NIVEL, Netherlands Institute for Health Services Research, Otterstraat 118-124, CR Utrecht 3513, The Netherlands.
Department of Sociology, Utrecht University, Heidelberglaan 2, CS Utrecht 3584, The Netherlands.
Eur J Public Health. 2017 Aug 1;27(4):594-599. doi: 10.1093/eurpub/ckw185.
Neighbourhood social capital might provide resources that can benefit chronic illness self-management. Improved self-management is a possible mechanism behind the relationship between neighbourhood social capital and health of people with chronic illness.
To test this mechanism, we collected data on self-management and self-rated health among a sample of 2091 people with chronic illness in 2013. Data on neighbourhood social capital were collected among 69 336 people in 3425 neighbourhoods between May 2011 and September 2012. A social capital measure was estimated with ecometric measurements. We conducted mediation analyses to examine whether the relationship between neighbourhood social capital and self-rated health was mediated through chronic illness self-management.
We found that neighbourhood social capital is related to chronic illness self-management only for people with chronic illness and mild physical disabilities and that, for this group, self-management mediates the relationship between neighbourhood social capital and health.
Improved self-management is a mechanism behind the relationship between neighbourhood social capital and health for people with chronic illness and mild physical disabilities. It is possible that the self-management support needs of people with chronic illness with moderate or severe physical disabilities cannot be met by the resources provided in neighbourhoods, but more tailored support is necessary. More research is needed to discover mechanisms behind the relationship between neighbourhood social capital and health and elucidate which resources in neighbourhoods can benefit specific groups of people with chronic illness.
邻里社会资本可能提供有益于慢性病自我管理的资源。改善自我管理是邻里社会资本与慢性病患者健康之间关系的一个可能机制。
为了检验这一机制，我们在 2013 年收集了 2091 名慢性病患者的自我管理和自我健康评估数据。2011 年 5 月至 2012 年 9 月期间，在 3425 个街区的 69336 人中收集了邻里社会资本数据。使用生态计量学测量方法估计了社会资本指标。我们进行了中介分析，以检验邻里社会资本与自我评估健康之间的关系是否通过慢性病自我管理来中介。
我们发现，邻里社会资本仅与慢性病和轻度身体残疾患者的慢性病自我管理有关，对于这一群体，自我管理中介了邻里社会资本与健康之间的关系。
改善自我管理是邻里社会资本与慢性病和轻度身体残疾患者健康之间关系的一个机制。对于中度或重度身体残疾的慢性病患者，邻里提供的资源可能无法满足他们的自我管理支持需求，因此需要更有针对性的支持。需要进一步研究以发现邻里社会资本与健康之间关系的机制，并阐明邻里中的哪些资源可以使特定群体的慢性病患者受益。
