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Social capital, trust in the health-care system and self-rated health: The role of access to health care in a population-based study.

Mohseni, Mohabbat LU and Lindström, Martin LU (2007) In Social Science and Medicine 64(7). p.1373-1383
Abstract
This paper investigates the relationship between institutional trust in the health-care system, i.e. an institutional aspect of social capital, and self-rated health, and whether the strength of this association is affected by access to health-care services. The 2004 public health survey in the Scania region of Sweden is a cross-sectional study; a total of 27,963 respondents aged 18–80 years answered a postal questionnaire, which represents 59% of the random sample. Logistic regression model was used to investigate the association between institutional trust and self-rated health. Multivariate analyses of self-rated health were performed in order to investigate the importance of possible confounders (age, country of origin, education,... (More)
This paper investigates the relationship between institutional trust in the health-care system, i.e. an institutional aspect of social capital, and self-rated health, and whether the strength of this association is affected by access to health-care services. The 2004 public health survey in the Scania region of Sweden is a cross-sectional study; a total of 27,963 respondents aged 18–80 years answered a postal questionnaire, which represents 59% of the random sample. Logistic regression model was used to investigate the association between institutional trust and self-rated health. Multivariate analyses of self-rated health were performed in order to investigate the importance of possible confounders (age, country of origin, education, economic stress, generalized trust in other people, and care-seeking behaviour) on this association. A 28.7% proportion of the men and 33.2% of the women reported poor self-rated health. A total of 15.0% and 58.3% of the respondents reported “very high” and “rather high” trust in the health-care system, respectively. Almost one-third of all respondents reported low institutional trust. Respondents born outside Sweden, with low/medium education, low generalized trust and low institutional trust had significantly higher odds ratios of poor self-rated health. Multiple adjustments for age, country of origin, education, economic stress, and horizontal trust had some effect on the significant relationship between institutional trust and poor self-rated health, for both men and women, but the additional introduction of care-seeking behaviour in the model substantially reduced the odds ratios. In conclusion, low trust in the health-care system is associated with poor self-rated health. This association may be partly mediated by “not seeking health care when needed”. However, this is a cross-sectional exploratory study and the causality may go in both directions. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Social capital, Horizontal trust, Self-rated health, Care-seeking behaviour, Access to health care, Sweden, Institutional trust
in
Social Science and Medicine
volume
64
issue
7
pages
1373 - 1383
publisher
Elsevier
external identifiers
  • wos:000245497900005
  • scopus:33847382357
ISSN
1873-5347
DOI
10.1016/j.socscimed.2006.11.023
language
English
LU publication?
yes
id
68cf7581-1390-468c-b833-264c9d58be75 (old id 165156)
date added to LUP
2007-07-24 16:15:11
date last changed
2017-08-27 03:52:36
@article{68cf7581-1390-468c-b833-264c9d58be75,
  abstract     = {This paper investigates the relationship between institutional trust in the health-care system, i.e. an institutional aspect of social capital, and self-rated health, and whether the strength of this association is affected by access to health-care services. The 2004 public health survey in the Scania region of Sweden is a cross-sectional study; a total of 27,963 respondents aged 18–80 years answered a postal questionnaire, which represents 59% of the random sample. Logistic regression model was used to investigate the association between institutional trust and self-rated health. Multivariate analyses of self-rated health were performed in order to investigate the importance of possible confounders (age, country of origin, education, economic stress, generalized trust in other people, and care-seeking behaviour) on this association. A 28.7% proportion of the men and 33.2% of the women reported poor self-rated health. A total of 15.0% and 58.3% of the respondents reported “very high” and “rather high” trust in the health-care system, respectively. Almost one-third of all respondents reported low institutional trust. Respondents born outside Sweden, with low/medium education, low generalized trust and low institutional trust had significantly higher odds ratios of poor self-rated health. Multiple adjustments for age, country of origin, education, economic stress, and horizontal trust had some effect on the significant relationship between institutional trust and poor self-rated health, for both men and women, but the additional introduction of care-seeking behaviour in the model substantially reduced the odds ratios. In conclusion, low trust in the health-care system is associated with poor self-rated health. This association may be partly mediated by “not seeking health care when needed”. However, this is a cross-sectional exploratory study and the causality may go in both directions.},
  author       = {Mohseni, Mohabbat and Lindström, Martin},
  issn         = {1873-5347},
  keyword      = {Social capital,Horizontal trust,Self-rated health,Care-seeking behaviour,Access to health care,Sweden,Institutional trust},
  language     = {eng},
  number       = {7},
  pages        = {1373--1383},
  publisher    = {Elsevier},
  series       = {Social Science and Medicine},
  title        = {Social capital, trust in the health-care system and self-rated health: The role of access to health care in a population-based study.},
  url          = {http://dx.doi.org/10.1016/j.socscimed.2006.11.023},
  volume       = {64},
  year         = {2007},
}