Social capital and self-rated health: A contextual analysis

Objectives. Social capital consists of features of social organization- suc h as trust between citizens, norms of reciprocity, and group membership-tha t facilitate collective action. This article reports a contextual analysis of social capital and individual self-rated health, with adjustment for ind ividual household income, health behaviors, and other covariates. Methods. Self-rated health ("Is your overall health excellent, very good, g ood, fair, or poor?") was assessed among 167 259 individuals residing in 39 US states, sampled by the Behavioral Risk Factor Surveillance System, Soci al capital indicators, aggregated to the state level, were obtained from th e General Social Surveys. Results. Individual-level factors (e.g., low income, low education, smoking ) were strongly associated with self-rated poor health. However, even after adjustment for these proximal variables, a contextual effect of low social capital on risk of self-rated poor health was found. For example, the odds ratio for fair or poor health associated with living in areas with the low est levels of social trust was 1.41 (95% confidence interval = 1.33, 1.50) compared with living in high-trust states. Conclusions. These results extend previous findings on the health advantage s stemming from social capital.