Elsevier

Social Science & Medicine

Volume 56, Issue 8, April 2003, Pages 1797-1805
Social Science & Medicine

Social capital and neighborhood mortality rates in Chicago

https://doi.org/10.1016/S0277-9536(02)00177-6Get rights and content

Abstract

Several empirical studies have suggested that neighborhood characteristics influence health, with most studies having focused on neighborhood deprivation or aspects of the physical environment, such as services and amenities. However, such physical characteristics are not the only features of neighborhoods that potentially affect health. Neighborhoods also matter because of the nature of their social organization. This study examined social capital as a potential neighborhood characteristic influencing health. Using a cross-sectional study design which linked counts of death for persons 45–64 years by race and sex to neighborhood indicators of social capital and poverty for 342 Chicago neighborhoods in the USA, we tested the ecological association between neighborhood-level social capital and mortality rates, taking advantage of the community survey data collected as part of the Project on Human Development in Chicago Neighborhoods. We estimated a hierarchical generalized linear model to examine the association of race and sex specific mortality rates to social capital. Overall, neighborhood social capital—as measured by reciprocity, trust, and civic participation—was associated with lower neighborhood death rates, after adjustment for neighborhood material deprivation. Specifically, higher levels of neighborhood social capital were associated with lower neighborhood death rates for total mortality as well as death from heart disease and “other” causes for White men and women and, to a less consistent extent, for Blacks. However, there was no association between social capital and cancer mortality. Although, the findings from this study extend the state-level findings linking social capital to health to the level of neighborhoods, much work remains to be carried out before social capital can be widely applied to improve population health, including establishing standards of measurement, and exploring the potential “downsides” of social capital.

Introduction

There is growing interest in identifying neighborhood-level influences on health (Macintyre & Ellaway, 2000). A series of studies have suggested that residents of poor neighborhoods have higher rates of premature mortality compared to residents of more affluent neighborhoods (Haan et al., 1987; Anderson et al., 1997; Waitzman & Smith, 1998; Cubbin et al., 2000). Moreover, the poorer health status of disadvantaged neighborhoods is not entirely explained by the characteristics of individuals living in them (Macintyre et al., 1993). In other words, there appear to be distinct features of places that make a difference to health, as opposed to the characteristics of people. For example, studies have shown that the number of supermarkets is lower (Weinberg & Epstein, 1996) and the number of liquor stores higher (LaVeist & Wallace, 2000) in lower income areas. In turn the availability of services and amenities (recreational spaces, commercial stores) can facilitate or constrain a person's ability to engage in healthy behaviors (such as taking up regular exercise or buying fresh foods). However, these physical characteristics are not the only features of neighborhoods that potentially affect health. Neighborhoods also matter because of the nature of their social organization. One such characteristic is the social capital of a neighborhood.

Social capital has been defined as features of social structure—such as trust, norms, and networks—that facilitate collective action for mutual benefit (Coleman, 1990; Putnam, 1993). It is a resource that resides in the relationships that people have with each other, and that individuals within a social structure (such as a neighborhood) can draw upon to achieve certain actions (Kawachi & Berkman, 2000; Veenstra, 2001). Social capital has been used to account for schooling and educational attainment (Coleman, 1988) as well as for the smooth functioning of democracies and civic institutions (Putnam, 1993). However, the benefits of social capital as it applies to health have only recently been examined. For example, studies linking social capital to health have examined mortality (Kawachi et al., 1997), violent crime (Sampson et al., 1997), self-rated health status (Kawachi et al., 1999; Veenstra, 2000), and binge drinking (Weitzman & Kawachi, 2000).

Kawachi et al. (1997) carried out an ecological analysis linking variations in social capital at the state level to mortality rates across the states of the US. Indicators of social capital—interpersonal trust, norms of reciprocity, and associational membership—were obtained from the General Social Surveys conducted by the National Opinions Research Center between 1986 and 1990 and aggregated to the state level (Putnam, 1995). When correlated with state-level mortality rates, these social capital indicators explained a significant portion of the cross-sectional variation in health status across states. Lower levels of social capital were associated with higher rates of most major causes of death, including heart disease, cancers, infant mortality, and violent deaths, including homicide. The association of social capital indicators with mortality remained after accounting for state differences in median income and poverty rates.

Expanding on the state-level ecologic associations, Kawachi et al. (1999) carried out a multilevel study of the relationship between state social capital and individual self-rated health. After taking account of individual-level differences in variables such as health insurance coverage, personal income, educational attainment, race/ethnicity, cigarette smoking, and obesity, residence in a low social capital area was still associated with about a 40% excess risk of reporting fair or poor health.

