Social Capital

Social capital is becoming an increasingly important and more generally accepted concept within the broad area of inquiry commonly referred to as social determinants of health. Social determinants of health include factors that influence health at multiple levels, including the individual, group, organization, community, system, and global levels. Factors such as risky behavior, social support, organizational culture, environmental stress, and the political system work simultaneously to determine the health of individuals and populations. More recently, the concept of social capital has been demonstrated to be an additional determinant of health and health outcomes (e.g., physical and mental morbidity) at both the person and group levels.

There are numerous definitions of social capital, but in general, the term is understood to refer to “resources” available to a population that bind it together as a system of social relations. The World Bank defines social capital as the norms and social relations embedded in the social structures of societies that enable people to coordinate action to achieve desired goals (http://www.worldbank.org/poverty/scapital/). Some research suggests that the resources that comprise social capital can be broken down into two parts: structural (i.e., how people interact with each other) and cognitive (i.e., how people perceive their interactions with others). Structural aspects of social capital could include the number and strength of social relationships, and cognitive aspects of social capital could include issues such as trust, sharing, and support. A second way to understand social capital is to view the “resources” according to their function. In this view, social capital is understood to have both a “bonding” and a “bridging” function. The bonding perspective suggests that social capital functions to bond similar and like groups to one another (social cohesion) at a horizontal or “within the same context” level. The bridging perspective suggests that social capital functions across contextual levels or vertically and aims to bridge relationships between different societal levels (social integration). An important distinction to keep in mind when defining social capital is that it is essentially an ecologic characteristic that is related to social structure. It is not a characteristic that is related to individual attributes as are the concepts of social support and social network.

The empirical relationship between social capital and health has just recently been demonstrated. In the United States, social capital has been shown to be associated with self-ratings of health, violent crime, heart disease, infant mortality, and life expectancy. In developing countries, social capital has been related to general household status. Several instruments to measure social capital have been developed, and most of them include variables that measure the structural and cognitive aspects of the construct. For example, factors related to connectedness and participation with family, friends, local communities, work, and neighborhoods are used to measure structure while, factors such as feelings of safety, trust, and tolerance of diversity can be used to measure the cognitive aspects of social capital.

The inclusion of social capital concepts, particularly as might be related to disability, provides numerous opportunities for new empirical research. For example, the notions of bonding and bridging functions suggest that the disability community might gain both local and national political power as it builds local community and national-level constituencies. Likewise, increased access to organizations that promote the working status of disabled individuals may increase feelings of self-esteem, thus demonstrating the positive impacts of both the structural and cognitive social capital.

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