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The purpose of this paper is to investigate the effect of social trust on the willingness to pay more taxes to improve public healthcare in post-communist countries. The well-documented association between higher levels of social trust and better health has traditionally been assumed to reflect the notion that social trust is positively associated with support for public healthcare system through its encouragement of cooperative behaviour, social cohesion, social solidarity, and collective action. Hence, in this paper, we have explicitly tested the notion that social trust contributes to an increase in willingness to financially support public healthcare. We use micro data from the 2010 Life-in-Transition survey (N = 29,526). Classic binomial probit and instrumental variables ivprobit regressions are estimated to model the relationship between social trust and paying more taxes to improve public healthcare. We found that an increase in social trust is associated with a greater willingness to pay more taxes to improve public healthcare. From the perspective of policy-making, healthcare administrators, policy-makers, and international donors should be aware that social trust is an important factor in determining the willingness of the population to provide much-needed financial resources to supporting public healthcare. From a theoretical perspective, we found that estimating the effect of trust on support for healthcare without taking confounding and measurement error problems into consideration will likely lead to an underestimation of the true effect of trust. [ABSTRACT FROM AUTHOR]

Drawing on ethnographic research with kanyeleng fertility society performers and health workers in The Gambia (2012–2013), this paper uses a social capital approach to analyze the relationship between musical performance and health communication. Health communication research has demonstrated the important role of social capital in mediating the impact of interventions. Music research has drawn attention to performance as a site in which social relationships and obligations are produced and negotiated. In this paper, I bring these two perspectives together in order to open up new ways of thinking about musical performance as a culturally appropriate strategy in health communication. Drawing on participant observation as well as individual and group interviews with performers and health workers (126 participants), I argue that kanyeleng performance facilitates health communication by building on existing social networks and forms of social capital. This research contributes to a paradigm shift in research on performance and health communication, moving away from individual-focused behaviour change communication, and toward a culture-centered approach that considers community participation in relation to broader social and structural issues. This research suggests that musical genres such as kanyeleng performance may help build trust between health professionals and target communities while also facilitating information dissemination and public debate on sensitive health topics. [ABSTRACT FROM AUTHOR]

A rising emphasis on patient involvement in clinical research and healthcare improvement has led to the steady incorporation of patients and caregivers into this work. However, interactional factors shaping recruitment processes are not well understood. In this paper, we present a qualitative analysis of interviews with twenty-six patients, family members, engagement staff and healthcare providers who are engaged in healthcare improvement work in the United States. We focus on how stakeholders account for recruitment decisions to participate in healthcare improvement work. We find that expressions of and judgments about patients' and caregivers' cultural health capital shape providers' decisions to extend invitations to participate in healthcare improvement work. These findings extend current conceptualizations of cultural health capital beyond the clinical encounter to reveal factors shaping patient recruitment into healthcare improvement work. In theorizing how cultural health capital shapes action in this new setting, we found that healthcare providers, engagement staff, and patients/caregivers attended to different aspects of cultural health capital when accounting for why they extended or received a recruitment pitch. We further found that participating in healthcare improvement work led to a boost in cultural health capital for patients and caregivers, which they could use to develop transmissible forms of cultural health capital for less centrally involved patients and caregivers. Finally, we describe how participants in healthcare improvement collaboratives account for a lack of diversity among partners. These findings help us hypothesize the consequences of recruitment processes that rely on displays and judgments of cultural health capital and identify possibilities for change. Using the case of healthcare improvement work in Collaborative Learning Health Systems, our findings advance past work on cultural health capital in medical sociology by theorizing the role of cultural health capital in recruitment processes. • Providers recruit patients for healthcare improvement work with subjective criteria. • Providers often recruit high-resourced, privileged patients that they "vibe" with. • Partners build cultural health capital from doing healthcare improvement work. • Recruiting for cultural health capital may exclude patients from diverse backgrounds. • The role of recruitment should be considered to improve partner representation. [ABSTRACT FROM AUTHOR]

This paper aims to clarify the association between various social capital components at the municipal level (community social capital) and two quality-of-life factors at the individual level [individual self-rated life satisfaction and self-rated health (SRH)] based on data from a nationwide social capital survey that the authors carried out in 2013 in Japan (N = 3406 in 99 municipalities). The survey covers residents in Japan between the ages of 20 and 79 years. We focus on both contextual social capital and household income inequality in terms of the Gini coefficient at the municipality level since, to the best of our knowledge, no paper has explicitly dealt with municipalities in Japan as the units of contextual social capital and the Gini. Our analyses show that the subjective life satisfaction of individuals, after controlling for socioeconomic status and health at the individual level, is associate with both an income gap and social capital at the municipal level. Every component of community social capital in this study except for generalized reciprocity, both cognitive (generalized trust, particularized trust, and particularized reciprocity), and structural (three types of group participation and daily contacts with neighbors, friends/acquaintances, and colleagues), and the Gini coefficient on earned income were associated with self-rated life satisfaction at the individual level with statistical significance. However, SRH is associated only with cognitive social capital at the community level. SRH has no significant association with structural components of community social capital or with a community income gap in terms of the Gini coefficient on personal income. Judging from the results of estimates in the study, most of the components of community social capital at the municipal level seem to play an important role in enhancing self-rated life satisfaction. Life satisfaction may be associated with the broad atmosphere of the municipal level where one resides, while SRH is associated with cognitive social capital rather than structural social capital. However, the difference in the impact of contextual social capital between the two QOL indices may indicate the importance of considering a proper contextual level that is suitable for the outcome. [ABSTRACT FROM AUTHOR]

An increasing number of studies have addressed the determinants of suicide. Social capital is a key factor in preventing suicide. However, little is known about the experience of suicide ideation using subjective values. From the viewpoint of suicide prevention, it is worth examining how people think of suicide. This paper attempts to examine the effect of social capital on suicide ideation. Furthermore, the paper compares the effect of social capital between urban and non-urban areas. In this paper, urban areas are equivalent to mega-cities with populations over one million. Non-urban areas are cities with populations of less than one million, towns and villages. Individual-level data from the Japanese General Social Surveys (JGSSs) are used. The survey, which was conducted in 2006, provides information about the subjective value of suicide ideation. The survey was answered by 1413 subjects with a mean age of 54.5. Of the subjects, 49% were male. Social trust is used to measure the degree of social capital, and the outcome of interest is suicide ideation within the past 5 years. After controlling for various factors, the major findings are that both individual-level social trust and social trust accumulated in one's residential administrative district reduce the probability that one will consider suicide. After dividing the sample into urban and non-urban residents, particularized trust plays a role in deterring suicide ideation in urban areas, while generalized trust plays a role in deterring suicide ideation in non-urban areas. The effect of each type of trust depends on its scarcity in residential areas. [ABSTRACT FROM AUTHOR]

