social capital and wellbeing

8/6/2019 Social Capital and Wellbeing

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Social Capital and Well-being

Michael S. Abrams

24 February 2008MA in Individualized Studies

Goddard College


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TABLE OF CONTENTS

Preface

I. What is Social Capital?

a. Measurement

b. Criticisms

II. Social Capital and Well-being

a. Social Capital and Health

b. Social Capital and Mental Health

c. Inequality and Health

III. An Alternative Approach

IV. Conclusion

References


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Preface

On the occasion of my first residency at Goddard College, the cab driver who drove me

to the school from the airport proffered his opinion that Burlington, and Vermont ingeneral, were exceptionally great places to live. "Why? I asked. "Quality of life," he

immediately respondedperhaps not realizing that his answer could be considered

tautological, but also entirely unaware that my avowed purpose in pursuing the MA in

Individualized Studies was specifically to investigate the many measures that have been

developed to assess 'quality of life' at the societal level.

If I were ever to doubt whether levels of social capital were associated with a

community's quality of life, I need only study Robert Putnam's 'social capital' map of the

US. (Putnam is the American political scientist who is universally given the credit of

almost single-handedly bringing the academic concept of social capital into the popular

lexicon.) East of the Mississippi--by Putnam's careful quantitative assessment--Vermont

stands alone as the single state that can boast an impressive level of social capital. If one

provisionally were to accept that a high level of social capital was prerequisite to a good

quality of life, my cab driver's intuition about Vermont would dovetail perfectly with

Putnam's painstaking analysis.

Social capital has a plethora of definitions, but all of them have some bearing on the

strength of the social fabric that binds us together. This is reflected in such items as the

degree to which we trust our neighbors, and the number of voluntary organizations to

which we belong. Through his writings, Putnam has endeavored to raise popular

awareness of the degree to which the quality of life that a society can offer is a function

of the level of social capital that it embodies.

In this paper I will attempt to critically examine his hypothesis. I will try to understand

the degree to which well-beingespecially as it manifests both in physical and mental

healthcan be linked to social capital. It would appear that healthboth physical and

mentalprovides the ultimate test of the impact of any particular factor on well-being,


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for the following reasons. First: it would be hard to imagine a meaningful definition of

human well-being that did not list health as a critical component. Second: although there

are obviously degrees of health--whether physical or mental--such degrees tend to be

objectively verifiable.

My goal is to understand the relation between social capital and human well-being, but

specifically in terms of its implications for my eventual purpose of evaluating the various

indicators that have been developed to assess quality of life at the societal level. (Such

indicators include the Human Development Index, the Genuine Progress Indicator, and

several others.) To the degree that I am successful, I should be in a better position to

make meaningful judgments about the usefulness of any such indicator.

Michael S. AbramsSao Paulo, Brazil


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I. What is Social Capital?

As a starting point for our discussion, we will use what would appear to be a basic

formulation: Social capital is a form of capital that exists within relationships amongindividuals. (Karner, 2001, p. 2637) So, social capital is a form of capital, one of the

fundamental concepts in Economics. Then, just what is capital? Pierre Bourdieu, the

first social scientist to develop a theory of social capital, defined capital as accrued labor

which can be tapped by individuals or groupseither to further their specific interests, or

to amass still more capital. (Karner, 2001, p. 2637)

From the point of view of the individual,

[s]ocial capital constitutes a specific kind of resource that is available to an actor.

Unlike other resources, social capital is based on reciprocity and thus comes withthe expectations that obligations will be repaid as requested by other individuals

in the network. (Karner, 2001, p. 2637)

The French social theorist Bourdieu, together with two Americanssociologist

James Coleman and political scientist David Putnamare generally regarded as having

been the most important influences on the contemporary theory of social capital.

(Hawkins, 2005, p. 2218) Bourdieus particular focus was on the elite in French society.

He was interested in elucidating disguised or invisible forms of social capital that

were deployed by elites to maintain social inequality. He saw the nonmaterialexchanges inherent in social relationships as producing resources that members ofelites drew upon to maintain their positions within the existing social structure.

(Hawkins, 2005, p.2219)

Contrasting with Bourdieus anti-democratic formulation, Coleman sough a far

more benign conceptualization:

His interest in social capital came out of his research on the importance of family

and community in educational results. He found that familial and community

resources, which he defined as social capital, were sufficiently powerful to

compensate for economic disadvantages. For Coleman . . . not only individualsbenefited from social capital, but also society as a whole. (Hawkins, 2005, p.

2219)

For Coleman, social capital was not monolithic, but rather manifested in a variety

of distinguishable forms:


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1) Obligations and expectations. A social network may rely on favors. An

individual in the network who has done many favors for other members, but who has not

requested any favors from them, can be said to have accumulated a certain amount of

social capital within the network. Such capital can be utilized when the individual needs

to request a favor from another member of the network.

Obligations and expectations constitute a form of social capital that depends on

trust. One does favors for other members within the social network because one trusts

that these favors will ultimately be reciprocated. Therefore, the strength of such networks

can be inferred from the amount of outstanding obligations, which corresponds to the

degree to which this trust is manifest.

