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    Does area-based social capital matter for the health of Australians? A multilevel analysis of self-rated health in Tasmania

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    Author
    Kavanagh, Anne M.; TURRELL, GAVIN; SUBRAMANIAN, S. V.
    Date
    2006
    Source Title
    International Journal of Epidemiology
    Publisher
    Oxford University Press
    University of Melbourne Author/s
    Kavanagh, Anne; Turrell, Gavin
    Affiliation
    Medicine, Dentistry and Health Sciences: Key Centre for Women's Health in Society
    Metadata
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    Document Type
    Journal (Paginated)
    Citations
    Kavanagh, A. M., Turrell, G., & Subramanian, S. V. (2006). Does area-based social capital matter for the health of Australians? A multilevel analysis of self-rated health in Tasmania. International Journal of Epidemiology, 35(3), 607-613.
    Access Status
    This item is currently not available from this repository
    URI
    http://hdl.handle.net/11343/33451
    Description

    Copyright confirmation in progress. Any queries to UMER-enquiries@unimelb.edu.au

    Abstract
    BACKGROUND: Material circumstances and collective psychosocial processes have been invoked as potential explanations for socioeconomic inequalities in health; and, linking social capital has been proposed as a way of reconciling these apparently opposing explanations. METHODS: We conducted multilevel logistic regression of self-rated health (fair or poor vs excellent, very good, or good) on 14,495 individuals living within 41 statistical local areas who were respondents to the 1998 Tasmanian Healthy Communities Study. We modelled the effects of area-level socioeconomic disadvantage and social capital (neighbourhood integration, neighbourhood alienation, neighbourhood safety, social trust, trust in public/private institutions, and political participation), and adjusted for the effects of individual characteristics. RESULTS: Area-level socioeconomic disadvantage was associated with poor self-rated health (OR 1.10, 95% CI 1.07-1.13) an effect that was attenuated, but remained significant, after adjusting for individual characteristics (OR 1.04, 95% CI 1.02-1.07). Social trust was associated with a reduction in poor self-rated health (OR 0.95, 95% CI 0.92-0.99) and remained significant when individual characteristics (OR 0.96, 95% CI 0.93-0.99) were included. Political participation was non-significant in the unadjusted model but became significant when adjusted for individual characteristics (OR 0.77, 95% CI 0.62-0.97). The effects of social trust and political participation were attenuated and became non-significant when area-level socioeconomic disadvantage was included. CONCLUSION: Area-based socioeconomic disadvantage is a determinant of self-rated health in Tasmania, but we did not find an independent effect of area-level social capital. These findings suggest that in Tasmania investments in improving the material circumstances in which people live are likely to lead to greater improvements in population health than attempts to increase area-level social capital.
    Keywords
    social capital; socio-economic disadvantage; multilevel analysis

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