Globally, an estimated 748 million people remain without access to improved sources of drinking water and close to 1 billion people practice open defecation (WHO/UNICEF, 2014). The lack of access to safe water and adequate sanitation presents significant health and development challenges to individuals and communities, especially in low and middle income countries. Recent research indicates that aside from financial challenges, the lack of social capital is a barrier to collective action for community based water and sanitation initiatives (Levison et al., 2011; Bisung and Elliott, 2014). This paper reports results of a case study on the relationships between elements of social capital and participation in collective action in the context of addressing water and sanitation issues in the lakeshore village of Usoma, Western Kenya. The paper uses household data ( N = 485, 91% response rate) collected using a modified version of the social capital assessment tool (Krishna and Shrader, 2000). Findings suggest that investment in building social capital may have some contextual benefits for collective action to address common environmental challenges. These findings can inform policy interventions and practice in water and sanitation delivery in low and middle income countries, environmental health promotion and community development. [ABSTRACT FROM AUTHOR]

Obesity remains a significant public health concern globally with over one billion adults projected to be obese by 2025. To better understand the drivers of obesity and to inform policy, it is important to explore the factors that influence obesity. The objective of this paper to examine if the crime rates in the neighbourhood or local area in which a person lives influences their likelihood of being obese. Thus, we seek to contribute to the literature on the determinants of obesity by asking the question: what is the effect of neighbourhood (i.e., postcode) crime on obesity? We also examine the pathways through which neighbourhood crime influences obesity with a focus on the role of social capital, physical activity and sleep quality. Using 14 waves of longitudinal data from the Household, Income and Labour Dynamics in Australia (HILDA) survey merged with official police statistics on crime rates at the postcode level, we apply identification strategies that address endogeneity arising from endogenous sorting and omitted variable bias. We find that an increase in neighbourhood crime rates is associated with an increase in body mass index (BMI) and the likelihood of being obese. Exploring the pathways through which neighbourhood crime influences obesity, we find that social capital and physical activity are important channels, while sleep quality is not. The evidence also suggests that the effects of violent crime are more pronounced compared to property crime. Our findings suggest that targeting crime, and in particular violent crime, which seems to be driving the findings, is a core mechanism for reducing BMI and maintaining healthy body weight. The mediating role of physical activity and social capital also suggest that public policy can specifically target these areas by providing interventions that promote social capital and physical activity even amidst high crime rates. • We examine the impact of neighbourhood crime on obesity. • We use 14 waves of longitudinal data from Australia. • Neighbourhood crime increases obesity. • Social capital and physical activity are important channels. • Effects are stronger for females than males. [ABSTRACT FROM AUTHOR]

Abstract: In the United States, racial disparities in kidney transplantation are large and especially stark for living donor transplants. Medical researchers frequently attribute this to the availability of medically compatible living kidney donors, who are usually kin. This paper evaluates this hypothesis by testing whether African American transplant candidates likely have lesser access to suitable living donors in their kinship networks than white candidates. This paper evaluates this hypothesis using a simulation design. Contrary to prior research on this topic, this simulation analysis concludes that black-white disparities in living donor kidney transplantation are unlikely to be the result of group differences in the availability of suitable donors. Although individual white kin are individually more likely to be suitable donors, African Americans' larger average kinship networks compensate for this difference. [Copyright &y& Elsevier]

This paper reports on research framed by theories of therapeutic landscapes and the ways that the social, physical and symbolic dimensions of landscapes relate to wellbeing and healing. We focus especially on the question of how attributes of therapeutic landscapes are constructed in different ways according to the variable perspectives of individuals and groups. Through an ethnographic case study in a psychiatric hospital in the North of England we explore the perceived significance for wellbeing of ‘smoking spaces’ (where tobacco smoking is practiced in ways that may, or may not be officially sanctioned). We interpret our findings in light of literature on how smoking spaces are linked to the socio-geographical power relations that determine how smoking is organised within the hospital and how this is understood by different groups using the hospital building. We draw on qualitative research findings from discussion groups, observations, and interviews with patients, carers and staff. These focused on their views about the building design and setting of the new psychiatric hospital in relation to their wellbeing, and issues relating to smoking spaces emerged as important for many participants. Creating and managing smoking spaces as a public health measure in psychiatric hospitals is shown to be a controversial issue involving conflicting aims for health and wellbeing of patients and staff. Our findings indicate that although from a physical health perspective, smoking is detrimental, the spaces in which patients and staff smoke have social and psychological significance, providing a forum for the creation of social capital and resistance to institutional control. While the findings relate to one case study setting, the paper illustrates issues of wider relevance and contributes to an international literature concerning the tensions between perceived psychological and psychosocial benefits of smoking vs. physical harm that smoking is likely to cause. We consider the implications for hospital design and the model of care. [Copyright &y& Elsevier]

Abstract: The prevalence of child obesity has increased steadily in the recent decades. Drawing on Bourdieu’s theory of lifestyle connecting objective conditions with preferences, values and behaviour, this paper seeks to provide an extension to previous research, which has found child body formation to be correlated with parental socioeconomic background. The paper shows how parental level of capital, especially cultural capital, influences the prevalence of child overweight and parental perceptions of child weight-levels. Parents with higher levels of cultural capital are less likely to have overweight children and more likely to perceive weight-levels in accordance with the BMI categories. The results also demonstrate clear gender differences. Parents have a tendency to overestimate their daughters’ weight-levels while underestimating the weight-levels of their sons compared to the BMI categories. The study is based on Danish survey data from 2007 and uses statistical estimation techniques. [Copyright &y& Elsevier]

Social epidemiology, as defined by the textbook of the same name (Berkman et al., 2014) is “that branch of epidemiology concerned with the way that social structures, institutions, and relationships influence health” (p. 2). As our Special Issue commemorates the 50th anniversary of Social Science & Medicine, it is worth noting that the Social Epidemiology office within the journal has existed only for a fraction of that time (fifteen years). So what has been learned in the fifteen years since the establishment of the new office? In this commentary, we spotlight some of the achievements, substantive topics, and future trends in the research papers that we have featured in our Section of the journal. [ABSTRACT FROM AUTHOR]

Despite increasing evidence that social capital is positively associated with health, the pathways that link social capital to health are not definitive and invite further investigation. This paper uses household survey data from 22 villages in China in 2002 to test the relationship between social capital and the self-reported health status of the rural population. Focusing on the cognitive dimension of social capital, this paper complements current social capital research by introducing an overlooked distinction between trust and mistrust. Trust and mistrust are measured at the individual and aggregate levels, and the distinct ways in which they affect general and mental health are explored. We adopt an ordered logistic regression using survey procedures in SAS version 9.1 to account for the stratified and clustered data structure. The results suggest that: (1) individual-level trust and mistrust are both associated with self-reported health in rural China – trust is positively associated with both general health and mental health, while mistrust is more powerfully associated with worse mental health; and (2) the effects of individual-level trust and mistrust are dependent on village context – village-level trust substitutes for individual-level trust, while individual-level mistrust interacts positively with village-level mistrust to affect health. However, an unexpected protective health effect of mistrust is found in certain types of villages, and this unique result has yet to be examined. Overall, this study suggests the conceptual difference between trust and mistrust and the differential mechanisms by which trust and mistrust affect health in rural China. It also suggests that effective policies should aim at enhancing trust collectively or reducing mistrust at the personal level to improve health status in rural areas of China. [Copyright &y& Elsevier]