2) Information potential. Knowledge and information can be a critical resource

for the accomplishment of ones objectives. Participation in a network can enable one to

avail oneself of the knowledge that others have accrued.

3) Norms and effective sanctions

Within a social system, norms can support and provide rewards for specificbehaviors. Norms that encourage the subjugation of self-interest to the needs of

the community are an especially powerful form of social capital.

4) Authority relations. For groups that are organized in the service of a

particular issue, the designation of a leader considerably amplifies the social capital of

each of their members.

5) Appropriable social organization When the issue for which a social

organization was constituted is resolved, the organization often continues to exist by

redefining its goals. The organization itself constitutes a form of social capital, one that

can be appropriated for a new purpose.

6) Intentional organization An intentional organization is an organization

formed for the purpose of directly benefiting its members. Examples include joint

business ventures and PTA chapters. This form of social capital advances the interest of

those who invest in it. There are two by-products of intentional organization: a public

good that benefits others who did not invest directly, and a social g organization that can

be appropriated for other purposes. (Karner, 2001, pp. 2638-39)


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These forms may be quite disparate, but each of them share two common

elements:(1) Social capital appears as an aspect of social structures, and (2) actors are

able to use social capital as a resource to achieve their goals within the social structure.

(Karner, 2001, p. 2638)

In addition to developing a typology of social capital, Coleman also identified

several canonical factors by which social capital could increase or decrease: Networks

could exhibit greater or lesser degrees of closure, or of stability. Their members could be

motivated by a common ideology. They could have access to more resources as the result

of affluence. Finally, they could flourish as the result of the availability of official aid.

(Karner, 2001, p. 2640)

Robert Putnam, the third figure in the social capital triumvirate, found his

inspiration in his efforts to understand why northern Italy manifested far higher levels of

civil integration than southern Italy.

In 1970, Italy created a net of 20 regional governments that collectively spanned

the country. These governments had the same form, but each sprouted within the context

of a unique configuration of social, economic, political and cultural conditions. Any

number of spectrums were represented, including the one from the pre-industrial to the

post-industrial, from the traditionalist Catholic to the radical Communist, from the quasi-

feudal to the thoroughly modern.

Several of the governments that were created floundered in corruption and

inefficiency. But others were amazingly successfulto the extent of generating an

impressive array of innovative social, economic and environmental programs.

Putnam and his colleagues sought the underlying cause for the radically different

resultswhy some of the governments flourished, and others floundered. He found that

the critical factor was not ideology or standard of living, nor was it in the respective

stabilities of the societies alone, nor in their respective degrees of political harmony. The

critical factor was the degree of civic engagement, as reflected in such statistics as voter

turnout, newspaper readership, and the level of membership in clubs and voluntary

associations. (Putnam, 1993, p. 2)


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Perhaps his graphic conclusions merit quoting at length:

Some regions of Italy, such as Emilia-Romagna and Tuscany have many activecommunity organizations. Citizens in these regions are engaged by public issues,

not by patronage. They trust one another to act fairly and obey the law. Leaders

in these communities are relatively honest and committed to equality. Social andpolitical networks are organized horizontally, not hierarchically. These civic

communities value solidarity, civic participation and integrity. And here

democracy works.

At the other pole are the uncivic regions, like Calabria and Sicily, aptly

characterized by the French term incivisme. The very concept of citizenship isstunted there. Engagement in social and cultural associations is meager. Fromthe point of view of the inhabitants, public affairs is somebody elses businessinotabili, the bosses, the politiciansbut not theirs. Laws, almost everyoneagrees, are made to be broken, but fearing others lawlessness, nearly everyone

demands sterner discipline. Trapped in these interlocking vicious circles, nearlyeveryone feels powerless, exploited, and unhappy. It is hardly surprising that

representative government here is less effective than in more civic communities.(Putnam, 1993, p. 3)

The Italian civic communities have their roots in the communal republics that

were established in early medieval times in such places as Florence, Balogna and Genoa.

It would appear that the tradition of an active citizen dies hard. Putnam believes that he

can discern a virtually continuous path from the guilds, religious fraternities and tower

societies for self-defense of those times to the cooperatives, mutual aid societies,

neighborhood associations, and choral societies of our own. (Putnam, 1993, p.3)

Fully aware that his findings had an enduring relevance, Putnam

went on to apply the concept of social capital to his study of civic culture in the

United States; in an article published in 1995 . . . he brought the concept of social

capital into the world of political debate and the popular media, first in the UnitedStates and then internationally. (Hawkins, 2005, p. 2219)

For Putnam social capital was a powerful latent factor to be tappedwhether the

issue at hand was the encouragement of economic development or the development of

more effective government. (Putnam, 1993, p. 3) He cited three reasons for its potential

to spur progress in both realms. First, it provides a basis for a generalized reciprocity

that makes for a more efficient society. Second, it makes it easier to obtain information

about the trustworthiness of individuals, and therefore helps reduce the possibility of


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opportunism and malfeasance. Finally, it embodies and reflects previous successful

efforts at collaboration in such a way as to provide a basis for future efforts. (Putnam,

1993, pp. 3-4)

The key to social capital is the difference it makes in peoples ability to cooperate.

