Aleck Ostry Canada Research Chair in the Social Determinants of Community Health, Michael Smith Foundation for Health Research, Scholar and Associate Professor, Faculty of Social Science University of Victoria British

1
Aleck OstryCanada Research Chair in the Social
Determinants of Community Health, Michael Smith
Foundation for Health Research, Scholar and
Associate Professor,Faculty of Social
ScienceUniversity of VictoriaBritish
ColumbiaCanadaostry_at_uvic.ca250-721-7336.http/
/nethrnbc.uvic.ca
Should we use Social Capital in Rural Health
Research?
2

• Work shop Assumptions
• There is a need to know how rural communities are
  structured and how they function in order to
  fruitfully conduct health research
• There is a need to know how macro factors impact
  rural community structure and function
• Important to know how change in community
  structure and function impacts health of rural
  residents

3
What models of community functioning might we use?

• Ideal elements of the model
• Based on, derived from, and sensitive to rural
  communities
• Widely used in rural community studies
• Used effectively with heath indicators
• Can be linked both with macro and micro factors
  of importance to both rural community and to
  health
• Intuitive and likely to be understood and used by
  researchers, communities, and policy makers

4
Can social capital do the job?

• Why not?
• 1. Very little work done applying social capital
  to the rural context
• 2. Studies with social capital are often based
  on large regions and metropolitan regions

5
Can social capital do the job?

• Why?
• 1. Lots of research on social capital linked to
  different health outcomes
• 2. Appears to have the attention of community
  leaders and policy makers

6
What is needed to effectively utilize social
capital in rural health research?

• 1. Critique of social capital as currently used
  in socio-epidemiological research
• 2. Conceptual and theoretical efforts directed
  at adapting or re-framing social capital for use
  in rural community health studies
• 3. Differentiating between availability and use

7
The critique

• 1. Social capital was originally theorized as
  having dimensions related to the market,
  bureaucratic, communal, and associative relations
  of individuals in communities
• 2. Putnam and others focused their research on
  the communal (family ties) and associational
  (member of clubs) elements of social capital
• 3. Socio-epidemiologists looked to Putnam and
  others to develop their models of social capital
• 4. Social capital as a way to describe community
  functioning in socio-epidemiological studies is
  therefore much too narrowly framed
• 5. Finally, social capital was never developed
  as a model to describe rural communities
• 6. To use social capital in rural health
  research we need to
• - go back to the origins to include a broader
  social capital construct
• - adapt it to the specific realities of rural
  communities
• - think about social capital availability and
  use

8
(No Transcript)
9
Youth Suicide Rates by the number of Cultural
Factors in the Community (1993-2000)
Chandler, Lalonde, Sokall, Halllet, (200343)
Personal Persistence, Identity Development, and
Suicide A Study of Native and Non-Native North
American Adolescents.
10
Table 1 Family Social Connections
See family p0.23 Rural GVRD
Once a week 56.41 45.58
Once a month 43.59 54.42
See friends p0.00 Rural GVRD
Once a week 81.04 75.49
Once a month 18.96 24.51
Talk to neighbour p0.00 Rural GVRD
Once a week 69.84 55.32
Once a month 30.16 44.68
11
Table 2 Social Trust
Lost wallet person close by p0.00 Rural GVRD
Very likely 56.87 33.33
Somewhat likely 34.05 49.54
Not at all likely 9.08 17.13
Lost wallet-store clerk p0.00
Very likely 73.43 47.57
Somewhat likely 22.51 40.36
Not at all likely 4.06 12.07
Lost wallet-police p0.00
Very likely 82.60 67.39
Somewhat likely 15.67 27.39
Not at all likely 1.73 5.23
Lost wallet- stranger p0.00
Very likely 12.86 10.41
Somewhat likely 56.90 47.22
Not at all likely 30.23 42.37
12
Table 3 Community Participation
How many service clubs p0.00 Rural GVRD
None 83.83 91.56
One or more 16.17 8.44
How many youth groups p0.00
None 66.81 71.83
One or more 33.19 28.17
How often attend religious services p0.00
Never 25.59 14.93
Some 55.11 51.94
Every week 19.30 33.13
How many hours did you volunteer p0.00
None 36.66 43.87
1-10 hrs 33.67 34.29
gt 10 hrs 29.66 21.84
How many charity p0.00
None 19.86 23.80
Some 80.14 76.20
13
(No Transcript)
14
(No Transcript)
15
Mean Values of Social Capital IndicesBy
Rural/Urban Status