Low linking social capital as a predictor of coronary heart disease in Sweden: a cohort study of 2.8 million people.
This study investigated the association between the recently minted concept of linking social capital and incidence of coronary heart disease (CHD). A follow-up study of 1,358,932 men and 1,446,747 women in Sweden aged 45-74 years was conducted between 1 January 1998 and 31 December 1999. Neighbourhood linking social capital was conceptualised as proportions of individuals voting in local government elections at neighbourhood level. The neighbourhood- and individual-level factors were analysed within a multilevel framework. Linking social capital was associated with CHD in both men and women beyond individual-level factors: in neighbourhoods with low linking social capital the odds ratios were 1.19 (CI = 1.14-1.24) and 1.29 (CI = 1.21-1.38) for men and women, respectively, after adjustment for age, country of birth, education, marital status, and housing tenure. The significant between-neighbourhood variance (i.e. the random intercept) showed significant differences in CHD incidence between neighbourhoods. Even in a relatively egalitarian society, as exemplified by the Swedish Welfare State, individual health is affected by differences between neighbourhoods in linking social capital. The use of linking social capital represents a novel conceptual advance in research on the association between CHD, one of the major causes of death in Western countries, and the multidimensional aspects of social capital.
Sundquist
Jan
J
Karolinska Institute, Center for Family and Community Medicine, Stockholm, Alfred Nobels allé 12, SE-141 83 Huddinge, Sweden. jan.sundquist@klinvet.ki.se
Johansson
Sven-Erik
SE
Yang
Min
M
Sundquist
Kristina
K
D000368:Aged; D015331:Cohort Studies; D003256:Community Participation; D003327:Coronary Disease / Q000191:economics / Q000453:epidemiology*; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005163:Factor Analysis, Statistical; D005260:Female; D006798:Housing / Q000145:classification; D006801:Humans; D015994:Incidence; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D016016:Proportional Hazards Models; D011593:Psychology, Social; D012111:Residence Characteristics / Q000145:classification* / Q000706:statistics & numerical data; D018570:Risk Assessment; D012923:Social Class; D012944:Social Support; D012959:Socioeconomic Factors; D013548:Sweden / Q000453:epidemiology