The ability of people in the population to form groups cooperating for joint projects is at

the heart of social capital. Social capital refers to those instances in which individuals

cooperate either out of trust, from personal motives, or as the result of group pressure

but only in the event in which the group is voluntarily chosen and may be left. It

specifically excludes the situation where the cooperation is not voluntary, but rather is

enforced by some party external to the group. (Paldam, 2000, p. 633)

It is entirely possible for a group to be created by an outside agent, but thereafter

common experiences result in the members learning to trust and rely on one another. The

classic example of this, of course, is the Army platoon. In such instances, the social

capital would correspond to the amount by which the trust that develops within the group

exceeds the level at which it is enforced by the third party. (Paldam, 2000, p. 633)

Coleman specifically defines social capital as the degree to which an individual

can voluntarily work with others. Numerous writers have grounded this willingness to

cooperate with others in the ability totrust

. Therefore, social capital might also bedefined as the degree of trust that the individual has in others. (This trust is likely to be

reciprocated, and is termed the individuals goodwill.) Another definition relates to the

degree to which an individual can receive benefits based on her goodwill. Finally, we

can define the social capital of a group as the average social capital of the individuals that

constitute that group. (Paldam, 2000, p. 635)

Trust and cooperation are interdependent. It would appear that trust is primary

to most cooperation. However, by working together people further build trust. To the

degree to which trust and cooperation are interdependent, we can base the concept of

social capital in their simultaneous presence and have some hope that it corresponds to an

empirical aspect of a societys functioning. (Paldam, 2000, p. 636)

An alternative definition to the trust-cooperation definition of social capital is the

network definition: an individuals social capital is the number of networks that he has


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built. A third definition is the total amount of benefits that the individual can draw on her

networks, when necessary. (Paldam, 2000, p. 641)

We might question to what degree our definition of social capital as trust-

cooperation is compatible with Putnams, which was based on civic engagement. Results

from the World Values Survey for 32 countries show a high, but not perfect, correlation

between trust and perceived political participation. (Trust is tested by responding to

the question, Generally speaking, do you believe that most people can be trusted, or

cant you be too careful in dealing with people?)

Problematizing the results are four countries that appear to be extreme outliers:

China (with very high trust), Brazil (seemingly with no trust), and Switzerland and the

Netherlands (both with very high levels of political participation). The anomalous results

with China and Brazil might point to the necessity of using a question based on trust-

payoff, such as: How many of your friends will trust you with a loan? (Paldam, 2000,

p.642)

In contemporary discussions of social capital three varieties are generally

recognized: bridging, bonding, and linking. Bonding social capital corresponds to the

strong ties between such groups as families and friends. Putnam cites fraternal

organizations and church reading groups as examples of bonding social capital. Bridging

social capital refers to the weak ties we have with distant friends, and business associates.

Putnam cites civil rights movements and ecumenical religious organizations as examples.

Finally, linking social capital refers to relations between individuals and groups in

different social strata in a hierarchy where power, social status, and wealth are accessed

by different groups. (Social Analysis and Reporting Division, 2001, p. 11)

In fact, social capital is a multidimensional variable that relies on three factors:

relationships, norms and trustboth within and between groups and institutions. The

three dimensions of social capital are:

1) Structural/Cognitive.

Structural social capital describes the relationships, networks, associations and

institutions that link together people and groups. It can be measured by counting the

number of voluntary organizations, or by determining the percentage of people who


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participate in them. Some consider an individuals social capital to be the degree of

participation in organizations beyond the workplace.

Cognitive social capital consists of values, norms, reciprocity, altruism and civic

responsibility, sometimes called collective moral resources. An individuals cognitive

social capital can be associated with trust and feelings of belonging. It can be measured

by surveys of how well individuals trust their neighbors, and how strong their civic

identity is.

2) Bonding/Bridging

Bonding social capital can be considered inward-focused and characterized by

homogeneity, strong norms, loyalty and exclusivity. It is intra-group, and relies on strong

ties. Examples of bonding capital include families and small close-knit migrant

groups.

Bridging social capital is outward-looking, linking disparate groups within

society. As the ties it invokes are necessarily weaker, it can be considered more fragile

than the bonding variety. Bridging social capital is manifest in a persons social

networks.

Bonding social capital can either be benign or malign, manifesting both in strong

families as in terrorist cells. However, bridging capital is almost always benignand

binding disparate groups, it can enable positive social action.

3) Horizontal/ Vertical

This distinction pertains to whether the individuals that are linked are of similar or

different strata in society. (McKenzie & Hapham, 2006, pp. 14-15)

Not the least of its values, social capital has the potential of being an important

unifying concept in the social sciences. It offers a common theoretical language that can

allow historians, political scientists, anthropologists, economists, sociologists, and

policymakers to work together in an open and constructive manner. (Karner, 2001, p.

2641) All of the social sciences use the concept, but not necessarily with the same name.

