Healthy bridges : Studies of social capital, welfare, and health

Abstract: The aim of this thesis is to study whether social capital is related to health and health inequality, and to investigate the significance of welfare state features for levels of social capital. Another aim is to examine whether social capital may be important for the relation between the welfare state and health. A final aim is to examine the downsides of social capital in relation to health.The theoretical definition of social capital guiding this thesis suggests that it comprises social resources that evolve in social networks and social structures characterized by mutual trust. These social resources, in turn, facilitate access to various instrumental and expressive returns, which might benefit the individual as well as the collective.The findings suggest that universal welfare states generally seem to have a positive influence on levels of social capital, as social capital increased rather than decreased during the time period when the Swedish welfare state was maturing. Accordingly, cross-national comparisons show that the highest levels of social capital are to be found in the universal welfare states, amongst them Sweden.The findings further show that both individual and collective social capital are related to various health outcomes, although the most robust findings are found at the individual level. Some of the findings also support that associations may be causal. Hence, social capital may be considered an important social determinant of health. Moreover, social capital at the individual level is important in explaining health inequalities especially between groups based on country of birth in Sweden, whereas collective social capital is important in explaining health inequalities between clusters of European countries, grouped into welfare regimes. Thus, social capital seems important in explaining and understanding health inequalities both between and within countries.Finally, the principle of migrant homophily – when migrants chiefly interact with other migrants – has negative consequences for migrants’ health in Sweden. However, only those migrants included in homogenous and closed networks have poorer health. This supports the hypothesis that social capital chiefly has negative health externalities when social networks are characterized by a high degree of network closure, lacking bridges to other networks.