Social Capital and Health: The Problematic Roles of Social Networks and Social Surveys
Abbott, Stephen, Health Sociology Review
Social capital, social networks, social support and health have all been linked, both theoretically and empirically. However, the relationships between them are far from clear. Surveys of social capital and health often use measures of social networks and social support in order to measure social capital, and this is problematic for two reasons. First, theoretical assumptions about social networks and social support being part of social capital are contestable. Second, the measures used inadequately reflect the complexity and ambivalence of social relationships, often assuming that all social ties and contacts are of similarly value, are mutually reinforcing, and, in some studies, are based on neighbourhoods. All these assumptions should be questioned. Progress in our understanding requires more qualitative research and improved choice of indicators in surveys; social network analysis may be a useful source of methodological and empirical insight.
Sociology, social capital, social networks, social support, survey methodology
Received 28 February 2008 Accepted 29 September 2008
A considerable body of work claims that high levels of social capital are associated with better health (e.g. Kennedy et al 1998; Rose 2000; Islam et al 2006; Khawaja et al 2006). Thus, social capital has come to be widely considered to be one of the many social determinants of health. Social capital has a variety of definitions; so wide a variety indeed that its usefulness has been questioned:
the concept has been stretched, modified, and extrapolated to cover so many types of relationships at so many levels of individual, group, institutional, and state analyses that the term has lost all heuristic value there does not appear to be consensus on the nature of social capital, its appropriate level of analysis, or the appropriate means of measuring it
(Macinko and Starfield 2001:394-410).
This alone should mean that claims about the association of social capital and health should be treated judiciously. Additionally, the literature on social capital and health (SCH) reveals a set of conceptual and methodological problems that arise from the dominance in this literature of survey research that looks for associations between social capital and health indicators (e.g. Onyx and Bullen 2000; Rose 2000). The difficulty is that, as Bowling (2005) points out, most measures have not been validated. Furthermore, many studies are often based on secondary analysis of data sets gathered by research not designed to measure or explore social capital (e.g. Chavez et al 2004; Pevalin and Rose 2003). In these cases, researchers use answers to questions that may be regarded as proxy measures for social capital. For example, Pevalin and Rose (2003) select as indicators of social capital questions from the British Household Panel Survey on the following topics:
* social participation (meaning participation in organisations and associations);
* frequency of contact with three closest friends;
* perceptions of crime in the neighbourhood; and
* neighbourhood attachment.
They also include questions on social support. However, aspects of social capital emphasised elsewhere, such as trust and reciprocity, are absent. This illustrates how the way that social capital is conceptualised and operationalised may be influenced by the nature of the proxy indicators available.
One effect of such methods is to give social networks and social support (SNSS) a greater importance in the empirical SCH literature than they do in the theoretical literature on social capital. The three most commonly cited theorists offer rather less certainty about the central role of social networks. For Bourdieu (1986), it is not the pleasures and benefits of sociability that constitute social capital, but the resources that social contact and networking can bring to members of affluent and powerful elites. …