Aging, social capital, and health care utilization in Canada

Abstract

This paper examines relationships between aging, social capital, and healthcare utilization. Cross-sectional data from the 2001 Canadian Community Health Survey and the Canadian Census are used to estimate a two-part model for both GP physicians (visits) and hospitalization (annual nights) focusing on the impact of community- (CSC) and individual-level social capital (ISC). Quantile regressions were also performed for GP visits. CSC is measured using the Petris Social Capital Index (PSCI) based on employment levels in religious and community-based organizations [NAICS 813XX] and ISC is based on self-reported connectedness to community. A higher CSC/lower ISC is associated with a lower propensity for GP visits/higher propensity for hospital utilization among seniors. The part-two (intensity model) results indicated that a one standard deviation increase (0.13%) in the PSCI index leads to an overall 5% decrease in GP visits and an annual offset in Canada of approximately $225 M. The ISC impact was smaller; however, neither measure was significant in the hospital intensity models. ISC mainly impacted the lower quantiles in which there was a positive association with GP utilization, while the impact of CSC was strongest in the middle quantiles. Each form of social capital likely operates through a different mechanism: ISC perhaps serves an enabling role by improving access (e.g. transportation services), while CSC serves to obviate some physician visits that may involve counseling/caring services most important to seniors. Policy implications of these results are discussed herein.

Different effects of social capital on health status among residents: Evidence from modern Japan

“…For instance, measures of trust and reciprocity and that of perceived social support have been used (Petrou and Kupek 2008). Laporte et al (2008) categorized social capital as community-level social capital based on employment levels in religious and community based organizations and individual-level social capital measured by self-reported connectedness to community. Both community-and individual-level social capitals need to be examined.…”

Perceptions of social capital and cost-related non-adherence to medication among the elderly

“…Despite the controversies that surround this literature 14,15 , social capital theory has become prominent in public health research, since it has been linked, both in the general as well as in elderly populations, to a wide range of health measures, including perceived health status 16,17,18 , quality of life 19 , and access to health care 20 .…”

Differences in the effect of social capital on health status between workers and non-workers

“…Empirical analyses have presented evidence that SC has a critical influence on health-related behaviors and related outcomes (e.g., Costa-Font and Mladovsky, 2008;Islam, 2008;Laporte et al, 2008;Scheffler and Brown, 2008). Although positive relationships between health status and SC have been observed in some studies (e.g., Kawachi et al, 1997;Islam et al, 2006;Petrou and Kupek, 2008), others do not report a positive association (Iversen 2008).…”