It is generally recognized that a greater degree of cooperation between these fields could


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lead to far greater progress. One of the main virtues of social capital is that it is close to

becoming a joint concept for all the social sciences. (Paldam, 2000, p. 631)


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a. Measurement

There is general agreement on the importance of the concept of social capital, both

academically and in public policy. However, there has yet emerged no clear consensus

on how to measure it. (Hawkins, 2005, p. 2219)

The attempt to determine the amount of social capital in a community is

problematic. First, it is questionable whether it should be determined simply by

aggregating the measures of the social capital of its individuals. But there are even more

fundamental problemsregarding the nature of the entity whose social capital should be

measured.

What is a communityis it geographical or psychological or functional . . . ? If it

is geographical, then what area size should we measure and who should define itthe community or the policy makers? (McKenzie & Hapham, 2006, p. 17)

Further there are numerous examples of situations where neighborhood is less

important than other social ties:

[A] refugee living in a stable neighborhood of a large city may find support in the

city-wide refugee community from the same country far more important than the

neighborhood community. Many faith groups find their faith community moreimportant than their residential community, especially if they are in the minority

in their geographical area. Socially excluded groups such as those suffering from

mental illness may link with each other through support groups whichincreasingly are based on telephone lines and the Internet. (McKenzie &Hapham, 2006, p. 17)

The best regarded measure of social capital is Putnams Instrument, which is the

per capita number of voluntary organizations in a given population. As organizations can

differ vastly in the intensity of the contacts that they can offer to the individual, we can

also consider a version of Putnams Instrument in which the calculation of the number of

organizations is weighted by the intensity of these contacts.

Putnams Instrument can serve as a proxy for social capital as trust-cooperation.

However, it cannot be regarded as a true measure, because the number of organizations

can be greatly influenced both by culture and the populations degree of affluence.

(Paldam, 2000, pp. 636-37)


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One intriguing theoretical approach to measuring social capital is via the well-

known Prisoners Dilemma:

Two suspects, A and B, are arrested by the police. The police have insufficient

evidence for a conviction, and, having separated both prisoners, visit each of them

to offer the same deal: if one testifies for the prosecution against the other and theother remains silent, the betrayer goes free and the silent accomplice receives the

full 10-year sentence. If both remain silent, both prisoners are sentenced to only

six months in jail for a minor charge. If each betrays the other, each receives afive-year sentence. Each prisoner must make the choice of whether to betray the

other or to remain silent. However, neither prisoner knows for sure what choice

the other prisoner will make. So this dilemma poses the question: How should the

prisoners act? (Wikipedia, n.d.)

Clearly the critical issue in the Prisoners Dilemma is trust. The prisoners

succeed or fail precisely to the degree that they are able and willing to trust one another.

In the context of the Prisoners Dilemma, social capital can therefore be defined as the

propensity to play the cooperative solution. (Note that either player does so despite full

knowledge thatfor any given choice by the other playerhe can always improve his

individual outcome by defecting.) Therefore, we may use the frequency with which the

cooperative solution of the Prisoners Dilemma is played as a measure of social capital.

(Paldam, 2000, p. 638)

Paldam concludes that the most promising measures of social capital are (1)

Putnams Instrument and surveys of generalized trust, and (2) network/trust payoffs.

It would appear that Putnams Instrument yields the same measures of social capital as

the standard polling question regarding generalized trust in mostbut not all

countries. (Paldam, 2000, p. 649)


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b. Criticisms

In Putnams optimistic view, social capital was the hidden key to progress both in the

political and the economic spheres. But the effects of social capital are not necessarily

benign, as it can itself lead to social problems, whether in the form of organized crime

associations, prostitution and gambling rings, or youth gangs. Such forms are obviously

not the kind that Putnam had in mind when he was considering the impact of voluntary

organizations and newspaper readership. (Hawkins, 2005, p. 2219)

In particular, Putnam saw social capital as something that primarily benefited

society, as opposed to the individual. He argued that there was a direct correlation

between the quality of civic culture and levels of poverty, violence and democracy.

Such an understanding had an inherent appeal, as it seemed to promise a non-economic

therapy that could assuage a variety of social ills. Unfortunately, Putnam had failed to

consider the role of economics adequately in the deterioration of civic culture to begin

with. (Hawkins, 2005, p. 2219)

Another criticism is that social capital can contribute to discrimination,

restriction of individual freedom and creativity, lack of economic opportunity, and

overwhelming obligations. It can encourage divisiveness, with in-groups and out-

groups. It demands conformity, which impinges on personal freedom and expression.Finally, it can result in excessive concentrations of powerwith the Mafia being the

classic example. (Karner, 2001, p. 2640)

A societys social capital tends to manifest in the form of vested interests that can

inhibit necessary social change. Obvious examples of this include guilds, trade

organizations, unions, and regional and tribal organizations. Though such organizations

are generally benign, they also tend to be heavily invested in the status quo. Further, it is

clear that organizations can work against the social interest. Examples of this include

networks that are associated with criminal, racist, and violent purposes. (Paldam, 2000,

pp. 634-35)

Also, participation in a network, by itself, cannot really be considered a sufficient

criterion. Networks only have value to the degree they have sufficient resources of

value to make a difference. (Karner, 2001, pp. 2640-41)


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There are, perhaps, even more serious issues regarding the use of social capital in

its tendency to conflate the political and economic spheres.