Abstract: This paper explores the role of social capital in mediating the effects of stressors on depression among a disadvantaged population. Utilizing a survey of 155 homeless people in a mid-sized southern U.S. city, the authors address the relevance of social capital for quality of life. The paper provides a critical test of whether social support and other forms of social capital matter when monetary and human capital is extremely limited. Under these resource-restricted circumstances does social capital add to our understanding of the distress process or does it merely restate the well established relationship between social support and quality of life outcomes? Various forms of social capital are measured: religious social capital, group participation, social trust, and bridging social capital along with a commonly used measure of social support -- perceived strong tie support. Findings suggest that social capital matters for even the most resource poor populations. In addition, social capital variables add significantly to the variance explained in depressive symptomatology over and above that traditionally explained by perceived social support. [Copyright &y& Elsevier]

Abstract: Robert Putnam showed that a social capital index, created as a weighted sum of 14 variables chosen to describe the civic degree of sociability and community mindedness, is correlated with many community outcomes, such as education, child well-being, crime, and the total mortality rate. Although correlation does not establish causation, we can find that in a large number of studies this index, a selection of its elements, or similar measures register as significantly correlated with health variables, virtually always in a direction consistent with the hypothesis that social capital improves health. The potential benefit of this relationship is substantial, especially if it proves to be robust to differences in time and place, statistical contexts, and ultimately if the relation can be supported to be causal. This paper subjects the social capital and health hypothesis to an expanded set of rigorous tests, which, by surviving, it becomes stronger or, by failing, its weaknesses are better revealed. The paper seeks to extend this body of research by a combination of study characteristics that are each relatively unusual in social capital and health research. Though causality cannot be established by these tests, the work shows that the association of social capital with health is quite robust when challenged in the following ways: (1) seven different health measures are studied, including five mortality rates; (2) the 48 contiguous states are observed at six points in time covering the years from 1978 to 1998 over four year intervals, thus forming a panel; (3) the multivariate tests feature economic variables from the production of health literature; and (4) a statistical method (instrumental variables) is applied to account for the possibility that omitted variables are confounding the social capital estimates. The results and the discussion find cases for which the social capital and health hypothesis performs only weakly, but, on the whole, the hypothesis is remarkably robust to these variations. [Copyright &y& Elsevier]

Social capital has been the focus of considerable academic and policy interest in recent years. Despite this interest, the concept remains undertheorized: there is an urgent need for a critical engagement with this literature that goes beyond summary. This paper lays a foundation for a critical dialogue between social capital and health promotion, by examining problematics in the conceptualization and practice of social capital building and linking these to models of community development, a cornerstone health promotion strategy. In so doing, the paper contributes to the existing literature by providing a theoretical exposition and critique of various threads in social capital discourse, and linking these threads explicitly to community development practice. Distinctions between communitarian, institutional and critical approaches to social capital are elaborated, and the relationships between these three approaches and three models of community development -- social planning, locality development, and social action -- are discussed. The existing social capital literature is then critically examined in relation to three key themes common to both literatures: community integration, public participation, and power relations. This examination suggests that social capital cannot be conceived in isolation from economic and political structures, since social connections are contingent on, and structured by, access to material resources. This runs counter to many current policy discourses, which focus on the importance of connection and cohesion without addressing fundamental inequities in access to resources. This paper posits that approaches to community development and social capital should emphasise the importance of a conscious concern with social justice. A construction of social capital which explicitly endorses the importance of transformative social engagement, while at the same time recognising the potential negative consequences of social capital development, could help community organizers build communities in ways that truly promote health. [ABSTRACT FROM AUTHOR]

Social capital has been linked to health outcomes, though there are some inconsistencies in the research and the link is dependent on the measures of social capital and health used. In this paper, we argue that social capital is multifaceted and its relationship with health is complex. We explore the relationship between a number of elements of neighbourhood life and neighbourhood-based social capital, and health, using both qualitative and quantitative methods. The paper reports on a study of the Western suburbs of Adelaide and the analysis of 2400 questionnaires and 40 in-depth interviews. A partial least-square path analysis was undertaken with the questionnaire data. It considered the impact of perceptions of the physical environment, neighbourhood connections, neighbourhood trust, reciprocity, perceived safety and local civic action, and a number of demographic variables, on physical and mental health as measured by the SF-12. Of the neighbourhood-related variables, only perceived neighbourhood safety was related to physical health, with neighbourhood safety and neighbourhood connections related to mental health. Of the demographic variables, higher-income level and educational achievement were related to better physical and mental health. In addition, physical health was lower and mental health higher within older age groups. The inter-relationships between the neighbourhood variables and demographic differences in experience of neighbourhood were also examined. The thematic analysis of the interviews linked a number of social aspects of neighbourhood, the physical neighbourhood environment, perceptions of safety, civic activities and availability of local services, to health outcomes. The paper concludes that there is a need for more complex measures of social capital and that socio-economic factors are of relatively greater importance in determining health. [Copyright &y& Elsevier]

This paper analyses the relationship between social capital and population health. The analysis is carried out within an econometric model of population health in 19 countries in the Organisation for Economic Co-operation and Development countries using panel data covering three different time periods. Social capital is measured by the proportion of people who say that that they generally trust other people and by membership in voluntary associations. The model performs well in explaining health outcomes. We find very little statistically significant evidence that the standard indicators of social capital have a positive effect on population health. By contrast, per capita income and the proportion of health expenditure financed by the government are both significantly and positively associated with better health outcomes. The paper casts doubt upon the widely accepted hypothesis that social capital has a positive effect on health and illustrates the importance of testing this kind of hypothesis in an extended model. [Copyright &y& Elsevier]

Social capital has become a popular term over the past two decades amongst researchers, policy makers and practitioners from varied disciplines. This popularity, however, has resulted in a great deal of confusion over the nature and application of social capital in different contexts. This confusion has made it difficult to identify and measure social capital within the evaluation of specific social and health programmes, one of the aims of which may be to stimulate social capital. This paper identifies a theoretical model that seeks to capture the dynamic nature of social capital to assist in the development of research methods that will facilitate its measurement and exploration within such programmes. The model reported in the paper identifies the key components of social capital and expresses the relationship between those components in a dynamic system based on Marx''s description of the process of capital (economic) exchanges expressed in the M–C–M′ cycle. The M–C–M′ cycle is the transformation of money (M) into commodities (C), and the change of commodities back again into money (M′) of altered value. The emphasis within the paper is on the capital element of the concept and its transactional nature with the aim of avoiding the pitfall of attributing social capital in relation to social behaviours in isolation of context and interaction. Importantly, the paper seeks to distinguish the central elements of social capital from some of the antecedent factors and outcomes often attributed to and confused with social capital adding to the problem of providing valid measurement. The model is presented as the basis for the measurement of social capital within a transactional process involving the investment of social resources in a cyclical process, which may result in net gains or losses. This process is described as the R–C–R′ cycle following Marx''s model of economic capital, with the focus being on the transfer of social resources (R) rather than money (M). R represents an internal resource held by individuals, C the external resource or commodity they obtain from the network and the R′ the internal resource of altered value. The possibilities of the model in assisting in the measurement of social capital specifically in assessing formal networks are explored. [Copyright &y& Elsevier]

