Abstract
Generalized interpersonal trust (as an indicator of social capital) has been linked to health status at both the individual and ecological level. We sought to examine how changes in contextual and individual trust are associated with changes in self-rated health in the European Social Surveys 2002-12. A multilevel analysis using a variance components model was performed on 203 452 individuals nested within 145 country cohorts covering 35 countries. Conditional on sociodemographic covariates, we sought to examine the association between self-rated health and individual trust, country average trust and a cross-level interaction between the two. Although individual trust perceptions were significantly correlated with self-rated health [OR = 0.95, 95% confidence interval (0.94-0.96)], country-level trust was not associated [OR = 1.12, 95% confidence interval (0.95-1.32)]. There was, however, a strong crosslevel interaction between contextual and individual trust (P < 0.001), such that individuals with high interpersonal trust reported better health in contexts in which other individuals expressed high average interpersonal trust. Conversely, low trust individuals reported worse health in high trust contexts. Our findings suggest that contexts with increasing average trust can be harmful for low trust individuals, which might reflect the negative impact that social capital can have in certain groups. These findings suggest that contextual trust has a complex role in explaining health inequalities and individual self-rated health.
Highlights
Health status is robustly associated with individual socioeconomic status such as education, income and occupation
Rostila,[4] building on diverse theories of social capital, defines it as ‘the social resources that evolve in accessible social networks or social structures characterized by mutual trust’
The individual-level determinants of self-rated health substantially replicated previous reports, i.e. being female, older, part of a minority, hampered in daily activities, divorced, not having an activity, lower education and lower income were each associated with worse health
Summary
Health status is robustly associated with individual socioeconomic status such as education, income and occupation. Conditional on sociodemographic covariates, we sought to examine the association between self-rated health and individual trust, country average trust and a cross-level interaction between the two. Conclusion: Our findings suggest that contexts with increasing average trust can be harmful for low trust individuals, which might reflect the negative impact that social capital can have in certain groups These findings suggest that contextual trust has a complex role in explaining health inequalities and individual self-rated health. Results: Specific patterns associated with extremely high rates of mortality from alcohol poisoning can be observed in Belarus, in the areas bordering Russia and Lithuania. The situation is severe on the Belarusian side, where there are extremely high levels of mortality from both alcohol poisoning and liver cirrhosis These areas should be considered primary targets for antialcohol policies
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