I absolutely agree with you. But too often the structural analysis stops at the social capital level, with the attendant community-celebrating and community-blaming being the end result. Toba Bryant, Robb Travers and I have a paper appearing in. Promotion and Education that argues that community research and action should be concerned with mobilizing communities to improve the social determinants of health through explicit political action. Sadly, much of the social capital literature is strikingly depoliticized and serves the interest of the entrenched. See especially Robert Putnam being frequently being welcomed to the Clinton White House! see International Journal of Epidemiology 2002;31:261-267 Essay Review Social capital, class gender and race conflict, and population health: an essay review of Bowling Alone's implications for social epidemiology Bowling alone. The collapse and revival of American community. RD Putnam. New York: Simon & Schuster, 2000, pp.544, US$26. ISBN: 0 684 83283 6. Carles Muntaner and John Lynch Full text at: http://ije.oxfordjournals.org/cgi/content/full/31/1/261 ------------------------- For whom the ball rolls Pollitt, Katha. The Nation. New York: Apr 15, 1996.Vol.262, Iss. 15; pg. 9, 1 pgs Abstract (Document Summary) Pollitt comments on Robert Putnam, whose article "Bowling Alone: America's Declining Social Capital" has gotten him a great deal of attention. Putnam argues that declining memberships in civic institutions have led to a weakened civil society. The only things I like about bowling are the shoes and the beer. Maybe that's why I can't get excited about Robert Putnam, the Harvard political scientist whose slender article "Bowling Alone: America's Declining Social Capital" in the January 1995 Journal of Democracy, has spawned more commentary than Hamlet, including a profile in People, and brought him tete-a-tete with President Clinton, whose State of the Union address he helped inspire. Putnam argues that declining membership in such venerable civic institutions as bowling leagues, the P.T.A., the League of Women Voters, the Boy Scouts, the Elks and the Shriners is an index of a weakened "civil society," the zone of social engagement between the family and the state. Why should you care about the leagues? Because, says Putnam, they bowl for thee: A weak civil society means less "trust" in each other, and that means a less vigorous democracy, as evidenced in declining electoral turnouts. It's the sort of thesis academics and pundits adore, a big woolly argument that's been pre-reduced to a soundbite of genius. Bowling alone--it's wistful, comical, nostalgic, sad, a tiny haiku of post-industrial loneliness. Right-wingers like Francis Fukuyama and George Will like it because it can be twisted to support their absurd contention that philanthropy has been strangled by big government. Clintonians and communitarians like it because it moralizes a middle-class, apolitical civic-mindedness that recognizes no hard class or race inequalities shaping individual choice: We are all equally able to volunteer for the Red Cross, as we are all equally able to vote. Putnam's prime culprit in the decline of civic America--television--is similarly beyond the reach of structural change. It's as though America were all one big leafy suburb, in which the gladhanders and do-gooders had been bewitched by the evil blue light of Seinfeld and Friends. At least Putnam doesn't blame working mothers. Still, the discussion around "Bowling Alone" is peculiar in a number of ways. How many of those who praise its thesis fit either half of his theory, I wonder: Is Bill Bradley a Shriner? Does The Washington Post's David Broder bake cookies for the P.T.A.? If not, is the boob tube to blame? As Theda Skocpol noted in her politely devastating rejoinder to Putnam's follow-up article, "The Strange Disappearance of Civic America," in The American Prospect (Winter 1996), Putnam seems to place both the burden of civic engagement and responsibility for its collapse on the non-elite classes. Tenured professors may be too busy to sing in a choir (Putnam's former avocation): The rest of us are just couch potatoes. Although Putnam is careful to disclaim nostalgia for the fifties, his picture of healthy civic life is remarkably, well, square. I've been a woman all my life, but I've never heard of the Federation of Women's Clubs. And what politically minded female, in 1996, would join the bland and matronly League of Women Voters, when she could volunteer with Planned Parenthood or NOW or Concerned Women of America, and shape the debate instead of merely keeping it polite? It's probably going too far to argue that the decline of the Boy Scouts is directly related to its barring of gay and nonbelieving lads. But should it really surprise us that such a stodgy organization has a hard time finding volunteers? Or take those bowling leagues. Putnam treats these as if they arose merely from the appetite of individuals for fellowship and tenpins. But in fact they came out of specific forms of working-class and lower-middle class life: stable blue-collar or office employment (businesses and unions often started and sponsored teams) that fostered group solidarity, a marital ethos that permitted husbands plenty of boys' nights out, a lack of cultural and entertainment alternatives. It would be amazing if league