Elsevier

Economics & Human Biology

Volume 17, April 2015, Pages 129-142
Economics & Human Biology

Structural social capital and health in Italy

https://doi.org/10.1016/j.ehb.2015.02.004Get rights and content

Highlights

  • We perform the first assessment of the relationship between SC and health in Italy.

  • Individuals who meet friends frequently are 16% more likely to report good health.

  • Unemployed workers have a 3% higher probability to report poor health.

Abstract

This paper presents the first empirical assessment of the causal relationship between social capital and health in Italy. The analysis draws on the 2000 wave of the Multipurpose Survey on Household conducted by the Italian Institute of Statistics on a representative sample of the population (n = 46,868). Our measure of social capital is the frequency of meetings with friends. Based on IV and bivariate probit estimates, we find that individuals who meet friends every day or more time times a week are approximately 11–16% more likely to report good health.

Introduction

The claim that social capital plays a role in determining actual and perceived health is commonly accepted in public health studies (Kawachi et al., 1997, Kawachi et al., 1999, Kim et al., 2006, Kim et al., 2011) and has recently attracted the attention of economists and economics journals (Brown et al., 2006, Petrou and Kupek, 2008, Scheffler and Brown, 2008, D’Hombres et al., 2010, Ljunge, 2014). Two critical issues have emerged from previous research on the topic.

First, social capital is a very multidimensional phenomenon and there is no univocal evidence on which of its dimensions is good for health. The relationship between the multiple facets of social capital and health is context-dependent and varies according to a number of individual, social, and institutional features.

Second, even if many studies identify social capital as a significant predictor of individual health, there are reasons to suspect this result to be due to a spurious correlation. It seems reasonable to assume the existence of reverse causality: unhealthy people may face obstacles to social interaction, while healthy people may be more inclined to certain relational activities such as, for example, doing sports with others.

The present paper contributes to the literature by carrying out the first assessment of the relationship between social capital and individual health in Italy. Similar research has been undertaken in North America (see for example Folland, 2007), Latin America (Ronconi et al., 2012), and Eastern Europe (D’Hombres et al., 2010) but, to the best of our knowledge, they have never been performed in Mediterranean countries.

Probit estimates show that, in addition to civil status, age, education, income and work status, individual structural social capital, as measured by the frequency of meetings with friends, is strongly and positively correlated with self-perceived health. However, since the habit of meeting friends may be endogenously determined, we follow some promising previous studies (see for example D’Hombres et al., 2010) and instrument this variable with Mass attendance and meetings with friends at the community level.

Instrumental variables regressions show that the habit of meeting friends is a strong predictor of perceived good health both with two-stages probit estimators and bivariate probit estimators.

The reminder of the paper is structured as follows. The next two sections review the literature on social capital and health. We then describe methodology and data. Section 5 describes and discusses empirical results. Concluding remarks and a brief discussion of policy implications close the paper.

Section snippets

Social capital

Over the past 20 years, the literature has extensively analysed the impact of social interactions on individual health. Various aspects of the relational sphere of individual lives have been addressed, from relationships with family and friends to membership of various kinds of association and community cohesion, often grouped together under the common label of social capital.

After Putnam's seminal work, social capital is usually referred to as “features of social organization such as networks,

Social capital and health

The idea that social relationships matter for health is not new in the sociological debate. Social isolation has historically been found to be associated with poorer mental and physical health. Durkheim (1897) first observed that less socially integrated people were more likely to commit suicide than the most integrated. In the 1950s, sociological studies found that psychiatric disorders, morbidity, and mortality rates are significantly higher for non-married than for married people (Tillman

Methodology and data

Our empirical strategy is in two steps. First, the empirical model of perceived health can be represented through the following model:Hi*=γSCi+Xiβ+εiwhere H is self-reported health for individual i; SC is our indicator of individual structural social capital; the X vector consists of annual household income and the other variables that are believed to influence self-perceived health; γ and β are the parameter to be estimated and ɛ is a random-error term.

We do not observe the “latent” variable H

Determinants of self-perceived good health

Table 2 presents estimates of the health equation (1). To compare relative magnitudes of the effects of the independent variables, we report their marginal effects. Column 1 reports the probit estimate (Eq. (2)) and column 2 presents the linear estimation (Eq. (3)).

Before discussing the impact of individual structural social capital, we briefly present the effect of individual and household variables on self-perceived good health. As the estimates resulting from probit and linear specifications

Conclusions

In this paper we have investigated the relationship between individual structural social capital and individual self-perceived good health in Italy. Results of the empirical analysis support the hypothesis that individual structural social capital improves the health conditions of individuals. Following the previous literature, we argue that the mechanism may work through the diffusion of relevant health information, the establishment of mutual assistance mechanisms, the promotion of healthy

References (100)

  • K. Engström et al.

    Contextual social capital as a risk factor for poor self-rated health: a multilevel analysis

    Soc. Sci. Med.

    (2008)
  • F. Etile

    Education policies and health inequalities: evidence from changes in the distribution of body mass index in France, 1981–2003

    Econ. Hum. Biol.

    (2014)
  • D. Fiorillo et al.

    Quality and quantity: the role of social interactions in self-reported individual health

    Soc. Sci. Med.

    (2011)
  • S. Folland

    Does ‘community social capital’ contribute to population health?

