone.0142300. eCollection 2015.
Three main opposing camps exist over how social capital relates to population health, namely the social support perspective, the inequality thesis, and the political economy approach. The distinction among bonding, bridging, and linking social capital probably helps close the debates between these three camps, which is rarely investigated in existing literatures. Moreover, although self-rated health is a frequently used health indicator in studies on the relationship between social capital and health, the interpersonal incomparability of this measure has been largely neglected. This study has two main objectives. Firstly, we aim to investigate the relationship between bonding, bridging, and linking social capital and self-rated health among Chinese adults. Secondly, we aim to improve the interpersonal comparability in self-rated health measurement. We use data from a nationally representative survey in China. Self-rated health was adjusted using the anchoring vignettes technique to improve comparability. Two-level ordinal logistic regression was performed to model the association between social capital and self-rated health at both individual and community levels. The interaction between residence and social capital was included to examine urban/rural disparities in the relationship. We found that most social capital indicators had a significant relationship with adjusted self-rated health of Chinese adults, but the relationships were mixed. Individual-level bonding, linking social capital, and community-level bridging social capital were positively related with health. Significant urban/rural disparities appeared in the association between community-level bonding, linking social capital, and adjusted self-rated health. For example, people living in communities with higher bonding social capital tended to report poorer adjusted self-rated health in urban areas, but the opposite tendency held for rural areas. Furthermore, the comparison between multivariate analyses results before and after the anchoring vignettes adjustment showed that the relationship between community-level social capital and self-rated health might be distorted if comparability problems are not addressed. In conclusion, the framework of bonding, bridging, and linking social capital helps us better understand the mechanism between social capital and self-rated health. Cultural and socioeconomic factors should be considered when designing health intervention policies using social capital. Moreover, we recommend that more studies improve the comparability of self-rated health by using the anchoring vignettes technique.
关于社会资本与人口健康的关系，存在三个主要的对立阵营，即社会支持视角、不平等论点和政治经济学方法。关系型、桥接型和连接型社会资本之间的区别可能有助于弥合这三个阵营之间的争论，而现有文献中对此鲜有研究。此外，尽管自评健康是社会资本与健康关系研究中常用的健康指标，但该指标在人际间的不可比性在很大程度上被忽视了。本研究有两个主要目标。首先，我们旨在调查中国成年人中关系型、桥接型和连接型社会资本与自评健康之间的关系。其次，我们旨在提高自评健康测量中的人际可比性。我们使用了来自中国一项具有全国代表性的调查的数据。通过锚定 vignettes 技术对自评健康进行调整以提高可比性。进行了两级有序逻辑回归，以模拟个体和社区层面社会资本与自评健康之间的关联。纳入了居住地与社会资本之间的相互作用，以检验该关系中的城乡差异。我们发现，大多数社会资本指标与中国成年人经调整的自评健康存在显著关系，但这些关系是复杂的。个体层面的关系型、连接型社会资本以及社区层面的桥接型社会资本与健康呈正相关。社区层面的关系型、连接型社会资本与经调整的自评健康之间的关联存在显著的城乡差异。例如，生活在关系型社会资本较高社区的城市居民往往报告经调整的自评健康较差，但农村地区的情况则相反。此外，锚定 vignettes 调整前后多变量分析结果的比较表明，如果不解决可比性问题，社区层面社会资本与自评健康之间的关系可能会被扭曲。总之，关系型、桥接型和连接型社会资本的框架有助于我们更好地理解社会资本与自评健康之间的机制。在利用社会资本设计健康干预政策时，应考虑文化和社会经济因素。此外，我们建议更多研究采用锚定 vignettes 技术提高自评健康的可比性。