bowling survived the passing of the way of life that brought it into being, nor am I so sure we need mourn it. People still bowl, after all. In fact they bowl more than ever, although they consume less beer and pizza, which is why league decline bothers the owners of bowling alleys. And despite Putnam's title, they don't bowl alone. They bowl with friends, on dates, with their kids, with other families. The bowling story could be told as one of happy progress: from a drink-sodden night of spouse avoidance with the same old faces from work to temperate and spontaneous fun with one's intimate fends and relations. No, the whole theory is seriously out of touch with the complexities of contemporary life. If church membership is down (good news in my book), it's hardly because people are staying home to watch TV. More likely, organized religion doesn't speak to their spiritual needs the way (for example) self-help programs do. Putnam dismisses the twelve-step movement much too quickly. At the very least, its popularity calls the TV-time-drain theory into question. I know people who've gone to A.A. every day, for years. As for building social capital, my own brief experience with Alanon more than fifteen years ago is still my touchstone of ordinary human decency and kindness. What's that if not "trust"? My membership in the P.T.A., by contrast, is motivated mostly by mistrust: As another parent put it, we join the P.T.A. to keep our kids from being shafted by the school system. Putnam's theory may not explain much about the way we live now, but its warm reception speaks volumes. The bigfoot journalists and academic superstars, opinion manufacturers and wise men of both parties are worried, and it isn't about bowling or Boy Scouts. It's about that loss of "trust," a continuum that begins with one's neighbor and ends with the two parties, government, authority. It makes sense for the political and opinion elites to feel this trust--for them, the system works. It's made them rich and famous. But how much faith can a rational and disinterested person have in the set-up that's produced our current crop of leaders? Love your neighbor if you can, but forget civic trust. What we need is more civic skepticism. Especially about people who want you to do their bowling for them. Please respond to Social Determinants of Health <[log in to unmask]> Sent by: Social Determinants of Health <[log in to unmask]> To: [log in to unmask] cc: Subject: Re: [SDOH] "Social Capital" vs. "Neomaterialist" Interpretations of Health Inequalities This is interesting. But it's also true that the effect of social capital on health depends on (1) how social capital is conceived & measured; (2) the level of analysis. At the individual level, it is fairly well established that having some close friends or family members is good for health (recall Wilkinson's advice). Social support is particularly beneficial in times of stress, when diagnosed with a serious illness, when recovering from surgery, etc. Some might argue that social support is not the same as social capital. Others see it as a type of social capital. At a more structural level, Rob Sampson (chair of my department) and Jeff Morenoff have some interesting research showing how "collective efficacy" partly mediates the effects of poverty and inequality on health. For example, in a neighbourhood setting, collective efficacy is the shared belief that you and your neighbours could come together and help each other out in times of crisis (e.g., if the city wants to build a highway through your neighbourhood and you and your neighbours don't want that, could you come together and stop it?). Perhaps not surprisingly, higher income communities have higher levels of collective efficacy, and this partly explains why these communities have less street crime and better health. Conversely, poverty and deprivation tend to harm the collective efficacy of a community, making it more vulnerable to things like violent crime (not necessarily perpetrated by people who live in that community). Granted, a poor community's lack of collective efficacy is often due to a realistic assessment of the barriers it faces. But, here's the trick: poor communities with higher collective efficacy have lower crime and better health than poor communities with lower collective efficacy (but the former still don't fare as well as rich communities). One implication might be that by building strong communities with lots of trust and social support, you can create the conditions for people to come together and demand better access to material resources, public services, etc. Eventually, if all goes well, resources will be more evenly distributed to these communities, and they will benefit from BOTH higher collective efficacy and better material conditions. To be clear, I think material conditions are by far the most important social determinant of health. But one of the ways they improve or harm people's health is by raising or lowering their levels of social capital. Conversely, social capital can be mobilized to seek broader structural changes and improve health - and I see people like Dennis Raphael, Chrystal Ocean, and several others on this list doing just that. :-) A few useful references (a google search will reveal more): Israel, Barbara A; et al. 2002. "The relationship between social support, stress, and health among women on Detroit's East Side." Health Educ Behav 29(3): 342-60. Uchino, Bert. 2005. Social Support and Physical Health: Understanding the Health Consequences of Relationships. New Haven: Yale U Press. Kawachi, I, BP Kennedy, K Lochner and D Prothrow-Stith. 