Deliberative and participatory versions of democracy require an atmosphere and

an attitude where people see their political interactions as motivated by the best,

most just solutions to political problems . . . . [P]eople must see themselves andtheir interests as capable of being transformed by the political process, and they

must constantly strive to have their deliberations informed by as many social

perspectives as possible. . . .

Economic transformations, on the other hand, assume and require no such attitude

of magnanimity and familiarity. Economic transactions generally begin with a

fixed interest and work to achieve that interest. Such transactions make little

economic sense if ones interests are fundamentally transformed in the processbecause economic transactions are instrumental not transformative ones. Theterm social capital ignores the emotionally rich world of meaningthat has surrounded the idea of democracy and reduces thatworld of meaning to the very different language of economics.[Italics mine.] (Smith & Kulynych, 2002, pp. 167-68)

Increasingly, the concept of social capitalism is being criticized as a way to

preempt discussions that properly belong to the political sphere. The World Bank, in

particular, is cited as the perpetrator of a conceptualization of social capital that argues

for cutbacks in government services in the name of community self-reliance. In

remaining silent on the role of political parties and unions in the amelioration of the kind

of power relations that help to maintain an underclass, the World Bank incurs a guilt by

omissionputting its considerable weight behind the spurious notion that it is possible

to have a meaningful public sphere without conflict and strife. (McKenzie & Hapham,

2006, p. 21)


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II. Social Capital and well-being

Having discussed some of the ways in which social capital is defined and measuredand

having noted some of the ways in which the concept has been criticizedwe now turn to

a discussion of its impact on human well-being. Of particular concern here will be social

capitals impact on health (both physical and mental), which is generally accepted as

among the most, if not the most, crucial way in which human well-being can manifest

itself.

Putnams 2000 DDB Needham Life Style Survey demonstrated a link betweensocial involvement and happiness, with monthly club meetings, monthly volunteering,

monthly entertaining, and bi-weekly church attendance each having the happiness of

four extra years of schooling or a doubling of income. However, one cannot directly

infer causality from such a correlation, as both may have their cause in a genetic

predisposition both to gregariousness and well-being. (J.F. Helliwell, 2001, p.54)

However, differences in social capital are well-correlated both to subjective well-

being and to suicide rates. This makes it more reasonable to posit that the causal path

goes from social capital to subjective well-being, rather than the converse. (Helliwell &

Putnam, 2004, p. 1444)

Social capital impacts well-being directly. A study in 1967 confirmed marriage

to be the social connection showing the strongest positive correlation with subjective

well-being. The results of Putnams DDB Needham Life Style Survey confirm

marriage to be the most beneficial form of social interactionequivalent to moving 70

percentiles up the income hierarchy. . . . [Italics mine] (J.F. Helliwell, 2001, p. 53)

The social circumstances that impact well-being include ones economic standard

of living. Indeed, until recently economists have generally equated well-being with

standard of living. However, research has begun to sever this equation: while well-being

tracks income up to a certain economic level, at some critical point the connection

inevitably breaks down. Social factors other than standard of living that influence


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subjective well-being include: marital status, race, education, employment and age.

(Helliwell & Putnam, pp. 1435-36)

The results of a meta-analysis of several global and national surveys show the

impact of various social factors on well-being:

1) well-being is highest in the young and the elderly, lowest in the middle-aged.

2) well-being tracks income, but only up to a point.

3) Unemployment significantly negatively impacts well-being, and much more

than would be predicted by the loss of income that it represents.

4) Education improves health and thus indirectly improves subjective well-

being, but net of that effect . . . education appears to have no direct impact on

subjective well-being.

5) Gender appears to have no strong and straightforward effect on subjective

well-being.

6) . . . [B]eing married increases both life satisfaction and happiness,

especially when the alternative is being separated or divorced. . . . Having a

family enhances subjective well-being, and spending more time with ones

family helps even more.

7) Both strong religious beliefs and frequent attendance at a house of worship are

linked to subjective well-being.

8) Frequent interactions with friends and neighbors support well-being.

9) Civic participation supports well-being.

10) Living in high-trust area supports well-being. (Helliwell & Putnam, 2004,

pp. 1440-43

Note that items 3, 6, 7, 8, 9, and 10 above directly pertain to the amount of social capital

upon which the individual is able to draw.

Health correlates well with subjective well-being, and it is likely that good health

causes subjective well-being. Further, research seems to be confirming that social factors

play a critical role in physical health. From this we may conclude that health constitutes

one pathway through which social factors influence subjective well-being.