In this paper, we present novel evidence of the extent to which intergenerational mobility is generalized or specific across domains of human and health capital. That is, do children who experience greater mobility in one domain (e.g., income) also experience mobility in other domains (education, health status, health behaviors, crime). Using rich data in Add Health, we find evidence against generalized mobility—families that are more mobile in one domain are not more mobile in others. We then ask a place-based version of this question, motivated by Chetty et al. (2014)'s work showing high levels of geographically-based income mobility in the US. The school-based sampling combined with parent-child links across many outcome domains of the Add Health allows us to use a common dataset between the two analyses. Like our individual-based results, we find limited evidence of generalized mobility by place—indeed, most estimates suggest close-to-zero correlations between many of the ten domains we explore. • Theoretically, intergenerational mobility could be generalized or specific. • Empirically, we find more evidence of specific mobility. • People and places with high income mobility may not have high health mobility. [ABSTRACT FROM AUTHOR]

The neoclassic economic rationale has taken for granted that the effect of effort on health is negative. However, several studies in the field of occupational health and medicine claim that working is clearly better for health than non-working or being unemployed, as some psychological and physical condition may improve with work effort. This paper analyzes the effect of work effort on occupational health. The proposed human capital approach builds upon the classic economic perspective, that assumes a negative effect of effort on health, and extends it by allowing positive effects, as suggested by occupational researchers. Using a sample from 2010 of 20,000 European workers we find that, under adequate working conditions, the level of effort (measured in working hours) at which health starts to deteriorate is very high (120 h per week). However, if working conditions are not adequate, even a moderate effort (35 h per week) can harm workers health. [ABSTRACT FROM AUTHOR]

Peer relations inform consumption practices that shape both alcohol use and prescription drug misuse. Integrating studies on pharmaceutical cognitive enhancement with research on consumptive based edgework, this paper examines the role of psychostimulant medications in resolving contradictory aspects of contemporary peer building processes. Drawing on qualitative interviews (n = 162) from a U.S. based study on the context of young adult prescription drug misuse, we demonstrate how medical resources are incorporated into peer bonding rituals in order to enhance consumptive capacity, reduce social risks, and facilitate the accumulation of relational capital. These findings highlight the paradoxical and problematic health ramifications of consumptive based peer bonding practices as well as how psycho-stimulant medications may compound those issues in unintended ways. • Explores how peer bonding and accumulation of relational capital shape substance use. • Examines medicines role in resolving paradoxical aspects of over-consumption. • Expands contextual understandings of pharmaceutical based cognitive enhancement. • Offers insight into unintended consequences of psychostimulant prescribing practices. [ABSTRACT FROM AUTHOR]

As health and social service professions increasingly emphasize commitments to equity, advocacy and social justice, non-traditional entrants to the professions increasingly bring much-needed diversity of social backgrounds and locations. Long the domain of elite social classes, the professions are not always welcoming cultures for those from lower social class backgrounds. This paper draws on notions of material, social and cultural capital, along with habitus , to examine the experiences of professionals with lower-class backgrounds, in educational programs and in their professions. The critical interpretive qualitative study draws on interviews with 27 professionals across Canada in medicine, nursing, social work and occupational therapy. While participants were clearly set apart from their colleagues by class origins, which posed distinct struggles, they also brought valuable assets to their work: enhanced connection and rapport with clients/patients, approachability, structural analysis and advocacy, plus nuanced re-envisioning of professional ethics to minimize power dichotomies. Rather than helping lower-class entrants adapt to the professions, it may be more beneficial to alter normative professional cultures to better suit these practitioners. • People from lower-class backgrounds may struggle in the professions. • The material, social and cultural capitals expected cast them as cultural outsiders. • They may more readily enact the social justice and equity aims of the professions. • We need transformational change to professional cultures of elitism and exclusion. [ABSTRACT FROM AUTHOR]

The present paper analysed the directions of associations between individual-level structural social capital, in the form of civic engagement, and depressive symptoms across time from age 16–42 years in Swedish men and women. More specifically, we asked whether civic engagement was related to changes in depressive symptoms, if it was the other way around, or whether the association was bi-directional. This longitudinal study used data from a 26-year prospective cohort material of 1001 individuals in Northern Sweden (482 women and 519 men). Civic engagement was measured by a single-item question reflecting the level of engagement in clubs/organisations. Depressive symptoms were assessed by a composite index. Directions of associations were analysed by means of gender-separate cross-lagged structural equation models. Models were adjusted for parental social class, parental unemployment, parental health, and family type at baseline (age 16). Levels of both civic engagement and depressive symptoms were relatively stable across time. The model with the best fit to data showed that, in men, youth civic engagement was negatively associated with depressive symptoms in adulthood, thus supporting the hypothesis that involvement in social networks promotes health, most likely through provision of social and psychological support, perceived influence, and sense of belonging. Accordingly, interventions to promote civic engagement in young men could be a way to prevent poor mental health for men later on in life. No cross-lagged effects were found among women. We discuss this gender difference in terms of gendered experiences of civic engagement which in turn generate different meanings and consequences for men and women, such as civic engagement not being as positive for women’s mental health as for that of men. We conclude that theories on structural social capital and interventions to facilitate civic engagement for health promoting purposes need to acknowledge gendered life circumstances. [ABSTRACT FROM AUTHOR]

Among various social factors associated with health behavior and disease, social cohesion has not captured the imagination of public health researchers as much as social capital as evidenced by the subsuming of social cohesion into social capital and the numerous studies analyzing social capital and the comparatively fewer articles analyzing social cohesion and health. In this paper we provide a brief overview of the evolution of the conceptualization of social capital and social cohesion and we use philosopher Erich Fromm’s distinction between “having” and “being” to understand the current research focus on capital over cohesion. We argue that social capital is related to having while social cohesion is related to being and that an emphasis on social capital leads to individualizing tendencies that are antithetical to cohesion. We provide examples drawn from the literature where this conflation of social capital and cohesion results in non-concordant definitions and subsequent operationalization of these constructs. Beyond semantics, the practical implication of focusing on “having” vs. “being” include an emphasis on understanding how to normalize groups and populations rather than providing those groups space for empowerment and agency leading to health. [ABSTRACT FROM AUTHOR]

What is the relationship between community trust and household health? Scholars working to understand the effects of trust and social capital on human health tend to focus on individual characteristics or social environments, frequently without integrating these two dimensions. In light of this, the present paper makes contributions in both conceptualization and measurement. First, I develop a spatially-based approach for operationalizing community trust as the product of individual orientation and social environment. This approach highlights the need for a household to trust its neighbors and for those neighbors to reciprocate trust in order to constitute the psychological and material mechanisms critical for linking social context to individual health. Second, I illustrate the utility of this measure by evaluating the relationship between community trust and self-rated health status using an original population census survey from 2009 to 2010 for two municipalities in western Honduras (approximately 2800 households with a response rate of 94.9%). I implement spatial regression analysis and show that there is a positive and substantively meaningful relationship between community trust and household health; households that are trusting and surrounded by similarly trusting neighbors report better health status, while those in uncertain or mutually distrusting environments report worse health. The theory and results presented here suggest an important link between trust and social capital at the community level, which is particularly salient for rural regions in developing countries where health resources are scarce and community-based interventions are common. [ABSTRACT FROM AUTHOR]

