Oguttu James W, Ncayiyana Jabulani R
Department of Agriculture and Animal Health, College of Agriculture & Environmental Sciences, University of South Africa, Pretoria, South Africa.
Division of Epidemiology and Biostatistics, School of Public Health, University of Witwatersrand, Johannesburg, South Africa.
SSM Popul Health. 2020 May 30;11:100607. doi: 10.1016/j.ssmph.2020.100607. eCollection 2020 Aug.
Although social capital has been linked to population health, there is a dearth of studies on the phenomenon especially in sub-Saharan Africa. We investigated the individual and contextual effects of social capital indicators (group membership, registered to vote, perception towards safety in community and generalised trust) on the self-rated health (SRH) of the residents of Gauteng province. We used data from the 2015 Quality of Life (QoL) survey, which included a random representative sample of 27476 residents (level 1) in 508 administrative wards (level 2). We employed a multilevel logistic regression to examine the association of social capital and SRH (good vs poor). After adjusting for individual and area-level factors, no main effect of group membership (Adjusted OR: 0.93: 95% CI: 0.85-1.02), generalised trust (Adjusted OR: 1.01: 95% CI: 0.89-1.49) and registered to vote (Adjusted OR: 0.95; 95% CI: 0.82-1.10) was observed. However, if respondents were positive in their perception towards safety in community, there was a positive association with good SRH (Adjusted OR: 1.15; 95% CI: 1.01-1.31); while if residents reported a negative perception towards safety in community, a strong negative association with good SRH (Adjusted OR: 0.70; 95% CI: 0.62-0.79) was observed. Both ward variance and median odds ratio (MOR) indicate significant differences in good SRH by wards. A strong positive joint effect on the multiplicative scale was observed between satisfied with safety and the ward-level South African Multiple Deprivation Poverty Index (SAMPI), while a strong negative joint effect was also observed on a multiplicative scale between dissatisfied with safety and the SAMPI. Perception of safety in community is the core domain of social capital that significantly impacts the SRH of residents of Gauteng. Although the effect of perception towards safety in community on good SRH is influenced by ward deprivation,the effect is not dependent on the level of deprivation. Contextual factors as evidenced by the persistent MOR, in addition to individual factors, explain variation in reporting good SRH in the study area.
尽管社会资本与人口健康相关联，但针对这一现象的研究却很匮乏，尤其是在撒哈拉以南非洲地区。我们调查了社会资本指标（群体成员身份、登记投票、对社区安全的认知以及普遍信任）对豪登省居民自评健康（SRH）的个体和背景影响。我们使用了2015年生活质量（QoL）调查的数据，该调查包括508个行政区（二级）中27476名居民（一级）的随机代表性样本。我们采用多水平逻辑回归来检验社会资本与SRH（良好与不佳）之间的关联。在对个体和地区层面因素进行调整后，未观察到群体成员身份（调整后的比值比：0.93；95%置信区间：0.85 - 1.02）、普遍信任（调整后的比值比：1.01；95%置信区间：0.89 - 1.49）和登记投票（调整后的比值比：0.95；95%置信区间：0.82 - 1.10）的主要影响。然而，如果受访者对社区安全的认知是积极的，那么与良好的SRH存在正相关（调整后的比值比：1.15；95%置信区间：1.01 - 1.31）；而如果居民报告对社区安全的认知是消极的，则与良好的SRH存在强烈的负相关（调整后的比值比：0.70；95%置信区间：0.62 - 0.79）。行政区差异和中位数比值比（MOR）均表明各行政区在良好的SRH方面存在显著差异。在对安全感到满意与行政区层面的南非多重贫困指数（SAMPI）之间，观察到在乘法尺度上有强烈的正联合效应，而在对安全不满意与SAMPI之间，在乘法尺度上也观察到强烈的负联合效应。对社区安全的认知是社会资本的核心领域，对豪登省居民的SRH有显著影响。尽管对社区安全的认知对良好SRH的影响受行政区贫困程度的影响，但该影响并不依赖于贫困水平。除个体因素外，由持续存在的MOR所证明的背景因素解释了研究区域内报告良好SRH的差异。