(Helliwell & Putnam, p. 1435)


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In the following sections, we shall consider the direct impact of social capital on

healthboth physical and mental.

a. Physical Health

The consensus of a spate of studies on the impact of the extent of social ties on health is

that people with more social capital are likely to live longer, and suffer from fewer

health disorders. (Field, 2003, p. 58)

Putnam suggests that there might be several reasons why social capital impacts

health. In his view, social networks 1) can provide the kind of concrete health that can

decrease stress levels, 2) provide support for healthy behaviors, 3) enable one to attain

medical services more easily, and 4) provide the kind of interaction that can boost ones

immunological system. (Field, 2003, p. 58)

According to Putnam,

There is very strong evidence of powerful health effects of social connectedness.This evidence is not only strong in American states, but also in Finland, Japan and

other countries. Controlling for your blood chemistry, age, gender, whether or not

you jog, and for all other risk factors, your chance of dying over the course of thenet year are cut in half by joining one group, and cut to a quarter by joining two

groups. . . . It is not people who are healthy that become joiners; it is clear from

the studies that the arrow runs in the other direction, from joining to health.(Putnam, 2001, p. 12)

Social capitalboth its presence and absencehave been linked to a variety of

health outcomes and behaviors.

Social capital has been empirically linked to both reduced mortality and increased

self-rated health. Social capital has also been linked to various health-relatedbehaviours, such as smoking, leisure time physical activity, and dietary habits and

to the prevalence of various diseases, such as the common cold, coronary heart

disease, HIV, depression, and dementia. (Ferlander, 2007, p. 121)

However, there is a dual aspect to the effect of social capital on health, reflecting

the dual aspect of social capital in general. Strong networks may well provide a buffer

against stress, but the demands that participating in them may entail themselves represent

a source of stress. They may support healthy lifestyles, but they may as easily support


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unhealthy ones. For example, the best predictor that an adolescent will smoke is whether

or not her peers smoke. There is a human tendency to follow ones peers. Whether this

is beneficial or harmful to ones health depends on the particular norms that prevail in the

network. (Ferlander, 2007, p. 122)

However, at least some of the results do appear to be unambiguous. A 1979 study

of a random sample of 5000 residents of Alameda County, California assessed the health

effects of four types of social ties: marriage, contacts with close friends, church

memberships, and membership in other types of social organizations. For each type, a

greater number of ties was associated with a lower mortality rate. The impact was

greatest for marriage, followed by the others in the order given above. It was shown that

a weighted index combining the four types predicted not only mortality as a whole, but

each of its component subdivisions: heart disease, cancer, cerebrovascular and

circulatory, and other.

For each participant, a variety of data was gathered, including: socio-economic

status, self-reported health status at the time of initial survey, year of death, behaviors that

could impact health, and availability/use of health care services. The connection between

social networks and mortality was shown to be independent of all such control variables.

This made it virtually impossible that differences in health status at the time of the initial

survey were the underlying determining factor both of the size of the social networks and

of the health outcomes. (J.F. Helliwell, 2001, pp. 49-50)

There are ways in which a societys social capital directly impacts the health and

well-being of its members. For example, respect for the rights of others gets a thorough

testing on the highways that we share. Therefore, the incidence of traffic fatalities

provides a good measure of social cohesion. Indeed, more than a third of the cross-

country variance of the late 1990s traffic fatalities is associated with mid 1990s national

differences in average survey answers to the trust question . . . (The trust question is,

In general, do you think that most people can be trusted, or that you cant be too careful

in dealing with people.) (J.F. Helliwell, 2001, p. 50)

A study was performed to show the correlation of poverty, social capital, and

income inequality with each of the four nationally-modifiable sexually-transmitted

diseases in the US: gonorrhea, syphilis, Chlamydia, and AIDS. State-wide rates of all


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four diseases correlated well with social capital, as measured by Putnams

Comprehensive Social Capital Index for US states. (It combined "14 variables that span

the domains of community organizational life, involvement in public affairs,

volunteerism, informal sociability, and social trust.") Of the three variables, only social

capital proved to be a useful predictor for gonorrhea and syphilis rates, with correlations

r2 =.45 and .348, respectively. All three variables had significant correlations with

Chlamydia (r2 = .128, .283, and .156, respectively). Finally, only social capital and

income inequality were useful predictors of AIDS (r2 = .248 and .220, respectively).

(Holtgrave & Crosby, 2003, p. 62-64)

Geographical studies appear to confirm these findings:

If you consider social capital to be a continuous variable, then areas with high

social capital may be expected to have a lower rate of illnesses associated withproblems of social cohesion compared with areas of low social capital. Indeed,

there are reports that areas with high levels of social capital have lower suiciderates, lower all-cause mortality and longer life-expectancy. (Holtgrave & Crosby,

2003, p. 63)


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b. Mental Health

Spatial patterns of social capital are also reflected in the incidence of problems with

mental health.

