Background: Social capital is employed as an asset when there is a lack of an efficient health-care system. However, this relationship is not homogeneous and can differ according to the characteristics of individuals and their context. In this paper, we aim to analyze the role of social capital in the solution of healthcare problems among individuals with different levels of marginalization and unequal access to health services. Methods: This qualitative study examines the role of social capital in the demand for healthcare among Mexican individuals with different levels of marginalization. The research draws data from semi-structured interviews (N = 247) that were collected in four Mexican states with different social welfare benefits: Mexico City, Tamaulipas, the State of Mexico, and Oaxaca. The interviewees were selected using the snowball method and other eligibility criteria such as education, age, and gender. Results: Findings suggest that social capital is a relevant factor in solving healthcare problems, depending on the level of marginalization. The role of social capital can be explained by the precariousness of medical service delivery, the poor health infrastructure, and the difficult access to health care in Mexico. Networks are the main resource to deal with health related issues, food, medicine, and out-of-the-pocket medical expenses in contexts of high levels of marginalization. In the middle level of marginalization, networks also help in raising funds for morespecialized medical services and higher quality hospitals. In the least-marginalized levels, social capital is used as companionship for sick individuals, while support networks act as emotional relief. At this level, most individuals have private health insurance, and many of them have major medical healthcare coverage. Conclusions: Participants reported low levels of trust in the health care system because of the poor infrastructure and quality of medical service delivery. Although the main criticism is focused on public healthcare institutions, there is a lack of trust in private medical services as well. These facts are related to the access and quality of medical service delivery and turn social capital into a significant asset. Despite that social bonds or links are valuable resources that individuals can use to solve healthcare related issues, the use of social capital is not homogenous. Indeed, it can be influenced by several factors that were represented in this study through the municipal marginalization index.

Higher educational attainment and cash-transfers may have a positive influence on reducing food insecurity. Depression and functional limitations may increase the likelihood of food insecurity among older adults.

This study presents evidence on the utility of including public insecurity indicators when assessing Social Welfare in Mexico. It estimates two multidimensional indices of social welfare using the DP2 method. The two measures (DP2a index and DP2b index) contain the following categories: (1) material welfare, (2) economic well-being, (3) subjective well-being, and (4) social capital. For the second, we included an additional category, (5) public insecurity, and examined its effect on social welfare. The results show that inclusion of indicators of insecurity, crime victimization, and homicides had a negative effect on social welfare within states. Specifically, trust in people, network membership, satisfaction with life, and happiness where reduced. Our results suggest that public insecurity should be a key consideration in the understanding of social welfare in Mexico.

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This study utilized a multidimensional measure of social welfare composed of 26 social indicators integrated in nine categories: education, employment and social protection, income, health, housing conditions, subjective wellbeing, social capital, use of technology, and culture and leisure to help understand social welfare in Mexico. We also compared the integrated measure with the Human Development Index. Estimation was performed using the normalDnormalP2 method. Our analysis indicated that the health and housing conditions categories contributed the most to social welfare across the 32 Mexican States. In relation to the indicators, income and trust in other people were associated with welfare. Further, results on the welfare ranking of Mexican states revealed variations between the two indices true(normalDnormalP2 and the HDI). Specifically, only four states occupied the same position on both indices, ten recorded different positions on normalDnormalP2 moving up or down from their levels of social welfare. Implications of observed correlations are presented.