Abstract
OBJECTIVE To investigate the association between social capital and social capital and self-perception of health based on examining the influence of health-related behaviors as possible mediators of this relationship.METHODS A cross-sectional study was used with 1,081 subjects, which is representative of the population of individuals aged 40 years or more in a medium-sized city in Southern Brazil. The subjects who perceived their health as fine, bad or very bad were considered to have a negative self-perception of their health. The social capital indicators were: number of friends, people from whom they could borrow money from when needed; the extent of trust in community members; whether or not members of the community helped each other; community safety; and extent of participation in community activities. The behaviors were: physical activity during leisure time, fruits and vegetable consumption, tobacco use and alcohol abuse. The odds ratios (OR) and confidence intervals (CI) 95% were calculated by binary logistic regression. The significance of mediation was verified using the Sobel test.RESULTS Following adjustment for demographic and clinical variables, subjects with fewer friends (OR = 1.39, 95%CI 1.08;1.80), those who perceived less frequently help from people in the neighborhood (OR = 1.30, 95%CI 1.01;1.68), who saw the violent neighborhood (OR = 1.33, 95%CI 1.01;1.74) and who had not participated in any community activity (OR = 1.39, 95%CI 1.07;1.80) had more negative self-perception of their health. Physical activity during leisure time was a significant mediator in the relationship between all social capital indicators (except for the borrowed money variable) and self-perceived health. Fruit and vegetable consumption was a significant mediator of the relationship between the extent of participation in community activities and self-perceived health. Tobacco use and alcohol abuse did not seem to have a mediating role in any relationship.CONCLUSIONS Lifestyle seems to only partially explain the relationship between social capital and self-perceived health. Among the investigated behaviors, physical activity during leisure time is what seems to have the most important role as a mediator of this relationship.
Highlights
Self-perception of health has been used in epidemiological studies as an indicator of health, which is useful due to the simplicity of obtaining and validating such information,[13,17,24] as well as the idea that individuals who have a negative perception of their health tend to present worse mortality and morbidity indicators.[4,9]
Associations between self-perception of health and demographic, behavioral and clinical indicators were analyzed by calculating the odds ratios (OR) and their 95% confidence intervals (CI), which were obtained by binary logistic regression, with adjusted and crude analysis being performed for all variables
Among the non-participants (n = 159) were 93 individuals who refused to be included, and 66 who could not be found after three or more attempts to make contact were made at different times and on different days
Summary
2011 was the year in which data for this cross-sectional study were collected, which evaluated residents from Cambé city, PR, aged 40 years or more. SC indicators, which are this study’s independent variables, were removed from the Brazilian version of the Integrated Questionnaire for the Measurement of Social Capital (IQMSC) This questionnaire is an instrument created by the World Bank’s Social Capital Thematic Group that is based on studies regarding the subject in different countries, as well as from contributions by specialists. Associations between self-perception of health and demographic, behavioral and clinical indicators were analyzed by calculating the odds ratios (OR) and their 95% confidence intervals (CI), which were obtained by binary logistic regression, with adjusted and crude analysis being performed for all variables. This study was approved by the Brazilian Health Secretariat in the Brazilian city of Cambé and by the Committee for Ethics in Research Involving Humans at the Universidade Estadual de Londrina (CEP-UEL, Protocol 236/10)
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