Antibiotic resistance is a collective action dilemma. Individuals may request antibiotics, but an overall reduction in use is necessary to limit resistance. A reoccurring theoretical claim is that social capital increase cooperation in social dilemmas. The aim of this paper is to investigate the link between generalized trust and reciprocity and the willingness to postpone antibiotic treatment in order to limit overuse in a scenario-based study. A between-subject scenario experimental approach with hypothetical scenarios was utilized. Participants were asked to imagine that they were seeing a doctor for a respiratory infection. The doctor prescribes antibiotics, but advise postponing therapy to see if the disease resolves by itself, for the sake of limiting overuse. Respondents were asked to answer how long they could accept postponing antibiotic treatment, from 0 to 7 days. The number of days that most people would be able to accept postponing treatment was considered the between-subject factor. In total, the study sample included 981 respondents with a mean age of 51 years. A majority of respondents were men (65.7%). The mean number of days that the respondents stated they were willing to postpone antibiotic treatment was positively associated with the number of days the respondents were told that most people were willing to postpone antibiotic treatment, p < 0.001. There was a positive association between number of days they were willing to postpone antibiotic treatment and generalized trust, p = 0.001. In conclusion, the results showed that the proclaimed public willingness to postpone therapy influenced a respondent's willingness to postpone antibiotic therapy in different scenarios. Also, generalized trust was positively associated with the willingness to postpone therapy. [ABSTRACT FROM AUTHOR]

The links between social capital and mental wellbeing are established but the direction of the social capital-wellbeing relationship is rarely systematically examined. This omission undermines the validity of social capital as a basis for health interventions. The aim of this paper was to explore the short-term (one-year) reciprocal relationship between community participation – an important component of social capital – and mental wellbeing. We used nationally representative Household, Income and Labour Dynamics in Australia (HILDA) Survey data, 2005–11. The HILDA Survey is an annual cohort study from which was extracted a sub-sample of panel data (the same people participating across multiple waves) enabling us to use fixed effects regression methods to model the longitudinal association of mental health and participation controlling for individual heterogeneity. The results showed that better mental wellbeing in one year was generally related to more community participation the next year, while greater past community participation was linked to better mental wellbeing the next year independent of (i) initial mental wellbeing, (ii) multiple potentially confounding factors and (iii) unobserved and time-constant heterogeneity. Political participation was marginally related to worse mental health in both directions. The results also showed that the association between community participation and mental wellbeing the next year is weaker for those with poor initial wellbeing than for initially healthier respondents. Our findings may inform the trial and scientific evaluation of programs aimed at increasing informal social connectedness and civic engagement to promote mental wellbeing. [ABSTRACT FROM AUTHOR]

Abstract: In recent years, there has been considerable interest in social capital theory in both research and policy arenas. Social capital has been associated with many aspects of improvements in health, environment and development. This paper assesses the theoretical support for a social capital based analysis of environment and health issues with a focus on the water-health nexus in low and middle income countries. We review conceptualisation of social capital by Pierre Bourdieu in relation to his concepts of “fields” and “habitus” as well as other conceptualisations of social capital by James Coleman and Robert Putnam. We integrate these authors' ideas with ecosocial analysis of social and geographical patterns of access to safe water, adequate sanitation and hygiene and the resulting health impacts. Further, we develop a conceptual framework for linking social capital and health through the water-health nexus. The framework focuses on the role of social capital in improving water-related knowledge, attitudes and practices as well as facilitating collective action towards improving access to water and sanitation. The proposed framework will facilitate critical engagement with the pathways through which social processes and interactions influence health within the context of access to water, sanitation and hygiene in low and middle income countries. [Copyright &y& Elsevier]

Abstract: Research from across disciplines has demonstrated that social and political contextual factors at the national and subnational levels can impact the health and health behavior risks of individuals. This paper examines the impact of state-level social capital and ideology on individual-level health outcomes in the U.S. Leveraging the variation that exists across states in the U.S., the results reveal that individuals report better health in states with higher levels of governmental liberalism and in states with higher levels of social capital. Critically, however, the effect of social capital was moderated by liberalism such that social capital was a stronger predictor of health in states with low levels of liberalism. We interpret this finding to mean that social capital within a political unit—as indicated by measures of interpersonal trust—can serve as a substitute for the beneficial impacts that might result from an active governmental structure. [Copyright &y& Elsevier]

Abstract: Although there has been extensive research on the adverse impacts of perceived discrimination on health, it remains unclear how perceived discrimination gets under the skin. This paper develops a comprehensive structural equation model (SEM) by incorporating both the direct effects of perceived discrimination on self-rated health (SRH), a powerful predictor for many health outcomes, and the indirect effects of perceived discrimination on SRH through health care system distrust, neighborhood social capital, and health behaviors and health conditions. Applying SEM to 9880 adults (aged between 18 and 100) in the 2008 Southeastern Pennsylvania Household Health Survey, we not only confirmed the positive and direct association between discrimination and poor or fair SRH, but also verified two underlying mechanisms: 1) perceived discrimination is associated with lower neighborhood social capital, which further contributes to poor or fair SRH; and 2) perceived discrimination is related to risky behaviors (e.g., reduced physical activity and sleep quality, and intensified smoking) that lead to worse health conditions, and then result in poor or fair SRH. Moreover, we found that perceived discrimination is negatively associated with health care system distrust, but did not find a significant relationship between distrust and poor or fair SRH. [Copyright &y& Elsevier]

Social capital has been linked to physical and mental health. While definitions of social capital vary, all include networks of social relationships and refer to the subsequent benefits and disadvantages accrued to members. Research on social capital for Aboriginal Australians has mainly focused on discrete rural and remote Aboriginal contexts with less known about the features and health and other benefits of social capital in urban settings. This paper presents findings from in-depth interviews with 153 Aboriginal people living in urban areas on their experiences of social capital. Of particular interest was how engagement in bonding and bridging networks influenced health and wellbeing. Employing Bourdieu's relational theory of capital where resources are unequally distributed and reproduced in society we found that patterns of social capital are strongly associated with economic, social and cultural position which in turn reflects the historical experiences of dispossession and disadvantage experienced by Aboriginal Australians. Social capital was also found to both reinforce and influence Aboriginal cultural identity, and had both positive and negative impacts on health and wellbeing. [Copyright &y& Elsevier]

