Explains Social Capital and it's importance in Public Health.

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By Dr. Devyani Wanjari, Junior Resident,
Department of Community Medicine,
MGIMS, Sevagram, Wardha, Maharashtra, India.
Social Capital and Public Health

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What is Social Capital?
• Capital: Anything that increases one’s ability to
generate value.
• Social Capital (by OECD): “Networks together
with shared norms, values and understandings
that facilitate co-operation within or among
groups”.
• “Glue that holds society together.”- World Bank
(OECD: Organisation for Economic Co-operation and Development)

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What is Social Capital?
• Robert D. Putnam’s national bestseller, Bowling Alone:
The Collapse and Revival of American Community.
• Bowling Alone-here, is a metaphor to illustrate the decline
of social, political, civic, religious, workplace connections in
the United States.
• The core idea is that social networks have value.
• Putnam’s most poignant example of the positive effects of
social capital: Story of John Lambert (64) and Andy
Boschma (33).

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What is Social Capital?
Social Capital is the sum of following characteristics: (Putnam)
1. The existence of community networks: clubs, societies, the church, and other
organisations/networks.
2. Civic engagement: participation of people
3. Civic identity: equal participation
4. Reciprocity: mutual help
5. Trust: as opposed to fear

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Individual asset- Social Network
Approaches
Collective attribute- Social Cohesion
Approaches
• Resources available to individuals through
involvement in social networks
(That would not be possible in the absence of
these networks)
• Connections among people- social
networks and the norms of reciprocity and
trustworthiness that arise from them.
Social capital and health

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Individual asset- Social Network Approaches
• Bourdieu (1996):
 Inclusion in social networks is not something naturally possessed, but a product of individual
“Investment strategies”.
 Dominant groups in the society have more power
• Coleman (1998):
 Doing something for others establishes an obligation for these others to reciprocate.
• Portes (1998):
 Social capital describes resources obtainable to individuals by virtue of their social ties.

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Individual social capital and health:
According to the Berkman and Glass (2000) hypothesis:
Social Support
Acts as a buffering
for stress
Social Influence
The influence of
peers on health
behavior
Eg. Role models
Social
Participation
Provide
opportunities to
learn new skills,
and meaning to life
Access to
material
resources
Can provide
access to
resources and
services
Eg. Job
opportunities, high
quality health
services.

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Individual social capital and health:
• Marmot (2005): called it “Status Syndrome”
• Comparison with “Significant others”- Material resources in absolute terms do not matter.
• More the opportunities- higher the status.
• Influence over health:
 Positive: Feeling of being privileged, decreased stress
 Negative: Increased stress with increased expectations of self or others
• Conclusion: Large status difference Poor population health

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Collective attribute- Social Cohesion Approaches
• Social Capital has both individual as well as collective characteristics leads to individual goods along
with collective goods.
• This can be achieved using “Spill over benefits” concept.
• Concept of Generalized Reciprocity – creates trust between people.
• Putnam (1993):
 Trust is essential for enabling cooperation for mutual benefit.
 A community with large stock of Social Capital will become a community with more efficient
democracy, economic prosperity, health and happiness.

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Collective Social Capital and health:
• Wilkinson (1996, 1999): Levels of inequality results into “Gap” between rich and poor. (Similar to
Status Syndrome).
• Income distribution:
Equal Unequal
Positive social
environment leading
to trust and social
cohesion within the
community
Difference in the status
between the citizens
leads to mistrust,
decreased social
cohesion and increase in
crime and social anxiety.

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Cognitive Structural
• Perceptions of the quality of social
relationships such as trust and social
harmony
• What people feel
• Perceptions of the quantity of network
memberships
• what people do
Forms of Social Capital:
Bonds Bridges Linkages
Thick Thin

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Bonds
Bridges
Linkages
• Social connection between
individuals who are similar
• Strong ties
• Family, close friends, culture,
ethnicity
• Social connection between
individuals who are dissimilar
• Weak ties
• distant friends, colleagues
and associates
• Social connection across
different levels of social
status
• Vertical ties
• Between People or groups
Forms of Social Capital:

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Forms of Social Capital:

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Measurements of social capital in health research
A. Quantitative
• Individual, ecological and
multilevel studies
A. Qualitative
• For a deeper understanding
• Open to people’s
perceptions and views

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Social capital and its relationship with other capitals:
Four Capitals:
1. Human Capital: What you know
2. Social Capital: Who you know
3. Economic Capital: What you have
4. Natural Capital:

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The relationship between Human Capital and Social Capital:
• Educated individuals may be more efficient producers of health (Grossman, 1972).
• Education also may lead individuals to make better health choices.
• The relationship is complicated between education and specific behaviours.
• Maternal education is a powerful predictor of infant mortality and child health.

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Social Capital and different aspects of health:
• Child Health
• Adolescent Health
• Geriatric Health
• Mental Health
• Psychosocial Health: Crime and violence

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Social Capital and Salutogenic approach:
• Creating healthier societies and healthier
lifestyles will ultimately heal ecosystems
and the planet.
• Salutogenesis — the generation of
positive health — as an alternative to the
disease-focussed approach on health.

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Social Capital and achieving
sustainability:
Communities with rich Social Capital-
1. Can influence political decisions and fighting cuts of
local services such as health care, schools, etc.
2. Can influence health related behaviours- spread of
healthy norms by social control.
(they facilitate the speedy dissemination of novel
information, expertise and resources across the Region.)

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Mobilizing collective social capital
• “Community Development Approach” within health promotion
• community building, community mobilizing, community organization, and community
empowerment.
• A supporting environment means a sense of reciprocal maintenance, an environment where
people take care of each other, their communities and their natural environment.
“Health-enabling communities” characterized by participation, mutual support and trust.
• Mobilizing social capital in local communities may therefore be seen as a key goal for health
promotion.

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Today’s most valuable currency is Social Capital, defined as the information,
expertise, trust, and total value that exist inthe relationships you have and social
networks towhichyou belong.
-Keith Ferrazzi

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References:
• https://www.oecd.org/insights/37966934.pdf
• https://www.researchgate.net/publication/279490376_Social_capital_health_and_community_actio
n_implications_for_health_promotion
• https://www.researchgate.net/publication/316537255_A_Critical_Review_of_Scales_Used_in_Soci
al_Capital_Research
• https://coregroup.org/wp-
content/uploads/2018/12/Components_of_a_Community_Health_System_final10-12-2011.pdf
• https://www.researchgate.net/publication/348050372_Measurement_of_Social_Capital_Reference
_Document_for_Public_Policy_Research_Development_and_Evaluation

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References:
• https://pubmed.ncbi.nlm.nih.gov/21311607/
• https://pubmed.ncbi.nlm.nih.gov/14670393/
• https://www.oecd.org/innovation/research/45760738.pdf
• https://medium.com/age-of-awareness/personal-and-planetary-health-we-need-a-salutogenic-
approach-8e3dc68c753f

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