Assessing urban-rural differences in the relationship between social capital and depression among Ghanaian and South African older adults

Abstract

Introduction Research has demonstrated benefits of social capital on depression, but variations in this relationship by geographic characteristics such as urbanicity have rarely been investigated. Methods Using survey data on 4,209 Ghanaian and 3,148 South African adults aged 50 and above from the World Health Organization (WHO) Study on Global AGEing and Adult Health (SAGE), exploratory and confirmatory factor analyses were conducted to extract dimensions of social capital from survey items. Structural equation models with the extracted factors were then used to estimate the associations between social capital and depression in each sample and assess differences between urban and rural settings with measurement and structural invariance tests. Results Factor analyses suggested three dimensions of social capital representing community engagement, sociability, and trust. Urbanicity did not substantially modify the effects of social capital on depression in either setting, but urban-rural differences in the measurement and level of social capital were observed. Urban Ghanaian older adults were less socially integrated and trusting than older rural residents (standardized mean difference: -0.28, -0.24, and -0.38 for community engagement, sociability, and trust, respectively) while urban South African older adults appeared less engaged in community activities but significantly more trusting and socially active informally than older rural residents (standardized mean difference: -0.33, 0.30, and 0.17 for community engagement, sociability, and trust, respectively). Moreover, while trust was associated with a lower risk of depression in South Africa overall, sociability and trust were associated with an increased risk of depression in Ghana. Conclusions Results indicate that the composition and average levels of social capital differ between urban and rural older adult residents in Ghana and South Africa although urban-rural differences in the strength of the association between social capital and depression were not substantial. Furthermore, the associations between social capital and depression are context-specific and are not uniformly beneficial.

Differences in the relationship between social capital and hypertension in emerging vs. established economies in Sub-Saharan Africa

“…Despite the scarcity of social capital intervention studies, there are some which show social capital interventions that promote community engagement and social participation are associated with better physical health [ 43 – 45 ]. In addition, though prior research on depression suggested differences may exist in the relationship with social capital by area of residence [ 46 , 47 ], this study found that there was no differential relationship between hypertension and social capital by rural/urban status. Detailed investigation into how social capital is built and how that influences health in a variety of situations will be necessary to understand this complex relationship.…”

Decomposing rural–urban differences in successful aging among older Indian adults

“…A considerable amount of literature suggests a difference in risk of many chronic diseases, disability, mental condition, and social engagement among older populations by their place of residence (urban and rural) 23 , 24 . It is mainly because of economic inequality, unequal accessibility to various type of health care services, and involvement gap in diverse social activities between urban and rural dweller elderly 25 – 27 .…”

Differences in depressive symptoms by rurality in Japan: a cross-sectional multilevel study using different aggregation units of municipalities and neighborhoods (JAGES)

“…The differences in the association between rurality and depression and the mechanisms underlying the variation across geographical units have received little attention among studies of the urban–rural depression gap. A study performed in Ghana and South Africa found no substantial urban–rural differences in the strength of the association between social capital and depression [ 48 ]. In a report from China that focused on the impact of rapid urbanization on social capital and health, the association between social capital and depression varied by period and rurality [ 49 ].…”