Ramasubramani Premkumar, Kar Sitanshu Sekhar, Sarkar Sonali
Department of Preventive & Social Medicine, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, IND.
Cureus. 2023 Oct 7;15(10):e46660. doi: 10.7759/cureus.46660. eCollection 2023 Oct.
Social capital denotes the relationships, networks, norms and values in the community. A high level of social capital positively improves health through a supportive social system. Illnesses affect health and social relationships. One such disease is tuberculosis (TB), known for its social stigma. India has the highest burden of morbidity and mortality due to TB. The assessment of social capital would highlight the importance of a supportive environment in reducing the disease burden and bringing better treatment outcomes.
A cross-sectional exploratory analytical study was conducted in two primary health centers in Puducherry between February 2020 and March 2021. Considering the feasibility and resource constraints, we assessed the social capital between 50 newly diagnosed pulmonary tuberculosis (PTB) patients, their age- and gender-matched 50 household contacts (HHCs) and 50 PTB patients who completed treatment a year before. The HHC was either the marital partner or sibling of the newly diagnosed PTB patients selected for comparison as their exposure to infection would be similar to those diseased but did not develop the illness. Social capital and its domains were assessed using the World Bank's social capital questionnaire. Sociodemographic characteristics and social capital domains were compared using a chi-squared test. Mean standardized Z-scores of the domains were compared using one-way analysis of variance (ANOVA). A p-value of <0.05 is taken as significant.
Most participants from each group belonged to lower socioeconomic strata and were males (80%). The overall level of social capital was low among the newly diagnosed PTB patients, especially the group and network and trust and solidarity domains. The mean standardized Z-scores of social capital were the highest among the HHCs, followed by the treatment-completed PTB patients. There was no consistent pattern, but the trust and solidarity domain showed a statistically significant difference.
A low level of social capital and its domains were seen among the newly diagnosed PTB patients. However, better scores among the HHCs and the treatment-completed patients infer a negative association between social capital and TB. Thus, higher social capital preserves and improves health. Therefore, caregivers and disease-cured patients can be utilized as a social support system for current diseased patients and improve their health status.
社会资本指社区中的人际关系、网络、规范和价值观。高水平的社会资本通过支持性的社会系统对健康产生积极影响。疾病会影响健康和社会关系。结核病(TB)就是这样一种疾病,它以社会污名为特征。印度因结核病导致的发病率和死亡率负担最高。对社会资本的评估将凸显支持性环境在减轻疾病负担和带来更好治疗效果方面的重要性。
2020年2月至2021年3月期间,在本地治里的两个初级卫生中心开展了一项横断面探索性分析研究。考虑到可行性和资源限制,我们评估了50名新诊断的肺结核(PTB)患者、与他们年龄和性别匹配的50名家庭接触者(HHC)以及一年前完成治疗的50名PTB患者之间的社会资本。HHC是被选中进行比较的新诊断PTB患者的配偶或兄弟姐妹,因为他们接触感染的情况与患病但未发病的人相似。使用世界银行的社会资本问卷评估社会资本及其领域。使用卡方检验比较社会人口学特征和社会资本领域。使用单因素方差分析(ANOVA)比较各领域的平均标准化Z分数。p值<0.05被视为具有统计学意义。
每组中的大多数参与者属于社会经济较低阶层,且为男性(80%)。新诊断的PTB患者中社会资本的总体水平较低,尤其是在群体与网络以及信任与团结领域。HHC中社会资本的平均标准化Z分数最高,其次是完成治疗的PTB患者。虽然没有一致的模式,但信任与团结领域显示出统计学上的显著差异。
新诊断的PTB患者中社会资本及其领域水平较低。然而,HHC和完成治疗的患者得分较高表明社会资本与结核病之间存在负相关。因此,较高的社会资本能维护和改善健康。所以,护理人员和治愈疾病的患者可作为当前患病患者的社会支持系统,改善他们的健康状况。