Academic journal article Health Sociology Review

It Is All about Who You Know: Social Capital and Health in Low-Income Communities

Academic journal article Health Sociology Review

It Is All about Who You Know: Social Capital and Health in Low-Income Communities

Article excerpt

INTRODUCTION

In the quest for better health, many people turn to doctors, self-help books, or herbal supplements. But they overlook a powerful weapon that could help them fi ght illness and depression, speed recovery, slow aging, and prolong life: their friends.

(New York Times, April 20, 2009)

Researchers are increasingly paying attention to the importance of social networks in overall health. Several studies released this past year demonstrate how important social relationships are to a variety of health issues, including brain functioning, longevity, and obesity (Christakis and Fowler 2007; Ertel et al 2008; Giles et al 2005). Through these research fi ndings, we get an idea of how important social capital is to health. Yet, few works have documented how public health practitioners operationalise social capital in their interventions. This paper seeks to provide guidance to public health practitioners by reviewing the literature on social capital and health to identify key elements of successful social capital/network interventions, and suggest several ways public health practitioners can apply these concepts in their interventions to improve health in poor, urban communities. We suggest three types of interventions (empowerment, community youth development, and collective effi cacy) and provide examples, based on a survey of the literature, of successful programs that exemplify each model.

Social capital is a core concept in business, economics, organisational behaviour, political science, sociology and public health (Portes 1998), and it has relational, material and political components. Health providers have gained the most understanding of applications for social capital from sociology and public health (Minkler 2004). Sociological studies of neighbourhoods, social mobility, and the integration of immigrants have shed light on both the positive and negative aspects of social networks (Domínguez and Watkins 2003; Menjívar 2000a; Waldinger 1995). Similarly, public health has illuminated the power of social support as it relates to physical and mental health (Belle 1982; Szreter and Woolcock 2004). This manuscript brings to light how public health practitioners and human service providers can utilise interventions based on social capital to affect change in the lives of their patients and clients and reduce health disparities in the process.

Network analysis allows us to see how individuals are situated within relational networks through which information and resources fl ow (Berkman and Glass 2000). By evaluating an individual's place within a network, we can assess the ways in which access to or limitations of opportunities and resources affect health-related behaviours. We argue that public health workers are in a position to undertake interventions that expand clients' social networks, thus providing access to opportunities which have signifi cant health benefi ts.

HEALTH AND HIGH POVERTY NEIGHBOURHOODS

Nowhere is it arguably more necessary to use social capital-building interventions than with populations living in high poverty neighbourhoods, which are highly correlated with a multitude of health and mental health problems that factor into health disparities (Fiscella and Williams 2004; Lillie-Blanton 1993). Researchers studying poor neighbourhoods and health point to a 'weathering effect,' which is a long-term process whereby the accumulated stress, lower environmental quality, and limited resources in poor communities experienced over time, erodes the health of residents, making them more vulnerable to mortality from any given disease (Ellen et al 2001; Geronimus 2001). A recent report by Johns Hopkins and the University of Maryland estimates the fi nancial cost of racial health disparities to be over $50 billion per year in the US (Brewington 2009).

It is especially important to bring social capital to the attention of health care practitioners who work with low-income, marginalised individuals and those who have been victims of exclusion and discriminatory policies over several generations, eroding their capacity to help along family lines. …

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