The Relationship Between Health Assets, Social Capital and Cohesive Communities

Abstract

This chapter explores the strength of “social cohesion” both as an individual and community asset. There is a growing body of evidence that supports the link between strong social capital and its beneficial impact on health, although the authors stress that social capital is, in itself, not a panacea and will not put right the detrimental impact of extreme poverty and deprivation. The authors suggest that whilst the strength of cohesion of a society can be perceived as an “asset”, conveying beneficial health and social outcomes, there are instances where it can be detrimental. A distinction is made between “bonding social capital” (formed within homogenous groups) which can have a negative impact and “bridging social capital” (between different social groups), which appears beneficial. Cognisant of these pitfalls the chapter suggests ways that communities may begin to build social capital and harness it as a community asset. Social capital embraces two distinct concepts. On the one hand, the “network” theory of social capital defines the concept in terms of the “individual” resources – for example, instrumental support, information channels, social credentials – that are embedded within an individual’s social network. By contrast, the “social cohesion” approach to social capital defines it in terms of the “community based” assets and resources – for example, levels of trust, norms, mutual assistance, and the exercise of sanctions – that are available to members of tightly-knit communities. Social capital, defined either way, can be considered as an example of a health asset, i.e. a resource which enhances the ability of individuals or communities to maintain health and well-being. In the public health field, however, the majority of empirical studies to date have focused on the social cohesion approach to social capital. The aim of this chapter is to summarize the state of knowledge – theories of causation, measurement approaches, empirical evidence, and debates – concerning social cohesion as a community-level asset and determinant of health. The first section summarizes the theoretical mechanisms and processes by which community cohesion is believed to promote and protect health. The second section outlines the existing measurement approaches for assessing community cohesion. The third section summarizes the empirical evidence ­linking community cohesion to health. The concluding section discusses the ongoing debate concerning the utility of mobilizing social cohesion as a strategy to improve community health, and what we need to know in order to move the field forward.