Kawachi 1999 - "Social capital and community effects on population and individual health"

Kawachi
"Social capital and community effects on population and individual health"
Annals of New York Academy of Sciences
1999; v896; pp 120-130
On the Web
Relevance: High

This paper references what is probably the single most convincing piece of evidence we have for believing that social capital affects health--Kawachi et al's 1997 analysis of the GSS survey for 39 states, conducted between 1986 and 1990. In two reported analyses, he finds a close state-by-state correlation between social capital and health. In particular, trust was important: "the level of trust explained 58% of the variance in total mortality across states, including statistically significant associations with most major causes of death including heart disease, malignant neoplasms, stroke, homicide, and infant mortality."

Interestingly, in this study, Kawachi attributes social capital to income inequality and scarcely breathes a word about sprawl. Also, he attributes social capital's effect on health to improved political mechanisms that, he argues, in turn improve society's generosity and liberalism. (Indeed, there is an astonishingly close correlation between states with high levels of social capital and blue states. Seen in the first chart in this paper and in both charts in the book, Urban Sprawl and Public Health by Frumkin et al.)

Analysis #1: Age-adjusted mortality versus percent responding "most people would try to take advantage of you if they got the chance." This analysis shows an obvious linear correlation between high mortality and high mistrust of others.

Analysis #2: Maximum welfare grant as % of per capita income versus percent responding "most people can't be trusted." This analysis--which is more about welfare state-generosity than social capital--shows that low levels of trust are correlated with low levels of welfare benefits. This is, I suppose, evidence for his claim that social capital effects health via political participation.

Kawachi severely annoyed me at the beginning of this article. In a section specifically talking about what he calls, "'appropriable' social organizations"--basically, grassroots community groups--he claims there are health benefits to social capital. As evidence he cites Berkman's 1995 study, which is specifically about the health benefits of very close social ties such as a spouse, relative, or close friend. This is a classic example of the equivocation in the literature that so bothers me.