Publication - Research and analysis

Social Capital and Health - Findings from the Scottish Health Survey and Scottish Social Attitudes Survey

Published: 29 Oct 2012
ISBN:
9781782560975

This paper explores the Scottish evidence for a link between social capital and health outcomes to inform the ongoing development of an assets-based approach to addressing health problems and inequalities.

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28 page PDF

365.6 kB

Contents
Social Capital and Health - Findings from the Scottish Health Survey and Scottish Social Attitudes Survey
4 Detailed Findings

28 page PDF

365.6 kB

4 Detailed Findings

4.1 The findings discussed here are based on the regression analyses described above. Where a factor is described as significantly associated with general health or mental wellbeing, this indicates (unless otherwise specified in text or footnotes) that it is independently statistically significant, even after its relationship with other variables is taken into account in a regression model. Full output from the regression analyses conducted for this paper are included in Annex A. In the following discussion, we use simple percentages (based on bivariate cross-tabulations) to illustrate key points for the lay reader.

General health

4.2 Before discussing the relationship between social capital and general health, it is worth briefly summarising key demographic and socio-economic variations in people's views of their own health (Table 2). As discussed in recent Scottish Health Survey reports, people's perceptions of their health tend to decline with age (see Bromley and Given, eds., 2011 for the most recent findings). In 2009, 91% of 16-24 year-olds considered their health to be good or very good, falling to 50% of those aged 75 and older. Analysis also shows that self-assessed health varies with area deprivation and income.[4] 90% of those living in the least deprived areas of Scotland viewed their health as good or very good, compared with 65% of those living in the most deprived areas. Similarly, 91% of those in the highest income quartile rated their health as good, compared with 54% of those in the lowest income group. Economic status also matters, even after taking account of income. Those who were in paid employment (89%) or education (95%) had higher levels of self-assessed health than those who were unemployed (73%), retired (59%), permanently unable to work (14%) or looking after the home and family (73%).[5] Similar patterns were apparent from analysis of SSA 2009 data - age, household income and economic activity were all closely related to self-assessed health.

Table 2 - Self-assessed health by age, area deprivation and economic status(SHeS 2009)

Very good/good Fair Bad/very bad Sample size1
% % % N
Age
16-24 91 8 1 233
25-34 89 10 2 355
35-44 85 10 5 457
45-54 79 14 7 478
55-64 69 21 10 429
65-74 67 22 11 347
75+ 50 36 15 303
Area deprivation (SIMD quintiles)2
Most deprived 65 20 15 526
2nd 75 18 7 497
3rd 73 20 7 513
4th 84 12 4 555
Least deprived 90 9 1 511
Annual household income
Lowest quartile 54 28 18 524
2nd quartile 75 17 8 509
3rd quartile 86 11 3 599
Highest quartile 91 8 1 576
Socio-economic status
In education 95 4 1 110
In paid employment, self-employed or on government training 89 10 1 1380
Permanently unable to work 14 35 50 131
Looking for/intending to look for paid work 73 16 10 77
Retired 59 27 14 687
Looking after home/family 73 22 5 183

1 - Note that the regression models on which the findings discussed in this paper are based were run on the sub-sample of SHeS 2009 respondents who were asked the social capital questions discussed below. All tables in this report are therefore based on this sub-sample.

2 - The Scottish Index of Multiple Deprivation (SIMD) 2009 measures the level of deprivation across Scotland - from the least deprived to the most deprived areas, based on 38 indicators in seven domains of: income, employment, health, education skills and training, housing, geographic access and crime. For more details about SIMD, see http://www.scotland.gov.uk/Topics/Statistics/SIMD/.

4.3 People's social capital assets were also significantly associated with their level of self-assessed health (Table 3). In particular, assets linked to people's own social networks and their feelings of self-efficacy in relation to community involvement were related to higher levels of self-assessed health. For example:

  • Those who had regular contact with friends, relatives and neighbours were more likely than those whose social contact was more restricted to report that their health was good or very good. 80% of those who had contact with friends, relatives or neighbours most days reported that their health was good or very good, compared with just 66% of those who had personal contact with friends, relatives or neighbours once or twice a month or less.
  • Having more than two people to turn to in a crisis was also associated with higher levels of general health - 60% of those who had two or fewer people they could turn to said their health was good or very good, compared with 74% of those with three or four people they could rely on, and 81-83% of those with five or more people they could turn to.
  • In contrast, feeling completely uninvolved in the community appears to be related to relatively lower levels of self-assessed health. However, here the difference appears to be between those who said they were not involved at all in their community and everyone else. 71% of those who said they were not involved at all in their community said their health was good or very good general health, compared with between 79% and 82% of those who felt they had some (even if not very much) community involvement.[6].

