Social capital and administrative contextual determinants of lack of access to a regular doctor: A multilevel analysis in southern Sweden

Lindström, Martin; Axén, Elin; Lindström, Christine; Beckman, Anders; Moghaddassi, Mahnaz; Merlo, Juan

doi:10.1016/j.healthpol.2005.12.001

Cited by 19 publications

(22 citation statements)

References 25 publications

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“…As a result, access to different forms of social protection is limited and benefits a smaller part of the population (Mesa-Lago, 2007; van Ginneken, 1999). In this context, social capital may be particularly relevant to enhance collective actions within communities, becoming a potential driver of health improvements (Aye et al, 2002; Lindstrom et al, 2006; Mohseni & Lindstrom, 2007). In support of this view, evidence suggests that cohesive communities may be more successful in protecting healthcare facilities from budget cuts (Sampson et al, 1997); organizing public services (Altschuler et al, 2004; Kawachi et al, 1997); reducing crime (Takagi et al, 2012); and promoting economic solidarity (Aye et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

Social capital, mental health and biomarkers in Chile: Assessing the effects of social capital in a middle-income country

Riumallo-Herl

Kawachi

Avendaño

2014

Social Science & Medicine

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In high-income countries, higher social capital is associated with better health. However, there is little evidence of this association in low- and middle-income countries. We examine the association between social capital (social support and trust) and both self-rated and biologically assessed health outcomes in Chile, a middle-income country that experienced a major political transformation and welfare state expansion in the last two decades. Based on data from the Chilean National Health Survey (2009–10), we modeled self-rated health, depression, measured diabetes and hypertension as a function of social capital indicators, controlling for socio-economic status and health behavior. We used an instrumental variable approach to examine whether social capital was causally associated with health. We find that correlations between social capital and health observed in high-income countries are also observed in Chile. All social capital indicators are significantly associated with depression at all ages, and at least one social capital indicator is associated with self-rated health, hypertension and diabetes at ages 45 and above. Instrumental variable models suggest that associations for depression may reflect a causal effect from social capital indicators on mental well-being. Using aggregate social capital as instrument, we also find evidence that social capital may be causally associated with hypertension and diabetes, early markers of cardiovascular risk. Our findings highlight the potential role of social capital in the prevention of depression and early cardiovascular disease in middle-income countries.

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Section: Introductionmentioning

confidence: 99%

Social capital, mental health and biomarkers in Chile: Assessing the effects of social capital in a middle-income country

Riumallo-Herl

Kawachi

Avendaño

2014

Social Science & Medicine

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“…How patients relate to primary care is linked to choice of primary care provider [9–14]. Differences in individual preferences and options can be explained using trust and other constructs related to theories on social capital [15].…”

Section: Introductionmentioning

confidence: 99%

Importance of healthcare utilization and multimorbidity level in choosing a primary care provider in Sweden

Ranstad

Midlöv

Halling

2014

Scandinavian Journal of Primary Health Care

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Objective. To study the associations between active choice of primary care provider and healthcare utilization, multimorbidity, age, and sex, comparing data from primary care and all healthcare in a Swedish population. Design. Descriptive cross-sectional study using descriptive analyses including t-test, correlations, and logistic regression modelling in four separate models. Setting and subjects. The population (151 731) and all healthcare in Blekinge in 2007. Main outcome measure. Actively or passively listed in primary care, registered on 31 December 2007. Results. Number of consultations (OR 1.31, 95% CI 1.30–1.32), multimorbidity level (OR 1.69, 95% CI 1.67–1.70), age (OR 1.03, 95% CI 1.03–1.03), and sex (OR for men 0.67, 95% CI 0.65–0.68) were all associated with registered active listing in primary care. Active listing was more strongly associated with number of consultations and multimorbidity level using primary care data (OR 2.11, 95% CI 2.08–2.15 and OR 2.14, 95% CI 2.11–2.17, respectively) than using data from all healthcare. Number of consultations and multimorbidity level were correlated and had similar associations with active listing in primary care. Modelling number of consultations, multimorbidity level, age, and sex gave four separate models with about 70% explanatory power for active listing in primary care. Combining number of consultations and multimorbidity did not improve the models. Conclusions. Number of consultations and multimorbidity level were associated with active listing in primary care. These factors were also associated with each other differently in primary care than in all healthcare. More complex models including non-health-related individual characteristics and healthcare-related factors are needed to increase explanatory power.

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“…Most studies have created one or more social capital scales by aggregating and combining a range of individual measures such as perceived interpersonal trust and social control/cohesion, community and voting participation, and sense of personal safety and efficacy (Hendryx et al 2002;Greenberg and Rosenheck 2003;van der Linden et al 2003;Wan and Lin 2003;Drukker et al 2004;Lindströ m et al 2006). Conceived of this way, social capital has been associated with individuals reporting fewer access problems across MSAs in the United States (Hendryx et al 2002) and better access to a regular doctor in Scania, Sweden (Lindströ m et al 2006); however, other studies found that the social capital scale was only related to access or utilization through its relationship to other factors like health status (Wan and Lin 2003) or neighborhood poverty (van der Linden et al 2003;Drukker et al 2004). When individual indicators of social capital (as opposed to a scale) have been used to examine health care access, the findings have also been largely inconclusive (Aye, Champagne, and Contandriopoulos 2002;Prentice 2006).…”

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confidence: 99%

Do Bonding, Bridging, and Linking Social Capital Affect Preventable Hospitalizations?

Derose

2008

Health Services Research

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Objective. To examine the relationship between social capital and preventable hospitalizations (PHs). Data Sources. Administrative and secondary data for Florida (hospital discharge, U.S. Census, voting, nonprofits, faith-based congregations, uninsured, safety net and primary care providers, and hospital beds). Study Design. Cross-sectional, zip code-level multivariate analyses to examine the associations among social capital, primary care resources, and adult PHs and pediatric asthma hospitalizations. Data Extraction. Data were merged at the zip code-level (n 5 837). Principal Findings. Few of the social capital measures were independently associated with PHs: longer mean commute times (reduced bonding social capital) were related to higher adult rates; more racial and ethnic diversity (increased bridging social capital) was related to lower nonelderly adult rates but higher pediatric rates; more faith-based organizations (linking social capital) were associated with higher nonelderly adult rates. Having a safety net clinic within 20 miles was associated with lower adult rates, while general internists were associated with higher rates. More pediatricians per capita were related to higher pediatric rates. Conclusions. The importance of social capital for health care access is unclear. Some bonding and bridging ties were related to PHs, but differentially across age groups; more work is needed to operationalize linking ties.Key Words. Social capital, access to care, primary care, race and ethnicity, social environment Community-level factors have been associated with access to health care, above and beyond covariates such as individual health status, insurance coverage, and sociodemographics. For example, previous research has found that neighborhood is related to whether individuals report a usual source of care, physician use, receiving preventive care, and having unmet need for care (Kirby and Kaneda 2005;Litaker, Koroukian, and Love 2005). Social capital r Health Research and Educational Trust

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Social capital and administrative contextual determinants of lack of access to a regular doctor: A multilevel analysis in southern Sweden

Abstract: This study suggests that both administrative health care district and social capital may partly explain the individual's self reported lack of access to a regular doctor.

Cited by 19 publications

References 25 publications

Social capital, mental health and biomarkers in Chile: Assessing the effects of social capital in a middle-income country

Social capital, mental health and biomarkers in Chile: Assessing the effects of social capital in a middle-income country

Importance of healthcare utilization and multimorbidity level in choosing a primary care provider in Sweden

Do Bonding, Bridging, and Linking Social Capital Affect Preventable Hospitalizations?

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