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      Social capital, neighbourhood characteristics and utilisation of local public health services among domestic migrants in China: a cross-sectional study

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          Abstract

          Objectives

          We examined the association between structural social capital and public health services use, and explored the modifiable effect of neighbourhood factors on this association among domestic migrants in China.

          Methods

          Data were from a 2014 nationally representative cross-sectional sample of domestic migrants aged 15–59 years in China. Survey-weighted logistic regression models were applied to assess the association between structural social capital, measured by participation in social organisations and social activities, and use of public health services. Interaction terms between neighbourhood urban status, neighbourhood composition and social capital were further assessed in the models.

          Results

          Migrants who participated in social organisations were more likely to establish health records (OR 1.467, 95% CI 1.201 to 1.793) and receive health education information (OR 1.729, 95% CI 1.484 to 2.016) than those who did not. Participation in social activities was positively associated with establishing health records only in urban communities (OR 1.853, 95% CI 1.060 to 3.239), and it was positively linked to receiving health education information among those living with a higher percentage of local neighbours (OR 1.451, 95% CI 1.044 to 2.017).

          Conclusions

          Structural social capital was related to an increased utilisation of local public health services among migrants. The findings of this study provided new evidence for the differential influences of social capital by neighbourhood characteristics in China, which suggested the importance to enhance social capital in rural/suburban communities and communities where the majority of the residents were migrants.

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          Most cited references29

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          From social integration to health: Durkheim in the new millennium.

          It is widely recognized that social relationships and affiliation have powerful effects on physical and mental health. When investigators write about the impact of social relationships on health, many terms are used loosely and interchangeably including social networks, social ties and social integration. The aim of this paper is to clarify these terms using a single framework. We discuss: (1) theoretical orientations from diverse disciplines which we believe are fundamental to advancing research in this area; (2) a set of definitions accompanied by major assessment tools; and (3) an overarching model which integrates multilevel phenomena. Theoretical orientations that we draw upon were developed by Durkheim whose work on social integration and suicide are seminal and John Bowlby, a psychiatrist who developed attachment theory in relation to child development and contemporary social network theorists. We present a conceptual model of how social networks impact health. We envision a cascading causal process beginning with the macro-social to psychobiological processes that are dynamically linked together to form the processes by which social integration effects health. We start by embedding social networks in a larger social and cultural context in which upstream forces are seen to condition network structure. Serious consideration of the larger macro-social context in which networks form and are sustained has been lacking in all but a small number of studies and is almost completely absent in studies of social network influences on health. We then move downstream to understand the influences network structure and function have on social and interpersonal behavior. We argue that networks operate at the behavioral level through four primary pathways: (1) provision of social support; (2) social influence; (3) on social engagement and attachment; and (4) access to resources and material goods.
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            Social capital and the built environment: the importance of walkable neighborhoods.

            I sought to examine whether pedestrian-oriented, mixed-use neighborhoods encourage enhanced levels of social and community engagement (i.e., social capital). The study investigated the relationship between neighborhood design and individual levels of social capital. Data were obtained from a household survey that measured the social capital of citizens living in neighborhoods that ranged from traditional, mixed-use, pedestrian-oriented designs to modern, car-dependent suburban subdivisions in Galway, Ireland. The analyses indicate that persons living in walkable, mixed-use neighborhoods have higher levels of social capital compared with those living in car-oriented suburbs. Respondents living in walkable neighborhoods were more likely to know their neighbors, participate politically, trust others, and be socially engaged. Walkable, mixed-use neighborhood designs can encourage the development of social capital.
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              Social Capital and Health: A Review of Prospective Multilevel Studies

              Background This article presents an overview of the concept of social capital, reviews prospective multilevel analytic studies of the association between social capital and health, and discusses intervention strategies that enhance social capital. Methods We conducted a systematic search of published peer-reviewed literature on the PubMed database and categorized studies according to health outcome. Results We identified 13 articles that satisfied the inclusion criteria for the review. In general, both individual social capital and area/workplace social capital had positive effects on health outcomes, regardless of study design, setting, follow-up period, or type of health outcome. Prospective studies that used a multilevel approach were mainly conducted in Western countries. Although we identified some cross-sectional multilevel studies that were conducted in Asian countries, including Japan, no prospective studies have been conducted in Asia. Conclusions Prospective evidence from multilevel analytic studies of the effect of social capital on health is very limited at present. If epidemiologic findings on the association between social capital and health are to be put to practical use, we must gather additional evidence and explore the feasibility of interventions that build social capital as a means of promoting health.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2017
                18 August 2017
                : 7
                : 8
                : e014224
                Affiliations
                [1 ] departmentDepartment of Social Medicine , School of Public Health, National Key Laboratory of Health Technology Assessment (Ministry of Health), Collaborative Innovation Center of Social Risks Governance in Health, Fudan University , Shanghai, China
                [2 ] departmentDepartment of Health Policy and Management , College of Public Health, University of Georgia , Athens, Georgia, USA
                Author notes
                [Correspondence to ] Dr Donglan Zhang; dzhang@ 123456uga.edu

                ZH and SL contributed equally.

                Article
                bmjopen-2016-014224
                10.1136/bmjopen-2016-014224
                5724155
                28821507
                9115cb6a-01c2-4166-b12b-8c24e9d00aa5
                © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                : 09 September 2016
                : 13 April 2017
                : 09 June 2017
                Funding
                Funded by: National Science Foundation of China;
                Categories
                Health Services Research
                Research
                1506
                1704
                1735
                1724
                Custom metadata
                unlocked

                Medicine
                social network,health services utilization,domestic migrants
                Medicine
                social network, health services utilization, domestic migrants

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