4.4 Regression analysis using SHeS 2009 data suggests that these relationships hold, even after demographic factors are controlled for.[7]

Table 3 - Self-assessed health by social capital assets (SHeS 2009)

Very good/good Fair Bad/very bad Sample size
% % % N
How often contact friends, relatives and neighbours in person, by phone, letter or e-mail
Most days 80 13 6 1765
Once or twice a week 75 19 6 668
Once or twice a month or less 66 23 11 151
How many people can turn to for support in a crisis
2 or fewer 60 27 13 315
3 or 4 people 74 17 9 469
5 or 6 people 82 13 5 762
7-10 people 81 14 5 552
11+ people 83 12 5 473
How involved feel in local community
A great deal 80 15 6 142
A fair amount 82 15 3 615
Not very much 79 15 6 1196
Not at all 71 18 10 625

4.5 The results of regression analysis of SSA 2009 were somewhat less conclusive,[8] perhaps reflecting the fact that, as discussed above, SSA questions focused on social networks in the local area, rather than on wider networks and support - perhaps the latter play a bigger role in relation to health and wellbeing. However, findings at a bivariate level again tend to suggest that having strong support networks may make a difference to people's general self-assessed health. For example, 76% of those who agreed strongly that there were people in their area they could turn to for advice and support had very good or good health, compared with 65% of those who disagreed with this statement.

Mental wellbeing

4.6 As with general health, mental wellbeing (as measured in SHeS 2009 by WEMWBS, described above) varies with age. However, in this case the relationship is not linear. Those aged 65-74 were most likely to have average or above WEMWBS scores, but there was no clear pattern across the other age groups. Mental wellbeing also varies with socio-economic status in a similar manner to general health. Those in employment or education have higher scores, particularly in comparison with those who are unemployed or permanently unable to work, while those living in the least deprived areas had higher self-reported wellbeing than those in the most deprived areas (Table 4).[9]

Table 4 - Mental wellbeing (WEMWBS) by age, area deprivation and socio-economic status (SHeS 2009)

Good mental wellbeing Average mental wellbeing1 Below average mental wellbeing Sample size
% % % N
Age
16-24 11 71 19 233
25-34 10 78 11 355
35-44 10 74 17 457
45-54 12 69 19 478
55-64 8 77 15 429
65-74 16 73 11 347
75+ 12 68 20 303
Socio-economic status
In education 13 76 11 110
In paid employment, self-employed or on government training 11 77 12 1380
Permanently unable to work 4 35 61 131
Looking for/intending to look for paid work 8 59 33
Retired 13 72 16 687
Looking after home/family 7 74 19 183
Area deprivation (SIMD quintiles)
1st (most deprived) 9 69 22 526
2nd 11 69 20 497
3rd 12 71 17 513
4th 11 76 13 555
5th (least deprived) 12 80 8 511

1 - 'Average' is defined as within one standard deviation of the mean score.

4.7 Again, regression analysis suggests that social capital assets are positively associated with mental wellbeing even after controlling for demographic and socio-economic variations.[10] In particular, feeling able to influence decisions in the local area and having more than one or two people to turn to in a crisis were significant.

  • Those who agreed or strongly agreed that they could influence decisions about their local area were more likely to have average or above levels of mental wellbeing (91%) compared with those who disagreed (81%) or strongly disagreed (74%) that they had such influence.[11]
  • Levels of mental wellbeing were also higher among those who had more people they could turn to for support in a crisis. Between 87% and 91% of those who had five or more people they could turn to reported average or above average levels of mental wellbeing, compared with 75% of those who only had three or four people and 70% of those with two or fewer people they could rely on in a crisis.

4.8 However, in contrast with general health, mental wellbeing did not appear to vary significantly by frequency of contact with family, friends or neighbours.

Table 5 - Mental wellbeing (WEMWBS) by social capital assets (SHeS 2009)

Above average Average1 Below average Sample size
% % % N
How many people can turn to for support in a crisis
2 or fewer 5 65 30 315
3 or 4 people 4 71 25 469
5 or 6 people 10 78 12 762
7-10 people 14 74 13 552
11+ people 18 72 9 473
Whether feel can influence decisions over local area
Agree/strongly agree 16 75 9 573
Neither 13 75 12 716
Disagree 8 73 19 985
Strongly disagree 7 67 26 244

1 - 'Average' is defined as within one standard deviation of the mean score.


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Email: Linzie Liddell