Health by association? Social capital, social theory, and the political economy of public health.
Three perspectives on the efficacy of social capital have been explored in the public health literature. A "social support" perspective argues that informal networks are central to objective and subjective welfare; an "inequality" thesis posits that widening economic disparities have eroded citizens' sense of social justice and inclusion, which in turn has led to heightened anxiety and compromised rising life expectancies; a "political economy" approach sees the primary determinant of poor health outcomes as the socially and politically mediated exclusion from material resources. A more comprehensive but grounded theory of social capital is presented that develops a distinction between bonding, bridging, and linking social capital. It is argued that this framework helps to reconcile these three perspectives, incorporating a broader reading of history, politics, and the empirical evidence regarding the mechanisms connecting types of network structure and state-society relations to public health outcomes.
Szreter
Simon
S
Faculty of History and Fellow of St John's College, University of Cambridge, Cambridge CB2 1TP, UK. srss@cam.ac.uk
Woolcock
Michael
M
D006293:Health Promotion; D006801:Humans; D011057:Politics; D011203:Poverty; D011634:Public Health; D012935:Social Justice; D012945:Social Values; D006113:United Kingdom