Health, inequities, community and social capital

Introduction

The health status and life opportunities of those in poorer communities are less than those elsewhere (Australian Institute of Health and Welfare 1998). Responding to this situation is internationally recognised as requiring a multifaceted national as well as community approach that includes both social and economic initiatives (World Health Organization 1986a). This chapter explores the potential for social capital to provide a framework for developing communities in such a way that the health and life opportunities of poorer communities are improved.

We address the relationship between social capital and the health and life opportunities of people in communities. This includes not only the individual health of those in communities, as often measured by mortality, morbidity, and quality of life instruments, but also the idea that there are ‘healthy communities’ in and of themselves - communities in which there is a good stock of social capital and other forms of resource. ‘Life opportunities’ refers to the equality of opportunity that comes about through the local availability of many types of resources - for example, access to local childcare to encourage early child development that is so important to later achievements at school and beyond. Indeed, where access to and availability of social, economic and cultural resources are limited, so the life opportunities are also limited and this eventually becomes reflected in health statistics.

The breadth of views about social capital necessitates a brief investigation of its historical origins and the way different disciplines have conceptualised the links to health and life opportunities. We begin with the theoretical underpinnings, address some of the key empirical findings and them describe the Adelaide study of health development and social capital. This is a study that pays attention to levels and types of local participation in community life, the role of organisations and groups in the generation of social capital in communities, and the predictive value of social capital on health status.