In addition to these studies examining health and social capital at the level of states, a few studies have examined the influence of social capital on health at smaller levels of aggregation. Sampson et al. (1997) examined what they termed “collective efficacy” as a determinant of neighborhood variation in violence, including homicide rates in Chicago neighborhoods. Their collective efficacy scale was comprised of two sub-scales, social cohesion and informal social control, which overlap with the concept of social capital (Lochner et al., 1999). The index of collective efficacy was significantly inversely associated with reports of neighborhood violence and violent victimization as well as homicide rates. For example, a two standard deviation (SD) elevation in collective efficacy was associated with a 39.7% reduction in the expected homicide rate.

Most recently, social capital has been applied to college campuses. Weitzman and Kawachi (2000) examined whether higher levels of social capital—operationalized as the average time committed to volunteering aggregated to the campus level—was protective against an individual's risk of binge drinking. They found that individuals from campuses with higher than average levels of social capital had a 26% lower individual risk of binge drinking, after controlling for individual-level volunteering, sociodemographic factors, and other campus-level factors.

Although provocative, these studies highlight the need for more evidence demonstrating the health effects of social capital, particularly at smaller units of aggregation. The purpose of the present study was to replicate the previously demonstrated state-level relationships between social capital and health at the level of neighborhoods. We set out to test the ecological association between neighborhood-level social capital and mortality rates, taking advantage of the community survey data collected as part of the Project on Human Development in Chicago Neighborhoods.

Section snippets

Social capital indicators

Indicators of neighborhood social capital were obtained from the 1995 Community Survey of the Project on Human Development in Chicago Neighborhoods (PHDCN). Neighborhood-level data for the city of Chicago were gathered in 1995 as part of the PHDCN and combined with 1990 US census data. Applying a spatial definition of neighborhood, the PHDCN combined all 847 census tracts in Chicago to create 343 ecologically meaningful and homogeneous “neighborhood clusters” (NCs), using geographic boundaries

Results

The PHDCN community survey included household interviews from 343 NCs. One NC was missing key social and economic information and was dropped from the analysis. In the remaining 342 Chicago NCs, 70% of respondents agreed that people were willing to help their neighbors and 56% agreed that people in their neighborhood could be trusted, while the average per resident number of associational membership was <1.0 (Table 1). The three indicators of NC social capital—reciprocity, trust, and civic

Discussion

The present analysis extends the existing literature on social capital and health to the level of neighborhoods. We operationalized social capital using three indicators. Civic participation taps into formal networks, while reciprocity and trust are consequences of both formal and informal networks (Putnam, 2001). Overall for Whites, we found that higher levels of NC social capital were associated with lower NC death rates from all-causes, heart disease, and “other” causes (which excluded

Acknowledgements

Funded by the MacArthur Network on SES and Health, contract no. NSS 07SC as well as grants from the MacArthur Foundation and the National Institute of Justice. The authors thank Stephen W. Raudenbush, Richard T. Congdon, Jr., and Kathy McGaffigan for their assistance with the statistical analyses.

References (30)

  • T.A LaVeist et al.

    Health risk and inequitable distribution of liquor stores in African American neighborhoods

    Social Science & Medicine

    (2000)
  • K Lochner et al.

    Social capitalA guide to its measurement

    Health & Place

    (1999)
  • G Veenstra

    Social capital, SES and healthAn individual-level analysis

    Social Science & Medicine

    (2000)
  • R.T Anderson et al.

    Mortality effects of community socioeconomic status

    Epidemiology

    (1997)
  • L.F Berkman et al.

    Social integration, social networks, social support, and health

  • N Breslow et al.

    Approximate inference in generalized linear mixed models

    Journal of the American Statistical Association

    (1993)
  • Coleman, J. S. (1988). Social capital in the creation of human capital. American Journal of Sociology,...
  • J.S Coleman

    Foundations of social theory

    (1990)
  • C Cubbin et al.

    Socioeconomic status and injury mortalityIndividual and neighbourhood determinants

    Journal of Epidemiology & Community Health

    (2000)
  • Geolytics, I. (1996–1998). CensusCD+Maps, Version 2.1, Geolytics, Inc....
  • M Haan et al.

    Poverty and healthProspective evidence from the Alameda county study

    American Journal of Epidemiology

    (1987)
  • I Kawachi et al.

    Social cohesion, social capital, and health

  • I Kawachi et al.

    Social capital, income inequality, and mortality [see comments]

    American Journal of Public Health

    (1997)
  • I Kawachi et al.

    Social capital and self-rated healthA contextual analysis

    American Journal of Public Health

    (1999)
  • S Macintyre et al.

    Ecological approachesRediscovering the role of the physical and social environment

  • Cited by (0)

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