Abstract: The goal of this paper was to investigate whether or not the factors beyond individual characteristics were associated with maternal smoking during pregnancy. Social capital has been found to have both negative and positive implications for health behaviors, and this study attempted to understand its association with maternal smoking during pregnancy. Specifically, the association between county-level social capital and rurality and maternal smoking during pregnancy was investigated. In this study, Putman''s definition of social capital was used (e.g., connections among individuals—social networks and the norms of reciprocity and trustworthiness that arise from them). The ecological dimension of rurality was used to define rurality, where rural areas are smaller in population size and are less densely populated when compared to non-rural areas. Using data for all women who gave birth during the year 2007 in the United States, we implemented a series of multilevel logistic regression models. The results showed that social capital was significantly associated with maternal smoking during pregnancy. Specifically, higher social capital in a county was associated with higher odds that women smoked during their pregnancy. However, in rural counties, higher social capital was associated with a decrease in the odds that a woman smoked during her pregnancy. A one unit increase in the social capital index was found to reduce the risk of smoking during pregnancy among those women living in rural counties by 11 percent. The results also showed that improvement of the socioeconomic status of the counties in which women live reduced the risk of maternal smoking during pregnancy. As this study found that factors beyond individual characteristics are important for reducing the risk that women smoked during pregnancy, county characteristics should be taken into account when developing policies focused on intervening maternal smoking during pregnancy. [Copyright &y& Elsevier]

Abstract: Study and opinion suggest that health services play a significant role in supporting the social fabric of fragile rural communities. We draw on empirical evidence about the added-value contributions of health services to communities and unite it with theory of capitals to propose a theoretical model depicting how rural health services contribute to community sustainability. While providing an analytical framework, the paper also points to construction of a measurement tool for enabling planners to measure the contributions of diverse sectors to community sustainability and predict or measure the impact of changes to models of service delivery on the future of rural communities. [Copyright &y& Elsevier]

Abstract: Social structures and socioeconomic patterns are the major determinants of population health. However, very few previous studies have simultaneously analysed the “social” and the “economic” indicators when addressing social determinants of health. We focus on the relevance of economic and social capital as health determinants by analysing various indicators. The aim of this paper was to analyse independent associations, and interactions, of lack of economic capital (economic hardships) and social capital (social participation, interpersonal and political/institutional trust) on various health outcomes. Data was derived from the 2009 Swedish National Survey of Public Health, based on a randomly selected representative sample of 23,153 men and 28,261 women aged 16–84 year, with a participation rate of 53.8%. Economic hardships were measured by a combined economic hardships measure including low household income, inability to meet expenses and lacking cash reserves. Social capital was measured by social participation, interpersonal (horizontal) trust and political (vertical/institutional trust) trust in parliament. Health outcomes included; (i) self-rated health, (i) psychological distress (GHQ-12) and (iii) musculoskeletal disorders. Results from multivariate logistic regression show that both measures of economic capital and low social capital were significantly associated with poor health status, with only a few exceptions. Significant interactive effects measured as synergy index were observed between economic hardships and all various types of social capital. The synergy indices ranged from 1.4 to 2.3. The present study adds to the evidence that both economic hardships and social capital contribute to a range of different health outcomes. Furthermore, when combined they potentiate the risk of poor health. [Copyright &y& Elsevier]

Abstract: Reports indicate that suicide in the U.S. military has increased significantly in recent years. This increase has been attributed to a number of factors, including more frequent deployments, more relaxed screening of recruits, combat trauma, economic difficulty amongst soldiers, and the breakdown of interpersonal relationships. In this article, we add an element that we believe is crucial to an understanding of military suicide: the socio-cultural environment of the military itself. In particular, we examine the role that the masculine ideologies governing military life play in the internalization of individual frustrations and in suicidal behavior. Suicide investigators often have ignored the role of masculine ideologies in military suicide because of the assumption that suicide results from social disintegration. In contrast, we argue that military suicide is driven largely by excessive social integration. From this perspective, current explanations of military suicide are constrained by gender and etiological assumptions. Finally, this paper suggests the implications of these findings for designing more effective prevention programs for military suicide. [Copyright &y& Elsevier]

Abstract: Although it is widely acknowledged that community social capital plays an important role in young people’s health, there is limited evidence on the effect of community social capital on the social gradient in child and adolescent health. Using data from the 2005–2006 Flemish (Belgium) Health Behavior among School-aged Children survey (601 communities, n = 10,915), this study investigated whether community social capital is an independent determinant of adolescents’ perceived health and well-being after taking account of individual compositional characteristics (e.g. the gender composition within a certain community). Multilevel statistical procedures were used to estimate neighborhood effects while controlling for individual level effects. Results show that individual level factors (such as family affluence and individual social capital) are positively related to perceived health and well-being and that community level social capital predicted health better than individual social capital. A significant complex interaction effect was found, such that the social gradient in perceived health and well-being (i.e. the slope of family affluence on health) was flattened in communities with a high level of community social capital. Furthermore it seems that socioeconomic status differences in perceived health and well-being substantially narrow in communities where a certain (average) level of community social capital is present. This should mean that individuals living in communities with a low level of community social capital especially benefit from an increase in community social capital. The paper substantiates the need to connect individual health to their meso socioeconomic context and this being intrinsically within a multilevel framework. [Copyright &y& Elsevier]

Abstract: While empirical evidence continues to show that low socio-economic position is associated with less likely chances of being in good health, our understanding of why this is so remains less than clear. In this paper we examine the theoretical foundations for a structure–agency approach to the reduction of social inequalities in health. We use Max Weber’s work on lifestyles to provide the explanation for the dualism between life chances (structure) and choice-based life conduct (agency). For explaining how the unequal distribution of material and non-material resources leads to the reproduction of unequal life chances and limitations of choice in contemporary societies, we apply Pierre Bourdieu’s theory on capital interaction and habitus. We find, however, that Bourdieu’s habitus concept is insufficient with regard to the role of agency for structural change and therefore does not readily provide for a theoretically supported move from sociological explanation to public health action. We therefore suggest Amartya Sen’s capability approach as a useful link between capital interaction theory and action to reduce social inequalities in health. This link allows for the consideration of structural conditions as well as an active role for individuals as agents in reducing these inequalities. We suggest that people’s capabilities to be active for their health be considered as a key concept in public health practice to reduce health inequalities. Examples provided from an ongoing health promotion project in Germany link our theoretical perspective to a practical experience. [Copyright &y& Elsevier]

Abstract: The public health literature on the detrimental effects of social isolation has shown that the quantity of social connections is positively correlated with individual health. Drawing on pooled cross-sectional data, we test this hypothesis on a representative sample of the Italian population. Our findings show that, in addition to the quantity of interactions, it is their quality – as measured by subjective satisfaction derived from relationships with friends – that works as the best predictor of self-reported health. The frequency of meetings with friends is significantly and positively correlated with good health in all regressions. However, when we add our measure of the quality of relationships to the probit equations, the statistical significance of “quantitative” measures is scaled down. Satisfaction with relationships with friends exhibits a positive and highly significant coefficient. Results of the multivariate probit analysis point out the potential role of unobservable variables suggesting the existence of endogeneity problems which require further investigation. We point out the existence of health disparities based on socio-economic status. There is a higher probability that poorer and less educated individuals report poor health conditions. The risk is even higher for unemployed and retired workers. This paper contributes to the literature in two substantive dimensions. This is the first empirical study of the relationship between social interactions and health in Italy. Second, we add to previous empirical studies by taking into account not only the frequency of various kinds of meetings but also indicators of their “quality”, as measured by agents’ subjective satisfaction with their social participation. The reliability of the analysis also benefits from the uniqueness and comprehensiveness of our dataset, which tries to overcome a structural deficiency in Italian data by merging information on agents’ behaviours and perceptions with data on household income. [Copyright &y& Elsevier]

