سرمایه اجتماعی، امید به زندگی و مرگ و میر: یک معاینه میان ملی

This paper analyses the relationship between social capital and population health. The analysis is carried out within an econometric model of population health in 19 countries in the Organisation for Economic Co-operation and Development countries using panel data covering three different time periods. Social capital is measured by the proportion of people who say that that they generally trust other people and by membership in voluntary associations. The model performs well in explaining health outcomes. We find very little statistically significant evidence that the standard indicators of social capital have a positive effect on population health. By contrast, per capita income and the proportion of health expenditure financed by the government are both significantly and positively associated with better health outcomes. The paper casts doubt upon the widely accepted hypothesis that social capital has a positive effect on health and illustrates the importance of testing this kind of hypothesis in an extended model.

There has been a great deal of interest in the last 20 years in analysing the socio-economic determinants of health outcomes in individuals, regions and countries. Much of this research is based on the theory that there is an inverse relationship between income distribution and health. This theory has been developed to incorporate the argument that the negative effects of income inequality on health operate mainly through its effect on social capital. While the theoretical debate in the literature is far from resolved, the view that income inequality, and low levels of social capital, are bad for health has become an accepted piece of policy wisdom, finding its way into national health policy strategies and popular commentaries on health policy. This development is surprising given the methodological questions surrounding the population-level evidence that has been accumulated to support these hypotheses (Gravelle, 1998; Wagstaff & van Doorslaer, 2000).