Health and Social Capital:
Complicating the Picture
Andy Gibson
The Open University
The Open University
a.j.gibson@open.ac.uk
Explanations of Contemporary
Health Inequalities
n
n
Materialist and Neo-materialist
Explanations
(Davey Smith et al)
Psychosocial Explanations
(Wilkinson et al )
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a.j.gibson@open.ac.uk
Social Capital/Social Status
and Health
n
n
n
Social capital provides care and
support, thus creating a sense of well
being
Reduces social stress which has a
significant effect on human physiology
Wider social relations impact on an
individual’s social status and selfesteem
The Open University
a.j.gibson@open.ac.uk
Definition of Social Capital
‘Social capital refers to the norms
and networks of civil society that
lubricate cooperative action among
both citizens and institutions’
(R. Putnam 1998)
The Open University
a.j.gibson@open.ac.uk
Foxhill/Southey Green
n
n
n
n
The ward is in the 1% of most deprived
wards in England.
45.3% of households within Southey
Green contain people who are on
means-tested benefits/JSA compared to
the Sheffield average of 27.5%
Unemployment is at 19.3%
It is the most deprived ward in Sheffield
out of 29 wards
The Open University
a.j.gibson@open.ac.uk
160
140
120
100
80
60
40
20
0
Southey Ward
All Sheffield
Hallam Ward
19
81
-8
19 4
83
19 86
85
-8
19 8
87
-9
19 0
89
-9
19 2
91
19 94
93
-9
6
SMR
Changes in Mortality Ratio (SMR).
Southey and Hallam wards of Sheffield
1981-1997.
Years
The Open University
a.j.gibson@open.ac.uk
Data Collection Techniques
n
In-depth focused interviews
n
Non/participant observation
n
Secondary statistical data
The Open University
a.j.gibson@open.ac.uk
Model of Material and
Psychosocial Pathways
The Material Environment
Direct impact of
the material
environment
As mediated by
psychosocial pathways
Experience of
economic insecurity
Experience of
low social status
The Open University
a.j.gibson@open.ac.uk
Psychosocial Stress
n
“A lot of illness is due to mental stress.
It’s always there but you don’t actually
consciously think about it. If you’ve got
a headache its not necessarily the fact
that you’ve got a headache, it’s a
problem because you are so stressed
out.” (Single Mum Age 34)
The Open University
a.j.gibson@open.ac.uk
Local Social Capital
n
n
There is strong evidence of the
existence of ‘social capital’ within the
community.
Recipricocity and mutual aid are
evident, particularly among more
established residents.
The Open University
a.j.gibson@open.ac.uk
Single mum age 26 and friend
“We support each other really, don’t
we?” (Friend) “Yeah we do definitely.”
“We’re our own little support network.
Which it does help, you do need
support. I mean silly things like you’ve
got a phone call, an important phone
call, you say, ‘Will you look after the
baby?’ “
The Open University
a.j.gibson@open.ac.uk
Local Cultural Capital
The degree of mastery an individual has
over the cultural practices that are
recognised as legitimate in a community
(or a section of it), and which do not
necessarily coincide with those in wider
society.
The Open University
a.j.gibson@open.ac.uk
Local Cultural Capital
“You should actually…(fiddle benefits)..
and if you get caught it’s tough. I had
to, to put food on the table for (my
children)…it’s a way of life, to be
honest, in areas like this.”
(Welder, Age 37)
The Open University
a.j.gibson@open.ac.uk
A Contradictory Sense of
Social Status
“You find if you’re out of the area and
people happen to say ‘Where do you
live?’ You say, ‘Foxhill.’ They say, ‘Oh
you don’t!…Well why do you live at
Foxhill? Y’know you’ve got your own
house why don’t you sell it and move?’
and I say, ‘Because I don’t want to, I
like it’.” (Woman, Age 74)
The Open University
a.j.gibson@open.ac.uk
Experience of Negative Social
Status
“Sometimes people can’t get anywhere
because of how people look at you. I
talk common. It doesn’t mean I’m thick,
but some people see you like that. I
think a lot of it is acceptance. Some
people don’t accept people for what
they are.” (Woman, Age 30)
The Open University
a.j.gibson@open.ac.uk
Embeddedness
n
“Ken (the next door neighbour) has
known them (local children) from so
high, so he can talk to them, but we’ve
only known them since they’ve turned
bad so you can’t build a relationship
with them. Everybody knows Ken. The
kids say hello to Ken…” (Woman, Aged
30s)
The Open University
a.j.gibson@open.ac.uk
Negative Consequences
“I mean, I’m not a racist person, I
never have been, but it just really gets
to you that they get more than you, I
mean, God, I were brought up in this
country, you know, I’ve lived and
worked in this country for near enough
26 years, and then some people come
across and they get everything.” (Single
mum, 26)
The Open University
a.j.gibson@open.ac.uk
A Social Ecology of Health
n
n
A whole social environment can come under
stress from a multiple of causes including:
levels of employment, neglect of the social
infrastructure and changes in the structures
of people’s daily lives.
People in differing social locations will
develop different coping mechanisms to deal
with these effects. This will in turn further
shape the social environment and impact on
health.
The Open University
a.j.gibson@open.ac.uk
Conclusions
n
n
n
n
There is strong evidence of local social and
cultural capital in the community
People draw on these resources to maintain
self esteem and cope with local disadvantage
in very diverse ways
These coping mechanisms can have both
positive & negative consequences for health
The interaction between individuals and the
social environment impacts on health, both
directly, via material factors and indirectly, as
mediated by psychosocial pathways
The Open University
a.j.gibson@open.ac.uk