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Arch Hellen Med, 26(4), July-August 2009, 523-535


Individual and contextual influences of social variables in health outcomes: Τhe impact of social capital

1Nursing Department, Technological Educational Institute of Crete,
2Neurology Department, AHEPA, Thessaloniki,
3Department of Social Medicine, Faculty of Medicine, University of Crete,
4Health Planning Division, Department of Medicine, University of Crete, Crete, Greece

The term social capital can be traced back to the beginning of the last century and many of its features and their relationship to health were well-established long before the introduction of the term into the academic agenda. Social capital is a concept that has now come to reorient the focus of health and social sciences from individuals to social groupings. Social capital is a multidimensional term, which is considered to be the synthesis of different, yet related, social features such as civic engagement, information and community networks, reciprocity and trust among people. It is of great interest to health professionals because of the positive influence it may exert on various health outcomes. References to social capital in the current literature do not share a common approach for its measurement. That is because the different theoretical paradigms do not conclude whether social capital is an individual or an ecological construct, affecting most people or communities. This diversity is reflected in the contradictory results of the empirical investigations of the influence social capital may have on health. It is also revealed by the lack of commonly accepted psychometrically tested tools, constructed specifically to measure the concept of social capital. Another ongoing debate is that of whether social capital has a negative influence on health indicators. This paper argues, based on empirical and theoretical evidence, that social capital is both an individual and contextual construct and that it may affect health both positively and negatively. This paper also analyses recent conceptual developments in social capital theory that distinguish between bonding, bridging, and linking, cognitive and structural, horizontal and vertical social capital. These differentiations will permit better understanding of its various functions in different settings and help in the determination of which type of social capital and which indicators are the most appropriate in promoting health in people with different sociodemographic, ethnic and cultural backgrounds.

Key words: Health, Mental health, Social capital, Social capital questionnaire, Social determinants of health.

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