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Social determinants of health - A question of social or economic capital?: Interaction effects of socioeconomic factors on health outcomes
Karolinska Inst, Dept Publ Hlth Sci, S-83140 Stockholm, Sweden.;Swedish Natl Inst Publ Hlth, Ostersund, Sweden..
Karolinska Inst, Dept Publ Hlth Sci, S-83140 Stockholm, Sweden.;Swedish Natl Inst Publ Hlth, Ostersund, Sweden..ORCID iD: 0000-0001-6681-2827
Malmo Univ Hosp, Malmo, Sweden.;Lund Univ, CED, S-22100 Lund, Sweden..
2012 (English)In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 74, no 6, p. 930-939Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
PERGAMON-ELSEVIER SCIENCE LTD , 2012. Vol. 74, no 6, p. 930-939
Keywords [en]
Social determinants, Social capital, Economic hardships, Self-rated health, Sweden
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-50054DOI: 10.1016/j.socscimed.2011.11.026ISI: 000302522600018PubMedID: 22305807Scopus ID: 2-s2.0-84857452515OAI: oai:DiVA.org:mdh-50054DiVA, id: diva2:1467353
Available from: 2020-09-15 Created: 2020-09-15 Last updated: 2022-03-18Bibliographically approved

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Wamala, Sarah P.

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