Abstract: As a social determinant of health, religiosity remains not well understood, despite the prevalence of religious activity and prominence of religious institutions in most societies. This paper introduces a working measure of Religious Social Capital and presents preliminary associations with neighborhood social capital and urban stressors. Religious social capital is defined as the social resources available to individuals and groups through their social connections with a religious community. Domains covered include group membership, social integration, values/norms, bonding/bridging trust as well as social support. Cross-sectional data come from a convenience sample of 104 community dwelling adults residing in a single urban neighborhood in a large US city, who also provided information on neighborhood social capital, and experiences of urban stressors. Results suggest that religious social capital is a valid construct that can be reliably measured. All indicators of religious social capital were higher among those who frequently attended religious services, with the exception of bridging trust (trust of people from different religious groups). A weak, inverse, association was also observed between religious and neighborhood social capital levels. Levels of religious social capital were correlated with higher levels of reported urban stressors, while neighborhood social capital was correlated with lower urban stressor levels. A significant percent of the sample was unaffiliated with a religious tradition and these individuals were more likely to be male, young and more highly educated. Social capital is a promising construct to help elucidate the influence of religion on population health. [Copyright &y& Elsevier]

Abstract: Immigrant health care is the product of the dynamic interaction between societal factors and the individual''s socio-economic and cultural characteristics. Our knowledge about immigrant health care, however, has been limited to individual characteristics, without paying attention to the social context in which immigrants reside. This paper explores the effects of social contexts on access to health care among recent immigrants. As a natural experiment, it compares health care experiences of three immigrant groups in Hawaii – Filipinos, Koreans, and Marshallese – who are situated in different social contexts including immigrant health policy, ethnic community, and individual networks. Through household surveys conducted between October 2005 and January 2006, information of 378 recent immigrant adults on health care access, health insurance status, socio-demographic characteristics, linguistic and cultural factors, health status, ethnic community social capital, and social networks was obtained. The results of analyses show that Marshallese respondents have better access to health care than the other two groups, in spite of their lowest socioeconomic status. The high insurance rate of the Marshallese, mainly associated with a state health policy that provides health insurance assistance for the Marshallese, is the major contributor of their greater health care access. While Filipino immigrants do not benefit from state insurance assistance, high levels of health care resources and social capital within the Filipino community enable them to have significantly better health care access than Koreans, who have higher income and educational attainment. Interestingly, the advanced family/kinship networks are associated with better levels of immigrant health care access, while the increase of co-ethnic friend networks is related to lower access to health care. This study implies that restoration of immigrants'' eligibility for public health insurance assistance, development of health care resources and social capital within ethnic communities, and mobilization of immigrant networks would be effective starting points to improve health care access among immigrants. [Copyright &y& Elsevier]

Abstract: This paper adds to the literature on social capital and health by testing whether an exogenous shock in the health of a family member (a new baby) affects the family''s investment in social capital. It also contributes to a small but growing literature on the effects of children''s health on family resources and provides information about associations between health and social capital in a socioeconomically disadvantaged population. We use data from the Fragile Families and Child Wellbeing study, a longitudinal survey of about 5000 births to mostly unwed parents in 20 U.S. cities during the years 1998–2000. Both parents were interviewed at the time of the birth and then again one and three years later. The infants'' medical records from the birth hospitalization were reviewed, and poor infant health was characterized to reflect serious and random health problems that were present at birth. Social interactions, reported at three years, include the parents'' participation in church groups, service clubs, political organizations, community groups, and organizations working with children; regular religious attendance; and visiting relatives with the child. Education, employment, wages, and sociodemographic characteristics are included in the analyses. The results suggest that infant health shocks do not affect the parents'' social interactions. [Copyright &y& Elsevier]

Abstract: While much descriptive research has documented positive associations between social capital and a range of economic, social and health outcomes, there have been few intervention studies to assess whether social capital can be intentionally generated. We conducted an intervention in rural South Africa that combined group-based microfinance with participatory gender and HIV training in an attempt to catalyze changes in solidarity, reciprocity and social group membership as a means to reduce women''s vulnerability to intimate partner violence and HIV. A cluster randomized trial was used to assess intervention effects among eight study villages. In this paper, we examined effects on structural and cognitive social capital among 845 participants and age and wealth matched women from households in comparison villages. This was supported by a diverse portfolio of qualitative research. After two years, adjusted effect estimates indicated higher levels of structural and cognitive social capital in the intervention group than the comparison group, although confidence intervals were wide. Qualitative research illustrated the ways in which economic and social gains enhanced participation in social groups, and the positive and negative dynamics that emerged within the program. There were numerous instances where individuals and village loan centres worked to address community concerns, both working through existing social networks, and through the establishment of new partnerships with local leadership structures, police, the health sector and NGOs. This is among the first experimental trials suggesting that social capital can be exogenously strengthened. The implications for community interventions in public health are further explored. [Copyright &y& Elsevier]

This paper explores the role of social capital in mitigating the mental health harms of social/mobility restrictions instigated in the wake of the COVID-19 pandemic. We test whether: (a) social capital continued to predict lower mental distress during the pandemic; and (b) whether social capital buffered (moderated) the harm of social/mobility restrictions on psychological distress. In addition, we test the level at which social capital mitigation effects operated, i.e., at the individual- and/or contextual-level. To do so, we apply multilevel models to three waves of the COVID-19 Household Impact Survey consisting of probability samples of U.S. adults (with the average interview completion rate of 93%). In a novel approach, we explore two modes of capturing contextual social capital: aggregated individual-level survey responses and independently measured social capital indices (SCIs). Findings show that at the individual level social capital was associated with lower psychological distress. It also buffered the harm of restrictions: increasing restrictions had a weaker effect on distress among individuals interacting with neighbors more frequently. Importantly, mitigating processes of contextual social capital appeared conditional on how it was measured. Using aggregated survey responses, contextual social capital had no direct effect on distress but exerted an additional buffering role: individuals in counties with higher average neighbor-interaction experienced a weaker impact of restrictions. Using the independent SCI measures, we found county social capital reduced distress. However, its negative effect on distress becomes increasingly weaker the more restrictions an individual reported: where individuals reported lower restrictions, higher county SCI reduced distress; however, where individuals reported higher restrictions, higher county SCI had no effect on distress. More restrictive environments thus cut individuals off from the benefits of higher county social capital as measured using the SCI. • Individual social capital (SC) is associated with lower psychological distress. • Individual SC buffers the negative effect of mobility restrictions on distress. • People with higher ecological SC experienced a weaker effect of mobility restrictions. • Those living in higher SC counties reported less distress but only with fewer restrictions. [ABSTRACT FROM AUTHOR]

