SOCIAL CAPITAL AND HEALTH - IMPLICATIONS FOR PUBLIC-HEALTH AND EPIDEMIOLOGY

Authors
Citation
J. Lomas, SOCIAL CAPITAL AND HEALTH - IMPLICATIONS FOR PUBLIC-HEALTH AND EPIDEMIOLOGY, Social science & medicine (1982), 47(9), 1998, pp. 1181-1188
Citations number
40
Categorie Soggetti
Social Sciences, Biomedical","Public, Environmental & Occupation Heath
ISSN journal
02779536
Volume
47
Issue
9
Year of publication
1998
Pages
1181 - 1188
Database
ISI
SICI code
0277-9536(1998)47:9<1181:SCAH-I>2.0.ZU;2-F
Abstract
Public health and its ''basic science'', epidemiology, have become col onised by the individualistic ethic of medicine and economics. Despite a history in public health dating back to John Snow that underlined t he importance of social systems for health, an imbalance has developed in the attention given to generating ''social capital'' compared to s uch things as modification of individual's risk factors. In an illustr ative analysis comparing the potential of six progressively less indiv idualised and Inure community-focused interventions to prevent deaths from heart disease, social support and measures to increase social coh esion fared well against more individual medical care approaches. In t he face of such evidence public health professionals and epidemiologis ts have an ethical and strategic decision concerning the relative effo rt they give to increasing social cohesion in communities vs expanding access for individuals to traditional public health programs. Practit ioners' relative efforts will be influenced by the kind of research th at is being produced by epidemiologists and by the political climate o f acceptability for voluntary individual ''treatment'' approaches vs u niversal policies to build ''social capital''. For epidemiologists to further our emerging understanding of the link between social capital and health they must confront issues in measurement, study design and analysis. For public health advocates to sensitise the political envir onment to the potential dividend from building social capital, they mu st confront the values that focus on individual-level causal models ra ther than models of social structure (dis)integration. The evolution o f explanations for inequalities in health is used to illustrate the na ture of the change in values. (C) 1998 Elsevier Science Ltd. All right s reserved.