Wittenberg Kevin, Corten Rense, van der Lippe Tanja, de Moor Tine
Utrecht University, Utrecht, The Netherlands.
Rotterdam School of Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
BMC Public Health. 2024 Dec 2;24(1):3360. doi: 10.1186/s12889-024-20780-7.
Ageing populations and the ability to cure an increasing number of ailments put pressure on the health care sector. Meanwhile, care institutions retreat from rural areas and some governments emphasizes the need for citizens to find informal care primarily in their own social network. In The Netherlands, citizens increasingly respond by coming together to organize (in)formal care among themselves in 'care collectives'. However, little is known about the conditions that need to be met for such collective action to develop, and explanations that go beyond an individualist perspective are particularly lacking. In this study, we aim to fill this gap, and specifically argue for the potential role of social cohesion to facilitate collective action among citizens through fostering a social identity, and through the prevalence of social relations that facilitate reciprocity and mutual trust among citizens. We further test whether these relations vary between municipalities, and whether they depend on the necessity for care services.
We obtain data on the location of care collectives from an extensive Dutch inventory and match it to register data from Statistics Netherlands from 2020. We create measures for neighborhood attachment and contact using the 'ecometric approach'. We test our hypotheses with multilevel logistic regression models and multilevel event history analysis for a subset of the data that can be analyzed longitudinally.
We find evidence for a positive association between neighborhood attachment and the emergence of a care collective, which is stronger if the necessity for care is higher. We do not find a relation between neighborhood contact and care collectives, nor do we find evidence that these relations vary between municipalities. We cannot replicate our positive associations in the longitudinal model, and thus remain reserved about their causal interpretation.
There is considerable variability in the extent to which neighborhoods organize care services collectively. Partly, this may be attributable to differences in the prevalence of neighborhood identity, which would imply that an increasing reliance on citizen collectives may increase inequality in access to healthcare. Further research should emphasize combining community-level information with data on individual participation in care collectives to delve deeper into the dynamics of invitation, representation and embeddedness than current data allows.
人口老龄化以及治愈越来越多疾病的能力给医疗保健部门带来了压力。与此同时，护理机构从农村地区撤离，一些政府强调公民主要需要在自己的社交网络中寻找非正式护理。在荷兰，公民越来越多地通过聚集在一起，在“护理集体”中自行组织（非）正式护理来做出回应。然而，对于这种集体行动得以发展需要满足的条件知之甚少，尤其缺乏超越个人主义视角的解释。在本研究中，我们旨在填补这一空白，并特别主张社会凝聚力通过培养社会认同感以及通过促进公民之间互惠和相互信任的社会关系的普遍存在，在促进公民集体行动方面的潜在作用。我们进一步检验这些关系在不同市镇之间是否存在差异，以及它们是否取决于护理服务的必要性。
我们从一份广泛的荷兰清单中获取护理集体的位置数据，并将其与荷兰统计局2020年的登记数据进行匹配。我们使用“生态计量方法”创建邻里依恋和联系的测量指标。我们使用多层次逻辑回归模型和多层次事件史分析对可纵向分析的数据子集检验我们的假设。
我们发现邻里依恋与护理集体的出现之间存在正相关，当护理需求更高时这种相关性更强。我们没有发现邻里联系与护理集体之间的关系，也没有发现这些关系在不同市镇之间存在差异的证据。我们无法在纵向模型中重现我们的正相关关系，因此对它们的因果解释持保留态度。
邻里集体组织护理服务的程度存在很大差异。部分原因可能在于邻里认同感的普遍程度不同，这意味着对公民集体的日益依赖可能会加剧医疗保健获取方面的不平等。进一步的研究应强调将社区层面的信息与关于个人参与护理集体的数据相结合，以便比现有数据更深入地探究邀请、代表性和嵌入性的动态变化。
