title: Social capital: a novel platform for understanding social determinants of health in systemic lupus erythematosus.
abstract: OBJECTIVE
  The objective of this paper is to introduce the concept of social capital as a unique and distinct entity from the traditional psychosocial factors of social support, depressive symptoms, and self-efficacy in systemic lupus erythematosus (SLE) patients, and to evaluate how social capital varies in an SLE sample according to demographic, clinical, and psychosocial variables.
  
  
  METHODS
  In a cross-sectional study, SLE patients completed the Adapted Social Capital Assessment Tool (A-SCAT), which measures cognitive and structural social capital. Patients also completed measures of social support, depressive symptoms, and SLE self-efficacy. Correlations were evaluated between social capital scores and demographic, clinical, and psychosocial variables.
  
  
  RESULTS
  We recruited 89 patients (mean age: 39 ± 15 years old, 83 (93): female; mean SLEDAI: 4; mean SLICC 1). The mean A-SCAT score was 34 ± 15 (normal: 0-71); higher scores were associated with female sex, older age, higher education, Caucasian race, and non-Medicaid insurance (p ≤ 0.03 for all); associations were attributable to structural social capital. Social capital was not associated with depressive symptoms, self-efficacy, or affectionate and interaction social support, but was associated with informational and tangible social support (r = 0.39, r = 0.26, respectively, p ≤ 0.02). There were no associations between SLEDAI and SLICC and social capital, social support, and depressive symptoms.
  
  
  CONCLUSIONS
  Social capital is a novel construct that, like other traditional psychosocial measures, addresses aspects of SLE not reflected by markers of disease activity. Social capital, however, is distinct from traditional psychosocial measures and offers a new platform on which ideas of social connectedness can broaden our understanding of health and chronic illness.
authors.affiliation: Department of Rheumatology, Lehigh Valley Health Network, USA susan.kim@lvhn.org.
authors.forename: S S
authors.initials: SS
authors.lastname: Kim
authors.affiliation: Department of Rheumatology, Hospital for Special Surgery, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Mancuso
authors.affiliation: Department of Rheumatology, Hospital for Special Surgery, USA.
authors.forename: W-T
authors.initials: WT
authors.lastname: Huang
authors.affiliation: Department of Rheumatology, Hospital for Special Surgery, USA.
authors.forename: D
authors.initials: D
authors.lastname: Erkan
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000503:physiopathology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D020377:Self Efficacy; D012720:Severity of Illness Index; D066270:Social Capital; D012944:Social Support; D055815:Young Adult
keywords: Systemic lupus erythematous; social health; social network; social support