Objectives: Research into the social determinants of health inequalities is increasingly focusing on macro-level forces affecting individuals and communities. The concept of social capital has been at the centre of this research as a potential explanatory framework for understanding these inequalities. The aim of this study was to identify the components that define social capital and its relationship to self-reported health in two neighbourhoods known to be disadvantaged in south-western Sydney.
Methods: This study uses data from cross-sectional household (door-knock) surveys originally developed as evaluation tools for neighbourhood based interventions. Secondary analyses including factor analysis and multiple regression analysis were used to provide empirical evidence of the components defining social capital and how these, as a concept, were associated with self-reported health.
Results: The study revealed six common social capital components in each sample and an additional component in one neighbourhood. These included neighbourhood attachment, support networks, feelings of trust and reciprocity, local engagement, personal attachment to the area, feelings about safety and proactivity in the social context. The social capital model incorporating demographic and socio-economic characteristics explained 23.4% of health variance in one neighbourhood, and 19.3% in the other. Examining the social capital:health relationship revealed that with the exception of feelings of trust and reciprocity, no other social capital component made significant contributions to explaining health variance and that macro-level factors such as housing conditions and employment opportunities emerged as key explanatory factors.
Conclusion: If interventions are to use social capital as a way of addressing health inequalities, these need to look closely at the role of trust for improving health outcomes of deprived populations as well as ensuring access to resources and infrastructure.
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