Much attention on the spread and impact of the ongoing pandemic has focused on institutional factors such as government capacity along with population-level characteristics such as race, income, and age. This paper draws on a growing body of evidence that bonding, bridging, and linking social capital - the horizontal and vertical ties that bind societies together - impact public health to explain why some U.S. counties have seen higher (or lower) excess deaths during the COVID19 pandemic than others. Drawing on county-level reports from the Centers for Disease Control and Prevention (CDC) since February 2020, we calculated the number of excess deaths per county compared to 2018. Starting with a panel dataset of county observations over time, we used coarsened exact matching to create smaller but more similar sets of communities that differ primarily in social capital. Controlling for several factors, including politics and governance, health care quality, and demographic characteristics, we find that bonding and linking social capital reduce the toll of COVID-19 on communities. Public health officials and community organizations should prioritize building and maintaining strong social ties and trust in government to help combat the pandemic. • This study examines excess death rates during the COVID19 pandemic among US counties. • We use a panel dataset of counties over 6 time-steps from February to September 2020. • We identified more comparable samples using coarsened exact matching, different only by social capital. • Bonding and linking social capital were associated with fewer excess deaths in US counties. • Bonding social capital was effective in spring, and linking social capital in summer. [ABSTRACT FROM AUTHOR]

The majority of theoretical models have defined stigma as occurring psychologically and limit its negative effects to individual processes. This paper, via an analysis of how ‘face’ is embodied in China, deepens an articulation of how the social aspects of stigma might incorporate the moral standing of both individual and collective actors defined within a local context. We illustrate (1) how one''s moral standing is lodged within a local social world; (2) how one''s status as a ‘moral’ community member is contingent upon upholding intrapersonal and social-transactional obligations; and (3) how loss of face and fears of moral contamination might lead to a ‘social death’. We first draw from Chinese ethnographies that describe the process of human cultivation before one can achieve fully ‘moral’ status in society. We integrate findings from empirical studies describing how social-exchange networks in China are strictly organized based on the reciprocation of favors, moral positioning, and ‘face’. We further ground these Chinese constructs within a theoretical framework of different forms of capital, and discuss the severe social consequences that loss of face entails. By utilizing the examples of schizophrenia and AIDS to illustrate how loss of moral standing and stigma is interwoven in China, we propose a model highlighting changes in moral status to describe how stigma operates. We suggest that symbolic restoration of moral status for stigmatized groups takes place as local-level stigma interventions. By analyzing the moral aspects of ‘face’, we propose that across cultures, stigma is embedded in the moral experience of participants, whereby stigma is conceived as a fundamentally moral issue: stigmatized conditions threaten what matters most for those in a local world. We further propose that stigma jeopardizes an actor''s ability to mobilize social capital to attain essential social statuses. [Copyright &y& Elsevier]

Abstract: Social capital has been controversially linked to public health benefits, particularly as an explanation for the relationship between economic inequalities and health. This paper focuses on social capital in this context, particularly a recent emphasis on social capital in neighbourhoods and growing use of Bourdieu''s social theory in empirical investigations. A review of some of this work is used to suggest the need for a more coherent theoretical approach to using Bourdieu and to introduce an ethnographic study of social connections in New Zealand. Forty-six residents of, a rural town, a deprived city suburb, or an affluent suburb, volunteered to be interviewed about their social connections. Their talk was transcribed and analysed in terms of everyday practice. The results of this study suggest that social connections are not necessarily located in neighbourhoods, and that social capital will be better understood in a broader social context which includes competition for resources between deprived and non-deprived groups, and the practices of all citizens across neighbourhoods. When considering social capital, an exclusive focus on deprived neighbourhoods as sites for research and intervention is not helpful. [Copyright &y& Elsevier]

Abstract: Studies of the social lives of men and women living with co-occurring disorders (substance abuse and serious mental illness) suggest that social networks critically influence recovery. In this paper, we examine some of the reasons that the social networks of individuals with co-occurring disorders are small, and the impact of small networks for this population. Using a social capital framework with cross-case analysis, we analyze 72 in-depth qualitative interviews with 39 formerly homeless mentally ill men and women who were substance abusers. All were participants in the New York Services Study (NYSS), a federally funded study of mentally ill adults in New York City. The patterns suggest that networks shrunk because (1) social network members died prematurely, (2) study participants withdrew or pushed others away, and (3) friends and family members faced so many obstacles of their own that they could not provide resources for the study participants. We suggest that as networks diminished, some participants responded by attempting to rebuild their networks, even if the networks provided negative social capital, and others isolated themselves socially to escape the pressures and disappointments of interaction. [Copyright &y& Elsevier]

Abstract: Recent years have seen a burgeoning of intergenerational programmes aiming to improve the well being of participants. However, very few programmes have been formally evaluated. In this paper we report results from a randomised controlled trial of a school-based intergenerational intervention undertaken in Brazil. Randomly selected samples of 253 adolescents and 266 elders aged 60 and over resident in the school''s catchment area were administered a questionnaire including questions on cognitive components of social capital, family relationships, and self-rated health. Participants were then randomly allocated to control and intervention groups. The intervention comprised participation in a 4 month programme of intergenerational activities in which the elders shared their memories with the students. At the end of the intervention the questionnaire was re-administered to the samples. High proportions (85–95%) of both samples completed the questionnaires but compliance with the intervention was low in the elderly group. In the analysis of results from the elderly sample, we therefore compared the control group with the group assigned to the intervention (intention to treat analysis). Results showed that adolescents in the intervention group were nearly three times more likely to rate their health as good than those in the control group, but also more likely to judge that most people were selfish. In the elderly sample, those from the intervention group were over twice as likely as those from the control group to report positively on the helpfulness of neighbours; judge most people to be honest or consider their family relationships as good. There were no significant differences between groups on other outcome measures. These results suggest that structured intergenerational activities may have positive effects on some aspects of social capital for both adolescents and elderly people, although further research is needed to elucidate the processes involved and the extent to which the findings are context specific. This study is the first to use a controlled trial design to evaluate this type of intervention and is valuable in showing that this design can be used in interventions of this kind, and also the difficulties involved. [Copyright &y& Elsevier]

Abstract: There is growing interest in the impact that neighbourhood environment might have on the health of older people. Although the number of older Australian women, particularly those living alone, is projected to increase in coming decades, their experiences of neighbourhood have not been exclusively examined. The aims of this paper are: (1) to explore, from the perspective of these women, the social and physical dimensions of neighbourhoods and (2) to investigate variation in these accounts according to whether women lived in areas of higher or lower socioeconomic status. Twenty women aged between 75 and 93 years, residing in metropolitan Adelaide, South Australia (SA), participated in a series of two in-depth interviews. Women''s perceptions of their neighbourhood, and accounts of every-day activities in the community were analysed to determine how both social and physical aspects of neighbourhood might relate to health and wellbeing. Findings suggest that a reciprocal and trusting relationship with neighbours underpinned older women''s sense of satisfaction with, and feeling of security within, the neighbourhood. Other factors such as living in close proximity to services and existing social networks were also seen as important. Women''s stories demonstrated that they were able to draw on both existing social networks and neighbours to sustain their independence and social connection within the community. Women living in more disadvantaged areas were more conscious of social disconnection in their neighbourhoods, and to the way that traffic noise and pollution detracted from their neighbourhood environment. These findings indicate that, for older women living alone, trusting and reciprocal relationships with neighbours are likely to form an important part of their broader social support network and should be recognised in relation to the process of maintaining the health of older women living in the community. [Copyright &y& Elsevier]