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      Conceptual understanding of social capital in a First Nations community: a social determinant of oral health in children

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          Abstract

          Objectives

          The purpose of the study was: (a) to better understand the concept of social capital and its potential role in oral health of children in a First Nations community and (b) to identify the strengths and resources in terms of social capital and a health promotion model that the community has at its disposal to address its oral health issues.

          Methods

          In this qualitative case study, participants were purposively selected in a First Nations community: Seven individual interviews and two focus groups involving 18 parents/care givers were selected. Putnam's concept of social capital guided all the interviews. The interviews were recorded and transcribed verbatim. Thematic analysis was employed using the NVivo software.

          Results

          The community was close-knit and seemed to have strong moral fibre, which encouraged members to help each other. A strong bonding social capital was also found among the members, especially inside the clans (families). A need for improvement in bridging social capital that would help the community to reach external resources was observed. While members of the community were actively involved in religious rituals and cultural ceremonies, more efforts seemed to be required to recruit volunteers for other events or programs. Active engagement of community members in any program requires that members be given a voice as well as some ownership of the process. Mobilizing or building community's social capital can play a role when planning future interventions.

          Conclusions

          A better understanding of social capital may enhance the community's investment and efforts by reinforcing healthy oral behaviours and improving access to external resources. With more dynamic collaboration, it may be possible to create more sustainable community-based oral health promotion programs.

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          Most cited references39

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          Case study research: Design and methods

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            Social capital, income inequality, and mortality.

            Recent studies have demonstrated that income inequality is related to mortality rates. It was hypothesized, in this study, that income inequality is related to reduction in social cohesion and that disinvestment in social capital is in turn associated with increased mortality. In this cross-sectional ecologic study based on data from 39 states, social capital was measured by weighted responses to two items from the General Social Survey: per capita density of membership in voluntary groups in each state and level of social trust, as gauged by the proportion of residents in each state who believed that people could be trusted. Age-standardized total and cause-specific mortality rates in 1990 were obtained for each state. Income inequality was strongly correlated with both per capita group membership (r = -.46) and lack of social trust (r = .76). In turn, both social trust and group membership were associated with total mortality, as well as rates of death from coronary heart disease, malignant neoplasms, and infant mortality. These data support the notion that income inequality leads to increased mortality via disinvestment in social capital.
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              Social capital and self-rated health: a contextual analysis.

              Social capital consists of features of social organization--such as trust between citizens, norms of reciprocity, and group membership--that facilitate collective action. This article reports a contextual analysis of social capital and individual self-rated health, with adjustment for individual household income, health behaviors, and other covariates. Self-rated health ("Is your overall health excellent, very good, good, fair, or poor?") was assessed among 167,259 individuals residing in 39 US states, sampled by the Behavioral Risk Factor Surveillance System. Social capital indicators, aggregated to the state level, were obtained from the General Social Surveys. Individual-level factors (e.g., low income, low education, smoking) were strongly associated with self-rated poor health. However, even after adjustment for these proximal variables, a contextual effect of low social capital on risk of self-rated poor health was found. For example, the odds ratio for fair or poor health associated with living in areas with the lowest levels of social trust was 1.41 (95% confidence interval = 1.33, 1.50) compared with living in high-trust states. These results extend previous findings on the health advantages stemming from social capital.
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                Author and article information

                Journal
                Int J Circumpolar Health
                Int J Circumpolar Health
                IJCH
                International Journal of Circumpolar Health
                Co-Action Publishing
                1239-9736
                2242-3982
                22 January 2015
                2015
                : 74
                : 10.3402/ijch.v74.25417
                Affiliations
                [1 ]School of Dentistry, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
                [2 ]Department of Family Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
                Author notes
                [* ]Correspondence to: Mohammad H. Salehyar, School of Dentistry, Faculty of Medicine & Dentistry, University of Alberta, Room 5-095, Edmonton Clinic Health Academy (ECHA), 11405 87 Avenue, Edmonton, Alberta, Canada T6G 1C9, Email: salehyar@ 123456ualberta.ca

                Responsible Editor: Rhonda M. Johnson, University of Alaska Anchorage, USA.

                Article
                25417
                10.3402/ijch.v74.25417
                4306758
                25623814
                5abd0f7e-6ca0-444c-b997-e624bfad59b4
                © 2015 Mohammad H. Salehyar et al.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 08 July 2014
                : 20 November 2014
                : 10 December 2014
                Categories
                Original Research Article

                Medicine
                social cohesion,dental health,aboriginal,native,indigenous,qualitative study
                Medicine
                social cohesion, dental health, aboriginal, native, indigenous, qualitative study

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