Enabling pathways to health equity: developing a framework for implementing social capital in practice

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background Mounting evidence linking aspects of social capital to health and wellbeing outcomes, in particular to reducing health inequities, has led to intense interest in social capital theory within public health in recent decades. As a result, governments internationally are designing interventions to improve health and wellbeing by addressing levels of social capital in communities. The application of theory to practice is uneven, however, reflecting differing views on the pathways between social capital and health, and divergent theories about social capital itself. Unreliable implementation may restrict the potential to contribute to health equity by this means, yet to date there has been limited investigation of how the theory is interpreted at the level of policy and then translated into practice. Methods The paper outlines a collaborative research project designed to address this knowledge deficit in order to inform more effective implementation. Undertaken in partnership with government departments, the study explored the application of social capital theory in programs designed to promote health and wellbeing in Adelaide, South Australia. It comprised three case studies of community-based practice, employing qualitative interviews and focus groups with community participants, practitioners, program managers and policy makers, to examine the ways in which the concept was interpreted and operationalized and identify the factors influencing success. These key lessons informed the development of practical resources comprising a guide for practitioners and briefing for policy makers. Results Overall the study showed that effective community projects can contribute to population health and wellbeing and reducing health inequities. Of specific relevance to this paper, however, is the finding that community projects rely for their effectiveness on a broader commitment expressed through policies and frameworks at the highest level of government decision making. In particular this relationship requires long term vision, endorsement for cross-sectoral work, well-developed relationships and theoretical and practical knowledge. Conclusions Attention to the practical application of social capital theory shows that community projects require structural support in their efforts to improve health and wellbeing and reduce health inequities. Sound community development techniques are essential but do not operate independently from frameworks and policies at the highest levels of government. Recognition of the interdependence of policy and practice will enable government to achieve these goals more effectively. Keywords: Social capital; Health inequities; Community development; Policy and practice; Health promotio

Neighbourhood Life, Social Capital and Perceptions of Safety in the Western Suburbs of Adelaide

In this paper we report on a South Australian study of perceptions of safety and aspects of neighbourhood life including social capital which involved the analysis of 2400 self-completed questionnaires. A path analysis found that perceptions of safety were directly associated with gender, age, perceptions of neighbourhood pollution and neighbourhood trust, and indirectly associated with age, neighbourhood pollution and neighbourhood connections. We conclude with a discussion of the implications of the findings for public policy

Practical Social Capital: a policy briefing.

This briefing is intended for policy makers who fund and make decisions about the availability of community based programs that intend to strengthen social capital and promote health and wellbeing. The briefing synthesises a more extensive guide (Practical Social Capital: a Guide to Creating Health and Wellbeing) and draws out key lessons for policy makers. The Guide is based on three case studies of the practical application of social capital to health, arts and local government projects. It uses the lessons from these case studies to demonstrate how social capital can be a tool in interventions designed to promote health and health equity. The Guide also provides tools and resources for organisations that want to adopt a social capital approach, and reviews literature on health and wellbeing, social capital and community development and capacity building. The case studies on which the Guide and this briefing paper are based were part of a research project funded by an Australian Research Council Linkage Grant and undertaken in collaboration with industry partners: SA Department of Health, Onkaparinga City Council and Arts SA

Practical Social Capital: a guide to creating health and wellbeing.

This Guide resulted from a research project funded by the Australian Research Council and conducted at Flinders University. The research process involved people who work in local and state governments and people who are the recipients of programs and initiatives from government. These inputs have been essential to ensuring this Guide is of practical use to people who want to apply ideas about how the social side of community life, in particular social interactions and networks, can work to increase community wellbeing and reduce inequities

People and Places – Urban location, social capital and health.

