Dataset Information

The relationship between social capital and self-rated health: a multilevel analysis based on a poverty alleviation program in the Philippines.

ABSTRACT: BACKGROUND:Poor health is both a cause and consequence of poverty, and there is a growing body of evidence suggesting that social capital is an important factor for improving health in resource-poor settings. International Care Ministries (ICM) is a non-governmental organization in the Philippines that provides a poverty alleviation program called Transform. A core aim of the program is to foster social connectedness and to create a network of support within each community, primarily through consistent community-led small group discussions. The purpose of this research was to investigate the relationship between social capital and self-rated health and how ICM's Transform program may have facilitated changes in those relationships. METHODS:Three types of social capital were explored: bonding-structural, bridging-structural and cognitive. Using cross-sectional data collected before and after Transform, multilevel modelling was used to examine their effects on self-rated health between the two time points. RESULTS:The analyses showed that while social capital had minimal effects on self-rated health before Transform, a series of associations were identified after the program. Evidence of interdependence between the different types of social capital was also observed: bonding social capital only had a beneficial effect on self-rated health in the presence of bridging social capital, but we found that there was a 17 percentage point increase in self-rated health when individuals possessed all possible bridging and bonding relationships. At the same time, our estimates showed that maximising all forms of social capital is not necessarily constructive, as the positive effect of cognitive social capital on self-rated health was weaker at higher levels of bridging social capital. CONCLUSIONS:The results from this study has shown that building social capital can influence the way people perceive their own health, which can be facilitated by intervention programs which seek to create bonding and bridging relationships. Transform's intentional design to learn in community could be relevant to program planners as they develop and evaluate community-based programs, making adaptations as necessary to achieve organisation-specific goals while acknowledging the potential for varied effects when applied in different contexts or circumstances.

SUBMITTER: Hung N

PROVIDER: S-EPMC6896750 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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The relationship between social capital and self-rated health: a multilevel analysis based on a poverty alleviation program in the Philippines.

Hung Natalee N Lau Lincoln Leehang LL

BMC public health 20191205 1

<h4>Background</h4>Poor health is both a cause and consequence of poverty, and there is a growing body of evidence suggesting that social capital is an important factor for improving health in resource-poor settings. International Care Ministries (ICM) is a non-governmental organization in the Philippines that provides a poverty alleviation program called Transform. A core aim of the program is to foster social connectedness and to create a network of support within each community, primarily thr ...[more]

PMID: 31806012

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Project description: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.

Project description:BackgroundAlthough various studies have found a positive association between neighborhood social capital and individual health, the mechanism explaining this direct effect is still unclear. Neighborhood social capital is the access to resources that are generated by relationships between people in a friendly, well-connected and tightly knit neighborhood community. We expect that the resources generated by cohesive neighborhoods support and influence health -improving behaviors in daily life. We identify five different health-related behaviors that are likely to be affected by neighborhood social capital and test these behaviors separately as mediators.MethodsThe data set pertaining to individual health was taken from the 'health interview' in the 'Second Dutch national survey of general practice' (DNSGP-2, 2002). We combine these individual-level data with data from the 'Dutch housing demand survey' (WBO, 1998 and WoON, 2002) and statistical register information (1995-1999). Per neighborhood 29 WBO respondents, on average, had answered questions regarding social capital in their neighborhood. These variables have been aggregated to the neighborhood level by an ecometric methodology. In the main analysis, in which we tested the mediation, multilevel (ordered) logistic regressions were used to analyze 9253 adults (from the DNSGP-2 data set) from 672 Dutch neighborhoods. In the Netherlands, on average, neighborhoods (4-digit postcodes) comprise 4,000 inhabitants at highly variable population densities. Individual- and neighborhood-level controls have been taken into account in the analyses.ResultsIn neighborhoods with a high level of social capital, people are more physically active and more likely to be non-smokers. These behaviors have positive effects on their health. The direct effect of neighborhood social capital on health is significantly and strongly reduced by physical activity. This study does not support nutrition and sleep habits or moderate alcohol intake as possible explanations of the effects of neighborhoods on health.ConclusionsThis study is one of the first to test a mechanism explaining much of the direct effect of small-area social capital on individual health. Neighborhood interventions might be most successful at improving health if they stimulate both social interaction and physical activity.

Project description:BackgroundSocial conditions, social relationships and neighbourhood environment, the components of social capital, are important determinants of health. The objective of this study was to investigate the association of neighbourhood and individual social capital with consistent self-rated health in women between the first trimester of pregnancy and six months postpartum.MethodsA multilevel cohort study in 34 neighbourhoods was performed on 685 Brazilian women recruited at antenatal units in two cities in the State of Rio de Janeiro, Brazil. Self-rated health (SRH) was assessed in the 1st trimester of pregnancy (baseline) and six months after childbirth (follow-up). The participants were divided into two groups: 1. Good SRH--good SRH at baseline and follow-up, and, 2. Poor SRH--poor SRH at baseline and follow-up. Exploratory variables collected at baseline included neighbourhood social capital (neighbourhood-level variable), individual social capital (social support and social networks), demographic and socioeconomic characteristics, health-related behaviours and self-reported diseases. A hierarchical binomial multilevel analysis was performed to test the association between neighbourhood and individual social capital and SRH, adjusted for covariates.ResultsThe Good SRH group reported higher scores of social support and social networks than the Poor SRH group. Although low neighbourhood social capital was associated with poor SRH in crude analysis, the association was not significant when individual socio-demographic variables were included in the model. In the final model, women reporting poor SRH both at baseline and follow-up had lower levels of social support (positive social interaction) [OR 0.82 (95% CI: 0.73-0.90)] and a lower likelihood of friendship social networks [OR 0.61 (95% CI: 0.37-0.99)] than the Good SRH group. The characteristics that remained associated with poor SRH were low level of schooling, Black and Brown ethnicity, more children, urinary infection and water plumbing outside the house.ConclusionsLow individual social capital during pregnancy, considered here as social support and social network, was independently associated with poor SRH in women whereas neighbourhood social capital did not affect women's SRH during pregnancy and the months thereafter. From pregnancy and up to six months postpartum, the effect of individual social capital explained better the consistency of SRH over time than neighbourhood social capital.

Dataset Information

The relationship between social capital and self-rated health: a multilevel analysis based on a poverty alleviation program in the Philippines.

Publications

The relationship between social capital and self-rated health: a multilevel analysis based on a poverty alleviation program in the Philippines.

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