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健康对社会资本的影响:英国的纵向观察研究。

The effect of health on social capital; a longitudinal observation study of the UK.

机构信息

School of Sport, Exercise and Health Sciences, Loughborough University, Ashby Road, Loughborough, LE11 3TU, UK.

School of Business and Economics, Loughborough University, Ashby Road, Loughborough, LE11 3TU, UK.

出版信息

BMC Public Health. 2020 Apr 7;20(1):466. doi: 10.1186/s12889-020-08577-w.

Abstract

BACKGROUND

UK health policy increasingly focusses on health as an asset. This represents a shift of focus away from specific risk factors towards the more holistic capacity by which integrated care assets in the community support improvements in both health and the wider flourishing of individuals. Though the social determinants of health are well known, relatively little research has focussed on the impact of an individual's health on their social outcomes. This research investigates how improved health can deliver a social return through the development of social capital.

METHODS

An observational study is undertaken on 25 years of longitudinal data, from 1991, drawn from the harmonised British Household Panel Survey (BHPS) and Understanding Society Survey (USS). Fixed effects instrumental variable panel data regression analysis is undertaken on individuals. The number of memberships of social organisations, as a measure of structural social capital, is regressed on subjectively measured general health and GHQ12 (Likert) scores. Distinction is drawn between males and females.

RESULTS

Improved general health increases social capital though differences exist between males and females. Interaction effects, that identify the impacts of health for different age groups, reveal that the effect of increased health on social capital is enhanced for males as they age. However, in the case of females increases in general health increase social capital only in connection with their age group. In contrast mental illness generally reduces social capital for males and females, and these effects are reduced through aging.

CONCLUSIONS

Investing in health as an asset can improve the social outcomes of individuals. Increasing the outcomes requires tailoring integrated care systems to ensure that opportunities for social engagement are available to individuals and reflect age groups. Targeting improvements in mental health is required, particularly for younger age groups, to promote social capital. The results suggest the importance of ensuring that opportunity for engagement in social and civic organisation be linked to general and mental health care support.

摘要

背景

英国的健康政策越来越关注健康作为一种资产。这代表着关注焦点从特定的风险因素转移到社区中综合护理资产更全面的能力,这些资产支持健康状况的改善和个人更广泛的繁荣。尽管人们熟知健康的社会决定因素,但相对较少的研究关注个体健康对其社会结果的影响。这项研究调查了通过发展社会资本,改善健康状况如何带来社会回报。

方法

对 1991 年以来的 25 年纵向数据,即来自协调的英国家庭面板调查(BHPS)和理解社会调查(USS)的数据进行了观测研究。对个体进行固定效应工具变量面板数据回归分析。以社会组织的会员人数作为结构社会资本的衡量标准,对主观衡量的一般健康状况和 GHQ12(李克特)评分进行回归。区分了男性和女性。

结果

一般健康状况的改善会增加社会资本,但男性和女性之间存在差异。交互效应,即识别不同年龄组健康对社会资本的影响,表明健康对社会资本的影响随着男性年龄的增长而增强。然而,在女性中,一般健康状况的改善仅在与其年龄组相关的情况下才会增加社会资本。相比之下,精神疾病通常会降低男性和女性的社会资本,而这些影响会随着年龄的增长而降低。

结论

将健康作为一种资产进行投资可以改善个体的社会结果。提高这些结果需要针对特定的人群定制综合护理系统,以确保个人有参与社交的机会,并反映年龄群体。需要针对精神健康进行改善,特别是针对年轻年龄群体,以促进社会资本。研究结果表明,必须确保参与社交和公民组织的机会与一般和精神健康护理支持相关联。

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