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Social determinants of health - A question of social or economic capital? Interaction effects of socioeconomic factors on health outcomes

Ahnquist, Johanna ; Wamala, Sarah P. and Lindström, Martin L LU (2012) In Social Science and Medicine 74(6). p.930-939
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... (More)
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. (C) 2012 Elsevier Ltd. All rights reserved. (Less)
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author
; and
organization
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type
Contribution to journal
publication status
published
subject
keywords
Social determinants, Social capital, Economic hardships, Self-rated, health, Sweden
in
Social Science and Medicine
volume
74
issue
6
pages
930 - 939
publisher
Elsevier
external identifiers
  • wos:000302522600018
  • scopus:84857452515
  • pmid:22305807
ISSN
1873-5347
DOI
10.1016/j.socscimed.2011.11.026
language
English
LU publication?
yes
id
0eb2b06d-ee02-4686-8391-f52b129c0d68 (old id 2571368)
date added to LUP
2016-04-01 10:02:40
date last changed
2022-04-27 18:02:51
@article{0eb2b06d-ee02-4686-8391-f52b129c0d68,
  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. (C) 2012 Elsevier Ltd. All rights reserved.}},
  author       = {{Ahnquist, Johanna and Wamala, Sarah P. and Lindström, Martin L}},
  issn         = {{1873-5347}},
  keywords     = {{Social determinants; Social capital; Economic hardships; Self-rated; health; Sweden}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{930--939}},
  publisher    = {{Elsevier}},
  series       = {{Social Science and Medicine}},
  title        = {{Social determinants of health - A question of social or economic capital? Interaction effects of socioeconomic factors on health outcomes}},
  url          = {{http://dx.doi.org/10.1016/j.socscimed.2011.11.026}},
  doi          = {{10.1016/j.socscimed.2011.11.026}},
  volume       = {{74}},
  year         = {{2012}},
}