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Kawachi I., Kennedy B. P., Glass R., (1999). Social capital and self-rated health: a contextual analysis. American Journal of Public Health, 89, 1187–1193.

OBJECTIVES: Social capital consists of features of social organization--such as trust between citizens, norms of reciprocity, and group membership--that facilitate collective action. This article reports a contextual analysis of social capital and individual self-rated health, with adjustment for individual household income, health behaviors, and other covariates. METHODS: Self-rated health ("Is your overall health excellent, very good, good, fair, or poor?") was assessed among 167,259 individuals residing in 39 US states, sampled by the Behavioral Risk Factor Surveillance System. Social capital indicators, aggregated to the state level, were obtained from the General Social Surveys. RESULTS: Individual-level factors (e.g., low income, low education, smoking) were strongly associated with self-rated poor health. However, even after adjustment for these proximal variables, a contextual effect of low social capital on risk of self-rated poor health was found. For example, the odds ratio for fair or poor health associated with living in areas with the lowest levels of social trust was 1.41 (95% confidence interval = 1.33, 1.50) compared with living in high-trust states. CONCLUSIONS: These results extend previous findings on the health advantages stemming from social capital.


Kawachi, Ichiro

Professor of Social Epidemiology Chair, Department of Society, Human Development, and Health Department of Society, Human Development, and Health 677 Huntington Avenue Kresge Building 7th Floor Boston, Massachusetts 02115 Phone: 617.432.3915 ikawachi@hsph.harvard.edu...

Kennedy, Bruce P.

Bruce P. Kennedy is a social epidemiologist, formerly at the Harvard School of Public Health.

Glass, Roberta

Roberta J. Glass is a statistician at i3 Drug Safety. Previously, Roberta Glass was a research specialist for the Harvard Center for Risk Analysis at the Harvard School of Public Health. She has 14 years' experience in the field of statistics analysis. She has conducted a variety of research...

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