People in some places have better mental health than people in other places. Thisis not just a reflection of their genetic vulnerability, the physical

environment, or their socioeconomic status. It also reflects the fabric of society

the way in which communities are set up and people live. (McKenzie & Hapham,2006, p. 11)

Concerns with the ways in which society impacted mental health date back at

least to Durkheims mid-century classic Suicide. As early as the 1930s, researchers

showed that variations in the incidence of mental illness in Chicago neighborhoods were

associated with their respective levels of social cohesion. (McKenzie & Hapham, 2006,

p. 11)

Mental illness has a powerful influence on overall health. Examples include the

impact of depression and stress. Depression impacts the functioning of the endocrinal

and immunological systems so as to make one susceptible to a large number of physical

illnesses. Stress is known to be a factor in the onset of the common cold, and has been

shown to delay the healing of wounds. (World Health Organization, 2001, p. 9)

Mental illness is not as different from physical illness as is commonly supposed:

The artificial separation of biological from psychological and social factors has

been a formidable obstacle to a true understanding of mental and behavioural

disorders. In reality these disorders are similar to many physical illnesses in that

they are the result of a complex interaction of all these factors. (World HealthOrganization, 2001, p. 10)

The physiological and behavioral ways by which physical and mental health can

affect each other are distinct but not independent. Health behaviors can affect physiology

for example, smoking and lack of exercise can weaken the immune system.


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Conversely, physiological functioning can impact health behaviorfor example, not

getting enough sleep can lead to forgetting medical regimens. What results is a

comprehensive model of mental and physical health, in which the various components

are related and mutually influential over time. (World Health Organization, 2001, p. 8)

In the last two decades, the field of behavioral medicine has accumulated an

impressive amount of evidence that links mental and physical health. Some notable

examples of this include: 1) Women with advanced breast cancer who participate in

supportive group therapy live significantly longer than women who do not participate in

group therapy. 2) Depression is a reliable predictor of heart disease 3) Realistic

acceptance of ones own death is associated with decreased survival time in AIDS.

(World Health Organization, 2001, p. 8)

It might be hoped that building social capital could result in the reduction of

health costs and in illness rates. Interest has focused on mental health in particular

because it ranks among the three biggest drains on life-years by disability, globally. Also,

it is reasonable to conjecture that the primary way in which social capital impacts

physical health is via predominantly psychological factors. (McKenzie & Hapham, 2006,

p. 12)

Research has established that social support can serve as a buffer against illness in

many contexts. It has been shown that the mortality rates for better-connected

individuals are significantly lower than those of their more isolated peers. Lack of social

support has been established as a risk factor for events as widely varied as accidents,

suicide, heart disease, and depression. To the degree such illnesses are the result of

stress, there is a simple explanation, since social support is believed to buffer the

individual against both chronic and acute stress through the provision of emotional,

informational and instrumental support. (McKenzie & Hapham, 2006, p. 13)

But recently, a meta-analysis was performed of 21 studies of the effects of social

capital on mental health14 of the studies were at the individual level, and 7 were at the

ecological level. The studies at the individual level found strong evidence for an inverse

association between cognitive social capital (trust) and common mental disorders.

However, there was less evidence for an inverse association between cognitive social

capital and child mental illness, and combined measures of social capital and common


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c. Inequality and Health

There would appear to be a basic connection between social capital, inequality, and

health.

Richard Wilkinson . . . found some evidence that social inequality tends to reduce

social stability and undermines social networks, leading to higher levels ofanxiety, stress and ill-health. Similar comparative research in the USA . . .

confirmed the broad association that he identified between health and social

cohesion. (Field, 2003, p. 57)

Social capital has been shown to have less of an impact on health than

socioeconomic status. It is likely that the kind of social capital that connects individuals

with their better-off and worse-off compatriots has more of an impact on health than the

kind that connects them with their socioeconomic peers. This might explain the finding

that countries with more economic equality have greater life expectancies. (Field, 2003,

p. 59)

Among nations, health correlates with equalitynot with per capita GDP. It

is . . . the most egalitarian rather than the richest developed countries which have the

best health. (Field, 2003, p. 75)

Data for 11 developed countries in 1970 show that life expectancy is negatively

correlated with post-tax income inequality, as measured by the Gini coefficient. (The

Gini coefficient measures the degree that a society deviates from a state of perfect

egalitarianism. It varies from 0 to 1--with 0, corresponding to perfect equality, and 1,

corresponding to the theoretical situation where a single individual controls all the wealth

and everyone else has none.) (Mustard, 1998, pp. 7-8)

A study of metropolitan areas in the US showed that higher levels of inequality

predicted higher levels of mortality. Those areas with the highest income inequality

had significantly greater age-adjusted mortality than those of low inequality

and . . . this relationship was independent of absolute levels of mean household

income. These findings were robust across three different measures of the incomedistribution. (Mustard, 1998, pp. 8-9)


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The findings that link income inequality to physical health (either through life

expectancy or mortality) have been criticized as not being robust with respect to the

particular inequality measure that is chosen. Another criticism regards the

meaningfulness of international comparisons of income inequality. However, neither of

these criticisms have proved to be compelling. (Mustard, 1998, pp. 9-10)

One proposed way by which higher levels of income inequality can adversely

impact the individuals health is that income inequality may be associated with a set of

social processes and economic policies that systematically under-invest in physical and

social infrastructure, and with these under-investments then having consequences for

health. Another explanation is that large disparities in income distribution may have

direct consequences on peoples perceptions of their relative place in the socialenvironment, leading to behavioral and cognitive states which influence health.

