Does Area-Based Social Capital Matter for the Health of Australians? A Multilevel Analysis of Self-Rated Health in Tasmania

Kavanagh, Anne, Subramanian, S, & Turrell, Gavin (2006) Does Area-Based Social Capital Matter for the Health of Australians? A Multilevel Analysis of Self-Rated Health in Tasmania. International Journal of Epidemiology, 35(3), pp. 607-613.

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Abstract

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Background Material circumstances and collective psychosocial processes have been invoked as potential explanations for socioeconomic inequalities in health; and, linking social capital has been proposed as a way of reconciling these apparently opposing explanations.

Methods We conducted multilevel logistic regression of self-rated health (fair or poor vs excellent, very good, or good) on 14 495 individuals living within 41 statistical local areas who were respondents to the 1998 Tasmanian Healthy Communities Study. We modelled the effects of area-level socioeconomic disadvantage and social capital (neighbourhood integration, neighbourhood alienation, neighbourhood safety, social trust, trust in public/private institutions, and political participation), and adjusted for the effects of individual characteristics.

Results Area-level socioeconomic disadvantage was associated with poor self-rated health (β = 0.0937, P < 0.001) an effect that was attenuated, but remained significant, after adjusting for individual characteristics (β = 0.0419, P < 0.001). Social trust was associated with a reduction in poor self-rated health (β = −0.0501, p = 0.008) and remained significant when individual characteristics (β = −0.0398, P = 0.005) were included. Political participation was non-significant in the unadjusted model but became significant when adjusted for individual characteristics (β = −0.2557, P = 0.045). The effects of social trust and political participation were attenuated and became non-significant when area-level socioeconomic disadvantage was included.

Conclusion Area-based socioeconomic disadvantage is a determinant of self-rated health in Tasmania, but we did not find an independent effect of area-level social capital. These findings suggest that in Tasmania investments in improving the material circumstances in which people live are likely to lead to greater improvements in population health than attempts to increase area-level social capital.

Impact and interest:

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ID Code: 22295
Item Type: Journal Article
Refereed: Yes
Additional Information: Articles free to read on journal website after 12 months
Keywords: Social Capital, Socioeconomic Disadvantage, Multilevel Analysis, Health
DOI: 10.1093/ije/dyl010
ISSN: 0300-5771
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PUBLIC HEALTH AND HEALTH SERVICES (111700) > Epidemiology (111706)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PUBLIC HEALTH AND HEALTH SERVICES (111700) > Public Health and Health Services not elsewhere classified (111799)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Funding:
Deposited On: 17 Jun 2009 13:10
Last Modified: 17 May 2017 22:46

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