1997. "Social capital, income inequality, and mortality." American Journal of Public Health 87(9): 1491-1498. Morenoff, Jeffrey. 2003. "Neighborhood mechanisms and the spatial dynamics of birth weight." American Journal of Sociology, 108 (5): 976-1017. Sampson, Robert J., Stephen Raudenbush, and Felton Earls. 1997. "Neighborhoods and Violent Crime: A Multilevel Study of Collective Efficacy." Science 277: 918-24. (I think all these studies were conducted in the US. But there is evidence that many of the same processes also occur elsewhere - for example, Sampson's collective efficacy model holds up in Sweden and Indonesia). Best, Jeff -- Jeff Denis PhD Student Department of Sociology Harvard University "The principle of organizing our society for the benefit of all the people and not for a privileged few - that is still here and that is a principle to which we adhere." - Tommy C. Douglas Quoting Dennis Raphael <[log in to unmask]>: > "Social Capital" vs. "Neomaterialist" Interpretations of Health > Inequalities > > Christine Lindström and Martin Lindström > > The effects of social capital, income inequality, and absolute per capita > income were investigated in an ecological analysis of 23 rich and poor > countries. Trust was chosen as an indicator of social capital, and GNP > (gross > national product) per capita and Gini index measured absolute and relative > income, respectively. These independent variables were analyzed in a > linear > regression model with the dependent variables adult mortality rate (25-64 > years), life expectancy, and infant mortality rate (IMR). Separate > analyses > were performed for poor and rich countries as well as all countries > combined. > Social capital (trust) showed no significant association with the three > health > outcomes. A particularly strong relationship was found between Gini index > and IMR for rich countries, and GNP per capita and life expectancy for all > countries. In the group of poor countries, GNP per capita and Gini index > in the > same model were associated with IMR. > > The results contradict the suggested impact of social capital on health, > and > instead support the notion that economic factors such as absolute income > and > relative income distribution are of importance. > > International Journal of Health Services, Volume 36, Number 4, Pages > 679-696, 2006 > > ------------------- > Problems/Questions? Send it to Listserv owner: [log in to unmask] > > > To unsubscribe, send the following message in the text section -- NOT the > subject header -- to [log in to unmask] > > SIGNOFF SDOH > > DO NOT SEND IT BY HITTING THE REPLY BUTTON. THIS SENDS THE MESSAGE TO THE > ENTIRE LISTSERV AND STILL DOES NOT REMOVE YOU. > > To subscribe to the SDOH list, send the following message to > [log in to unmask] in the text section, NOT in the subject header. > > SUBSCRIBE SDOH yourfirstname yourlastname > > To post a message to all 1200+ subscribers, send it to [log in to unmask] > Include in the Subject, its content, and location and date, if relevant. > > For a list of SDOH members, send a request to [log in to unmask] > > To receive messages only once a day, send the following message to > [log in to unmask] > SET SDOH DIGEST > > To view the SDOH archives, go to: > https://listserv.yorku.ca/archives/sdoh.html > ------------------- Problems/Questions? Send it to Listserv owner: [log in to unmask] To unsubscribe, send the following message in the text section -- NOT the subject header -- to [log in to unmask] SIGNOFF SDOH DO NOT SEND IT BY HITTING THE REPLY BUTTON. THIS SENDS THE MESSAGE TO THE ENTIRE LISTSERV AND STILL DOES NOT REMOVE YOU. To subscribe to the SDOH list, send the following message to [log in to unmask] in the text section, NOT in the subject header. SUBSCRIBE SDOH yourfirstname yourlastname To post a message to all 1200+ subscribers, send it to [log in to unmask] Include in the Subject, its content, and location and date, if relevant. For a list of SDOH members, send a request to [log in to unmask] To receive messages only once a day, send the following message to [log in to unmask] SET SDOH DIGEST To view the SDOH archives, go to: https://listserv.yorku.ca/archives/sdoh.html ------------------- Problems/Questions? Send it to Listserv owner: [log in to unmask] To unsubscribe, send the following message in the text section -- NOT the subject header -- to [log in to unmask] SIGNOFF SDOH DO NOT SEND IT BY HITTING THE REPLY BUTTON. THIS SENDS THE MESSAGE TO THE ENTIRE LISTSERV AND STILL DOES NOT REMOVE YOU. To subscribe to the SDOH list, send the following message to [log in to unmask] in the text section, NOT in the subject header. SUBSCRIBE SDOH yourfirstname yourlastname To post a message to all 1200+ subscribers, send it to [log in to unmask] Include in the Subject, its content, and location and date, if relevant. For a list of SDOH members, send a request to [log in to unmask] To receive messages only once a day, send the following message to [log in to unmask] SET SDOH DIGEST To view the SDOH archives, go to: https://listserv.yorku.ca/archives/sdoh.html