    Soc. Sci. Med.

    (2007)
  • U.G. Gerdtham et al.

    A note on the effect of unemployment on mortality

    J. Health Econ.

    (2003)
  • M.K. Islam et al.

    Social capital externalities and mortality in Sweden

    Econ. Hum. Biol.

    (2008)
  • B. Kennelly et al.

    Social capital, life expectancy and mortality: a cross-national examination

    Soc. Sci. Med.

    (2003)
  • D. Kim et al.

    The contextual effects of social capital on health: a cross-nation instrumental variable analysis

    Soc. Sci. Med.

    (2011)
  • D. Kim et al.

    US state- and county-level social capital in relation to obesity and physical inactivity: a multilevel, multivariable analysis

    Soc. Sci. Med.

    (2006)
  • R. Klanjsek et al.

    Religious orientation, low self-control, and deviance: Muslims, Catholics, Eastern Orthodox-, and Bible Belt Christians

    J. Adolesc.

    (2012)
  • A.S. Kraus et al.

    Some epidemiologic aspects of the high mortality rate in the young widowed group

    J. Chronic Dis.

    (1959)
  • M. Lindström et al.

    Individual self-reported health, social participation and neighbourhood: a multilevel analysis in Malmö

    Prevent. Med.

    (2004)
  • M. Ljunge

    Social capital and health: evidence that ancestral trust promotes health among children of immigrants

    Econ. Hum. Biol.

    (2014)
  • C. Mansyur et al.

    Social capital, income inequality, and self-rated health in 45 countries

    Soc. Sci. Med.

    (2008)
  • D. O’Reilly et al.

    Religious affiliation and mortality in Northern Ireland: beyond Catholic and Protestant

    Soc. Sci. Med.

    (2008)
  • W. Poortinga

    Social relations or social capital? Individual and community health effects of bonding social capital

    Soc. Sci. Med.

    (2006)
  • S.J. Rossetti

    The impact of child sexual abuse on attitudes toward god and the catholic church

    Child Abuse Neglect

    (1995)
  • F. Sabatini

    The relationship between happiness and health: evidence from Italy

    Soc. Sci. Med.

    (2014)
  • I. Theodossiou et al.

    The social gradient in health: the effect of absolute income and subjective social status assessment on the individual's health in Europe

    Econ. Hum. Biol.

    (2009)
  • J.G. Trogdon et al.

    The effect of friend selection on social influences in obesity

    Econ. Hum. Biol.

    (2014)
  • J.S. Vander Wal

    The relationship between body mass index and unhealthy weight control behaviors among adolescents: the role of family and peer social support

    Econ. Hum. Biol.

    (2012)
  • W. Yip et al.

    Does social capital enhance health and well-being? Evidence from rural China

    Soc. Sci. Med.

    (2007)
  • G.W. Allport et al.

    Religious orientation and prejudice

    J. Personal. Soc. Psychol.

    (1967)
  • L. Artazcoz et al.

    Unemployment and mental health: understanding the interactions among gender, family roles, and social class

    Am. J. Publ. Health

    (2004)
  • E.C. Banfield

    The Moral Basis of a Backward Society

    (1958)
  • M. Barrera

    Distinctions between social support concepts, measures, and models

    Am. J. Community Psychol.

    (1986)
  • M. Bartley

    Unemployment and ill health: understanding the relationship

    J. Epidemiol. Community Health

    (1994)
  • M. Bartley et al.

    Employment status, employment conditions, and limiting illness: prospective evidence from the British household panel survey 1991–2001

    J. Epidemiol. Community Health

    (2004)
  • L. Becchetti et al.

    What are we learning from the life satisfaction literature?

    Int. Rev. Econ.

    (2013)
  • R. Bosse et al.

    Mental health differences among retirees and workers: findings from the normative aging study

    Psychol. Aging

    (1987)
  • P. Bourdieu

    Le capital social

    Actes de la Recherche en Sciences Sociales

    (1980)
  • P. Bourdieu et al.

    An Invitation to Reflexive Sociology

    (1992)
  • A. Branthwaite et al.

    Depression in the young unemployed and those on youth opportunities schemes

    Br. J. Med. Psychol.

    (1985)
  • T.T. Brown et al.

    The empirical relationship between community social capital and the demand for cigarettes

    Health Econ.

    (2006)
  • J. Cassel

    The contribution of the social environment to host resistance. The Fourth Wade Hampton Frost Lecture

    Am. J. Epidemiol.

    (1976)
  • A.C. Cameron et al.

    Microeconometrics Using Stata

    (2010)
  • E. Clark et al.

    Unhappiness and unemployment

    Econ. J.

    (1994)
  • S. Cobb

    Social support as a moderator of life stress

    Psychosom. Med.

    (1976)
  • J. Coleman

    Social capital in the creation of human capital

    Am. J. Sociol.

    (1988)
  • J. Coleman

    Foundations of Social Theory

    (1990)
  • Cited by (0)

    We are deeply indebted to four anonymous reviewers whose comments allowed a substantial improvement of the paper. We thank Luigi Aldieri, Sergio Destefanis, Francesco Drago, Elena Fumagalli and Alessandra Gualtieri for precious suggestions. Needless to say, usual caveats apply.

    View full text