Thursday, 31 August 2017

#ClinicSpeak & #GuestPost: how much social capital do you have?

Social capital is important in MS; but how important? #ClinicSpeak #GuestPost

Summary: The following post explains the concept of social capital; in essence how socially connected you are. Social capital predicts outcome in many chronic diseases and is closely linked to quality of life (QoL). MS reduces social capital, but by how much? Not enough research has been done on social capital in in the field of MS. 


It's good to be back for a second post. I have enjoyed reading all your comments on my first post about MS in South America (In case you missed it!). A lot has happened since then. This training programme has pushed me out of my comfort zone and has triggered my interest in and passion for addressing health inequalities. As always, the proof of the pudding is in the eating! Here is my new post on Social Capital.


THE UNEXPLORED ROLE OF SOCIAL CAPITAL IN MS


While previous studies have shown mixed results, emerging evidence suggests that there is an association between higher income inequality and worse health outcomes. Despite global progress in reducing poverty, inequality continues to persist and large disparities remain in health outcomes. Accordingly, researchers have become increasingly interested in exploring the effects of the socio-economic environment on individual and public health. Although the impact of social conditions on health equity is well documented, there is no consensus as to the relative importance of each factor. Many determinants are involved and, among them, social capital has emerged as one of the most interesting old ideas being revisited from a new perspective.

The social capital concept emerged in sociology early in the past century. Social capital refers to the resources derived from the cooperation between individuals and groups. It has been hypothesized to partially explain how social conditions influence health and mortality. More recently, the concept of social capital has become the subject of intense discussion, as it may represent a pathway by which public health interventions lead to health improvement. The exact nature and magnitude of these effects remain controversial as there is no standardized method to measure social capital. However, there are several tools that attempt to address its multidimensional nature.



Many types of social capital are theoretically possible, but an important distinction that should be made is between its cognitive and structural components. The structural dimension is derived from the “visible” forms of social capital and consists of networks, relationships, associations, institutions and organizations that link individuals and communities. On the other hand, the cognitive component refers to the quality of those social structures in terms of peoples’ perceptions of trust, sharing and reciprocity. The different dimensions of social capital are not necessarily mutually exclusive; they are all immersed within a multi-level analytical framework. As many social aspects are encompassed under the same concept, oversimplification and overstandardization are both equally dangerous for social capital research.

Neurological disorders represent a large burden on worldwide health. Patients with neurological conditions are embedded in social networks that may affect their outcomes. This effect has been postulated to modify the risk of dementia and the long-term prognosis in patients with stroke. Regardless of the growing recognition of the role of social capital in chronic diseases, not enough attention has been paid to its potential impact on other disabling neurological conditions such as MS.

A few researchers have explored the relationship between social support and quality of life in patients with MS. However, and to the best of our knowledge, only one study has specifically focused on social capital. The results of this study showed that in patients with MS, quality of life and social capital are somehow related. This study only evaluated one potential target. Many questions remain to be explored in our understanding of how social capital may lead to either positive or negative consequences for patients with MS.

Addressing health inequality matters! Addressing social capital matters too!!

This paper is for those who want to read further, and perhaps more deeply, about this fascinating area: https://goo.gl/GwVajR

References

1. Carpentier CL, Kozul-Wright R, Passos FD. Goal 10 - Why Addressing Inequality Matters. UN Chronicle. 2015;LI,4. https://unchronicle.un.org/article/goal-10-why-addressing-inequality-matters. Accessed 10 August 2017.

2. Bourdieu P. Forms of Capital. In: Richardson JG, ed. Handbook of theory for the sociology of education. Westport, CT: Greenwood Publisher, 1986:241-58. 


3. Nyqvist F, Pape B, Pellfolk T, et al. Structural and cognitive aspects of social capital and all-cause mortality: a meta-analysis of cohort studies. Soc Indic Res 2013;116:545-66.

4. Eriksson M. Social capital and health - implications for health promotion. Glob Health Action 2011;4:1-11.

5. Dhand A, Luke DA, Lang CE, et al. Social networks and neurological illness. Nat Rev Neurol 2016;12(10):605-12.

6. Rimaz S, Mohammad K, Dastoorpoor M, et al. Investigation of Relationship Between Social Capital and Quality of Life in Multiple Sclerosis Patients. Global Journal of Health Science. 2014;6(6):261-272.

7. Harpham T, Grant E, Thomas E. Measuring social capital within health surveys: key issues. Health Policy and Planning 2002,17(1):106-111.

7 comments:

  1. The management of my MS has been through the prism of a university education. The skills learnt in the course of study are 100% applicable to getting to grips with a serious condition. The advice you get from the hospital is the baseline, not the full picture. Getting your head round the issues requires you to read, search out ideas and useful people, plan, analyse - all with the doggedness and self-discipline that you needed to pass Finals (in my opinion!). I think the opposite would be disastrous i.e. that you are left alone with only the words of the docs to guide you. The more inter-connected I am with a) MS research news, b) health professionals and Msers and c) friends and family, the more I feel in control and enjoy life. I was brought up always to value education but now with MS I see the enormity of the difference it makes and feel very fortunate.

    ReplyDelete
    Replies
    1. You're on the right track!
      Social capital interventions, specially those that promote social participation, may increase well-being and promote healthy lifestyles.
      Thanks!

      Delete
  2. Read this: http://www.independent.co.uk/voices/disability-un-failing-disabled-people-its-no-surprise-a7910181.html

    This blog never discusses matters like the UK's non-compliance with the UN Convention on the Rights of Disabled People. It is so important socially.

    ReplyDelete
    Replies
    1. This represents a critical area where laws and institutions should be upgraded. It's a worrisome situation that deserves profound attention!

      Thank you for sharing this info!

      Delete
  3. Social isolation is a big problem. Since having had to give up work because of MS I feel as if I have had to withdraw from society. My social capital has definitely become smaller.

    ReplyDelete
    Replies
    1. Whether social capital is a cause or a consequence of your health status, make sure you keep socially active! Social networks influence health!

      Thanks for sharing your story with us.

      Delete
  4. Sad to say but shrinking of social capital is an inevitable consequence of MS. I have progressive MS. I can no longer drive, been obliged to go into medical retirement and now I cannot walk so I must use a mobility scooter. That is just the tip of the iceberg.

    It is an uphill battle to maintain sociaL capital and actually it means a total change to my lifestyle. Different hobbies, even admit I might now be a wrinkly. I'm only 62 and should still be working

    There is very little help for people to help them adapt to the new life so it is easier to shrink into your shell and shut youreself off from the outside world.

    ReplyDelete

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