Decomposing social capital inequalities in health

BACKGROUND Research has shown network social capital associated with a range of health behaviours and conditions. Little is known about what social capital inequalities in health represent, and which social factors contribute to such inequalities. METHODS Data come from the Montreal Neighbourhood Networks and Healthy Aging Study (n=2707). A position generator was used to collect network data on social capital. Health outcomes included self-reported health (SRH), physical inactivity, and hypertension. Social capital inequalities in low SRH, physical inactivity, and hypertension were decomposed into demographic, socioeconomic, network and psychosocial determinants. The percentage contributions of each in explaining health disparities were calculated. RESULTS Across the three outcomes, higher educational attainment contributed most consistently to explaining social capital inequalities in low SRH (% C=30.8%), physical inactivity (15.9%), and hypertension (51.2%). Social isolation, contributed to physical inactivity (11.7%) and hypertension (18.2%). Sense of control (24.9%) and perceived cohesion (11.5%) contributed to low SRH. Age reduced or increased social capital inequalities in hypertension depending on the age category. CONCLUSIONS Interventions that include strategies to reduce socioeconomic inequalities and increase actual and perceived social connectivity may be most successful in reducing social capital inequalities in health.