People's health status is strongly related to their socio-economic status. Less well-off people are more likely to have a shorter life expectancy and more illnesses than their richer counterparts. There is also a growing body of research suggesting a relationship between area of residence and health. This project, the Urban Locational Disadvantage, Social Capital and Health Project, was designed to contribute to greater understanding of this relationship with the NHMRC funding support

From causes to solutions - insights from lay knowledge about health inequalities

<p>Abstract</p> <p>Background</p> <p>This paper reports on a qualitative study of lay knowledge about health inequalities and solutions to address them. Social determinants of health are responsible for a large proportion of health inequalities (unequal levels of health status) and inequities (unfair access to health services and resources) within and between countries. Despite an expanding evidence base supporting action on social determinants, understanding of the impact of these determinants is not widespread and political will appears to be lacking. A small but growing body of research has explored how ordinary people theorise health inequalities and the implications for taking action. The findings are variable, however, in terms of an emphasis on structure versus individual agency and the relationship between being 'at risk' and acceptance of social/structural explanations.</p> <p>Methods</p> <p>This paper draws on findings from a qualitative study conducted in Adelaide, South Australia, to examine these questions. The study was an integral part of mixed-methods research on the links between urban location, social capital and health. It comprised 80 in-depth interviews with residents in four locations with contrasting socio-economic status. The respondents were asked about the cause of inequalities and actions that could be taken by governments to address them.</p> <p>Results</p> <p>Although generally willing to discuss health inequalities, many study participants tended to explain the latter in terms of individual behaviours and attitudes rather than social/structural conditions. Moreover, those who identified social/structural causes tended to emphasise individualized factors when describing typical pathways to health outcomes. This pattern appeared largely independent of participants' own experience of advantage or disadvantage, and was reinforced in discussion of strategies to address health inequalities.</p> <p>Conclusions</p> <p>Despite the explicit emphasis on social/structural issues expressed in the study focus and framing of the research questions, participants did not display a high level of knowledge about the nature and causes of place-based health inequalities. By extending the scope of lay theorizing to include a focus on solutions, this study offers additional insights for public health. Specifically it suggests that a popular constituency for action on the social determinants of health is unlikely to eventuate from the current popular understandings of possible policy levers.</p

Neighbourhood life and social capital: the implications for health

Social capital has been linked to health outcomes, though there are some inconsistencies in the research and the link is dependent on the measures of social capital and health used. In this paper, we argue that social capital is multifaceted and its relationship with health is complex. We explore the relationship between a number of elements of neighbourhood life and neighbourhood-based social capital, and health, using both qualitative and quantitative methods. The paper reports on a study of the Western suburbs of Adelaide and the analysis of 2400 questionnaires and 40 in-depth interviews. A partial least-square path analysis was undertaken with the questionnaire data. It considered the impact of perceptions of the physical environment, neighbourhood connections, neighbourhood trust, reciprocity, perceived safety and local civic action, and a number of demographic variables, on physical and mental health as measured by the SF-12. Of the neighbourhood-related variables, only perceived neighbourhood safety was related to physical health, with neighbourhood safety and neighbourhood connections related to mental health. Of the demographic variables, higher-income level and educational achievement were related to better physical and mental health. In addition, physical health was lower and mental health higher within older age groups. The inter-relationships between the neighbourhood variables and demographic differences in experience of neighbourhood were also examined. The thematic analysis of the interviews linked a number of social aspects of neighbourhood, the physical neighbourhood environment, perceptions of safety, civic activities and availability of local services, to health outcomes. The paper concludes that there is a need for more complex measures of social capital and that socio-economic factors are of relatively greater importance in determining health.Social capital Health inequities Neighbourhood Location Physical environment Path analysis Australia

Detecting Biodiversity Changes Along Climatic Gradients: The IBISCA-Queensland Project

The IBISCA-Queensland project established 20 permanent plots over an altitudinal range of 300 m to 1100 m above sea-level (a.s.l.) in rainforest within Lamington National Park, south-east Queensland. Four replicate plots were established at each 200 m interval, representing an average temperature change between altitudes of about 1.5°C - a full range of approximately 7.5°C. The project aimed to identify which animal and plant groups are likely to be most sensitive to climate change and which ones can best be used as indicators for monitoring such change. Full vegetation analyses were carried out at each plot and basic climatic and soil data collected. Over an 18 month period insect collections, using a wide-range of trapping methods, were made and specific projects carried out by more than 55 scientists from 14 countries. This paper summarises the history and goals of the project and the general 'IBISCA' model within which it was conceived. Site locations are presented, as is an outline of the specific trapping programme and more specific projects carried out within the broader objectives of IBISCA-Queensland. The strengths and weaknesses of the IBISCA approach are discussed. The first comparative syntheses are anticipated and a broader context for future work is defined. © The State of Queensland (Queensland Museum) 2011.Link_to_subscribed_fulltex

Detecting biodiversity changes along climatic gradients: the IBISCA-Queensland Project

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