A multilevel analysis of social capital and self-reported health: evidence from Seoul, South Korea

Abstract

BackgroundThis study aims to resolve two limitations of previous studies. First, as only a few studies examining social capital have been conducted in non-western countries, it is inconclusive that the concept, which has been developed in Western societies, applies similarly to an Asian context. Second, this study considers social capital at the individual-level, area-level and cross-levels of interaction and examines its associations with health while simultaneously controlling for various confounders at both the individual-level and area-level, whereas previous studies only considered one of the two levels. The purpose of this study is therefore to examine the associations between social capital and health by using multilevel analysis after controlling for various confounders both at the individual and area-levels (i.e., concentrated disadvantage) in non-western countries.MethodsWe conducted a cross-sectional survey from December 2010 to April 2011 in Seoul, South Korea. The target population included respondents aged 25 years and older who have resided in the same administrative area since 2008. The final sample for this study consisted of 4,730 respondents within all 25 of Seoul's administrative areas.ResultsIn our final model, individual-level social capital, including network sources (OR = 1.23; 95% CI = 1.11-1.37) and organizational participation (OR = 2.55; 95% CI = 2.11-3.08) was positively associated with good/very good health. Interestingly, the individual × area organizational participation cross-level interaction was negatively associated with good/very good health (OR = 0.40; 95% CI = 0.32-0.50), indicating that in areas with higher organizational participation, individuals with high organizational participation were less likely to report good/very good health when compared to low organizational participation individuals.ConclusionOur study provides evidence that individual-level social capital is associated with self-reported health, even after controlling for both individual and area-level confounders. Although this study did not find significant relationships between area-level organizational participation and self-reported health, this study found the cross-level interaction for social capital. Hence, in areas with lower organizational participation, the probability of reporting good/very good health is higher for individuals with high organizational participation than individuals with low organizational participation. This study, albeit tentatively, suggests that policy makers should focus upon social capital when making policies which aim to enhance one's health.

Social Participation and Health among Ageing People in East-Central Europe

“…Our results are in accordance with earlier studies in which researchers proved the relationships between social activity and health status (Uphoff et al, 2013;Han et al, 2012;Shöllgen, 2011;Vonneilich, 2012). The results showed that health is closely correlated with health status and the intervention to improve it should concentrate on social activity and social participation, like health intervention in team where people can change their opinions and ideas thanks to each others.…”

“…We need to analyse them with the help of the following environmental factors: social situation, income status, and level of education. The social capital can affect the health condition, but it can apply also the other way aroundthat is why we need to be careful with the data or examine it with longitudinal research (Han et al, 2012). In our study we considered to social capital at individual level, highlighting person's social participation.…”

Focusing neighborhood context and self-rated health in the Pró-Saúde Study

“…There is evidence that neighborhood psycho-social characteristics can mediate the adverse effect of having a chronic disease and attenuate the impact of such conditions on poor self-rated health 53 . A number of studies report significant effects of environmental, social and physical contextual characteristics being perceived as potential mediators in the association mechanism between contextual socioeconomic characteristics and self-rated health 34,37,43,54 .…”

“…Even when different socioeconomic indicators are applied, areas that are more deprived, less affluent or with greater income inequalities return higher percentages of individuals with poor self-rated health 29,30,31,32 . Physical, environmental characteristics (signs of physical disorder such as graffiti, poor public lighting, waste accumulated in the streets) 33,34,35 and psycho-social features (social capital) 36,37 , collective efficacy 38 or social cohesion 34 also display an association with self-rated health, although of a lesser magnitude than socioeconomic indicators 39,40 . In England and Scotland, physical, social and political aspects of the environment (such as high levels of unemployment, low access to private transport, poor quality of the physical environment and low levels of political engagement) were all associated with worse self-rated health 38 .…”

Association of Neighbourhood and Individual Social Capital, Neighbourhood Economic Deprivation and Self-Rated Health in South Africa – a Multi-Level Analysis

“…A few of these studies have also been conducted in low and middle income countries and very few in sub-Saharan Africa [11]–[13]. This lack of information presents a serious challenge to the expansion of the beneficial effects of social capital on health as implied in various studies [14]–[16]. It is thus very important to have evidence of social relations and their effect on health in sub-Saharan African countries, to inform decision making, resource allocation and priority setting for healthcare interventions.…”