Abstract
The aim of the paper is to critically review the notion of social capital and review empirical literature on the association between social capital and health across countries. The methodology used for the review includes a systematic search on electronic databases for peer-reviewed published literature. We categorize studies according to level of analysis (single and multilevel) and examine whether studies reveal a significant health impact of individual and area level social capital. We compare the study conclusions according to the country's degrees of economic egalitarianism. Regardless of study design, our findings indicate that a positive association (fixed effect) exists between social capital and better health irrespective of countries degree of egalitarianism. However, we find that the between-area variance (random effect) in health tends to be lower in more egalitarian countries than in less egalitarian countries. Our tentative conclusion is that an association between social capital and health at the individual level is robust with respect to the degree of egalitarianism within a country. Area level or contextual social capital may be less salient in egalitarian countries in explaining health differences across places.
Highlights
The use of social factors to explain community health status is not a new phenomenon
Researchers should be cautious about including other contextual predictors and keep in mind the multicolinearity problem. Keeping these methodological limitations in mind, the conclusions observed in some of the reviewed studies need to be interpreted with caution. It is evident from the fixed effect results across studies and countries that the positive health impact of social capital and a country's degree of egalitarianism seemed rather unimportant factors in modifying the effects of social capital on health
A significant fixed effect association was observed between area level social capital and better health in multilevel studies, low variability in health across areas reported in some studies suggests that the differences in health were predominantly affected by individual factors rather than by area characteristics, especially in egalitarian countries
Summary
The use of social factors to explain community health status is not a new phenomenon. Since Durkheim's classic work on suicide, the importance of social integration and social capital has been recognised for population wellbeing [1]. The notion of 'social capital' has attracted wide-ranging attention in the social sciences and public health literature over the last decade [e.g., [2,3,4,5,6,7,8,9,10]]. In the public health arena, the concept attracted attention following the work of James Coleman and Robert Putnam [11,12]. A growing body of empirical research has been conducted on the links between individual (micro) and area (macro/meso) level social capital and population health [e.g. Social capital is a multifaceted phenomenon [2]. It is thought that social capital may generate material/market and non-material/non-market returns to the individual
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