American Journal of Public Health
Volume 93(1) January 2003, pp 122-129

Is Social Capital the Key to Inequalities in Health?
Pearce, Neil PhD; Smith, George Davey MD, MSc, DSc, FFPHM

Abstract

There has been vigorous debate between the "social capital"
and "neomaterialist" interpretations of the epidemiological
evidence regarding socioeconomic determinants of health. We
argue that levels of income inequality, social capital, and
health in a community may all be consequences of more macrolevel
social and economic processes that influence health across the
life course.

We discuss the many reasons for the prominence of social
capital theory, and the potential drawbacks to making social
capital a major focus of social policy. Intervening in
communities to increase their levels of social capital
may be ineffective, create resentment, and overload community
resources, and to take such an approach may be to "blame the
victim" at the community level while ignoring the health effects
of macrolevel social and economic policies.

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