Are social connections associated with health and wellbeing in a context of social disadvantage and ethnic diversity? A study of Pakistani and White British women and infants in the Born in Bradford cohort.

Abstract

Social disadvantage extends beyond a lack of income and basic necessities, to being deprived of the material and social resources required to lead a happy, healthy and fulfilling life. The focus of this study is on the role of social connections in relation to health, in a context of social disadvantage and ethnic diversity. In this thesis I aim to study the associations between ethnic density, social capital and health for Pakistani and White British mothers and infants in the Born in Bradford study. Data from the Born in Bradford cohort were linked with area-level data to create a multilevel dataset of 4,357 Pakistani and 3,869 White British mother-infant pairs. While own ethnic density was not associated with birth weight or preterm birth, higher South Asian density was associated with lower odds of smoking for both Pakistani and White British women. Although levels of social capital seemed to be low and levels of social disadvantage were high, different indicators of social capital were associated with health outcomes for Pakistani and White British mothers and infants. There was some evidence to suggest that social capital provides health benefits especially to those in disadvantaged circumstances. Social disadvantage for Pakistani women and infants in particular proved hard to capture with measures of individual socioeconomic status and area deprivation, and social gradients in health were attenuated for Pakistani women and infants in the Born in Bradford study and the Millennium Cohort Study. The associations between social resources and health vary by ethnic group, social status, and health outcome, and there is no strong evidence that the promotion of social capital is a useful public health strategy. Greater social equality together with the social inclusion of minority groups are likely to provide the ideal context in which social capital can thrive, regardless of the social or ethnic composition of neighbourhoods