(Mustard, 1998, pp. 14-15)

Income inequality also has an impact on mental health. Low income inequality

has been identified as a risk-lowering factor for mental health at the community level.

(K.McKenzie, 2006, p. 30)


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III. An Alternative Approach

Both social capital and healthespecially, mental healthare complex concepts.

Intuitively we may feel confident that a causal relation should exist between them

surely, ones connectedness, trust, sense of belonging, civic participation, etc. havepositive ramifications for ones health and well-being. For example, one researcher

discusses several complex graphical models that purport to detail the precise causal

pathways in which low levels of social capital inevitably results in poor mental health at

the community level. (K.McKenzie, 2006, pp. 27-36)

I propose that there is a connection between social capital and well-beingand,

in particular, the kind of well-being that is associated with physical and mental health

but that this connection should not necessarily be understood solely in terms of elaborate

networks of causal relations. My approach starts with the recognition that many, if not

all, of the behaviors associated with the concept of social capital are themselves basic

human needs. When any basic human need is thwarted, there will necessarily be an

adverse effect on well-being. One important aspect of this adverse effect could plausibly

manifest as a worsening of the individuals physical and/or mental health.

In his Hierarchy of Needs, Abraham Maslow , recognized that after the

individuals physiological and safety needs were met, the very next level was the

satisfaction of needs pertaining to love and belonging, which include friendship and

family; this would correspond well to what we have been discussing as bonding social

capital. Recall that the one unambiguous result of a meta-analysis of studies of the

impact of social capital on mental health found that bonding social capital, in particular,


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made a significant difference in the mental health of individuals. (De Silva, McKenzie,

Hapham, & Huffy, 2005, p. 626)

More recently, the economist Manfred Max-Neef has proposed a schema that

attempts to significantly improve upon Maslows hierarchical formulation. According to

Max-Neef, there are, in fact, nine basic human needs: Subsistence, Protection, Affection,

Understanding, Participation, Creation, Leisure, Identity and Freedom. In his schema,

the only strict hierarchy is between Subsistencethe precondition of life, itself--and the

remaining categories. Each need interacts with the four basic human modalities of Being,

Having, Doing, and Interacting; the result is his Matrix of Human Needs. While these

needs are purported to be constant throughout all times and cultures, the particular means

that are available for satisfying any of them are entirely dependent on the time and

culture. (Max-Neef, 1992, p. 199)

In contrast to Maslows hierarchy, the Matrix of Human Needs attempts to

understand human needs as a system.

Human needs must be understood as a system; that is, all human needs are

interrelated and interactive. With the sole exception of the need of subsistence .. . no hierarchies exist within the system. On the contrary, simultaneities,

complementaries and trade-offs are characteristic of the process of needs

satisfaction. (Max-Neef, 1992, p. 199)

In Max-Neefs schema, Affection, Participation, and Identity are the needs mostassociated with what we have been calling social capital. Affection, in the context of

Having, can manifest as the need for friendships and family. Participation, in the

context of Doing, can manifest as the need to cooperate, to dissent, and to express

opinions; in the context of Interacting, it manifests as associations, parties, churches

and neighborhoods. Identity, in the context of Being, can manifest as the need for a

sense of belonging.

Poverty is conventionally defined either as an absolute or relative lack of income.

However, with the recognition that there are nine basic needs, we can speak of nine

corresponding forms of poverty. Each of these poverties can be said to have its own

particular pathology. (Max-Neef, 1992, p. 200)

Thus, it should not be unreasonable to infer that a lack of social capitalwhich,

as we have seen, can be associated with deprivation regarding at least three of the nine


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basic needs identified by Max-Neef, and in all four of his basic modalitiescould result

in the particular kind of pathologies that we subsume within the categories of physical

and/or mental illness.

IV. Conclusion

As we have noted several times in this report, the concept of social capital has an

inescapably dual character. There are numerous results which confirm the intuitive idea

that higher levels of social capital support well-being in general, and both physical and

mental health in particular. On the other hand, for almost every supposed benefit of

social capital there might seem to correspond some significant drawback.

From our study, however, it appears very likely that individuals flourish according their

ability to draw on their networks for support, or trust their neighbors to be fair in their

dealings with them. Regarding two social milieus that are identical in every other aspect,

the one that supports higher levels of cooperation might reasonably be expected also to

support a higher general level of well-being. On this basis, one may provisionally require

that any meaningful measure of a societys quality of life include some way of accounting

for its social capitalfor example, as measured by a survey that asked the trust

question.

There is however one aspect of social capitalor, more properly, the consequences of

social capitalon which a very strong consensus appears to have emerged regarding its

ability to impact well-being, both in individuals and at the community level.. This

concerns how evenly, or unevenly, the communitys aggregate wealth is distributed

among its members. (Annual income is generally used as a convenient proxy for this

wealth.) Therefore, it seems indisputable that we should require that assessments of

societal quality of life include some provision for taking account the degree of economic

inequality within the societyfor example, through the Gini coefficient.


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