Association between social capital and self-perception of health in Brazilian adults

Loch, Mathias Roberto; Souza, Regina Kazue Tanno de; Mesas, Arthur Eumann; González, Alberto Durán; Rodriguez-Artalejo, Fernando

doi:10.1590/S0034-8910.2015049005116

Acessibilidade / Reportar erro

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original Articles • Rev. Saúde Pública 49 • 2015 • https://doi.org/10.1590/S0034-8910.2015049005116 copy

Association between social capital and self-perception of health in Brazilian adults

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE

To investigate the association between social capital and social capital and self-perception of health based on examining the influence of health-related behaviors as possible mediators of this relationship.

METHODS

A cross-sectional study was used with 1,081 subjects, which is representative of the population of individuals aged 40 years or more in a medium-sized city in Southern Brazil. The subjects who perceived their health as fine, bad or very bad were considered to have a negative self-perception of their health. The social capital indicators were: number of friends, people from whom they could borrow money from when needed; the extent of trust in community members; whether or not members of the community helped each other; community safety; and extent of participation in community activities. The behaviors were: physical activity during leisure time, fruits and vegetable consumption, tobacco use and alcohol abuse. The odds ratios (OR) and confidence intervals (CI) 95% were calculated by binary logistic regression. The significance of mediation was verified using the Sobel test.

RESULTS

Following adjustment for demographic and clinical variables, subjects with fewer friends (OR = 1.39, 95%CI 1.08;1.80), those who perceived less frequently help from people in the neighborhood (OR = 1.30, 95%CI 1.01;1.68), who saw the violent neighborhood (OR = 1.33, 95%CI 1.01;1.74) and who had not participated in any community activity (OR = 1.39, 95%CI 1.07;1.80) had more negative self-perception of their health. Physical activity during leisure time was a significant mediator in the relationship between all social capital indicators (except for the borrowed money variable) and self-perceived health. Fruit and vegetable consumption was a significant mediator of the relationship between the extent of participation in community activities and self-perceived health. Tobacco use and alcohol abuse did not seem to have a mediating role in any relationship.

CONCLUSIONS

Lifestyle seems to only partially explain the relationship between social capital and self-perceived health. Among the investigated behaviors, physical activity during leisure time is what seems to have the most important role as a mediator of this relationship.

Adult Health; Self-Assessment; Social Support; Interpersonal Relations; Social Participation; Life Style; Health Behavior; Cross-Sectional Studies

Variable	Negative self-perception of health			OR_crude	95%CI	OR_adjusted^b	95%CI
Variable	n	%	95%CI	OR_crude	95%CI	OR_adjusted^b	95%CI
Total	456	42.2	39.2;45.1	–	–	–	–
Gender
Male	173	34.8	30.5;39.1	1.0	–	1.0	–
Female	283	48.5	44.5;52.4	1.76	1.37;2.25	1.68	1.26;2.24
Age group (years)
40 to 49	154	34.4	29.8;38.9	1.0	–	1.0	–
50 to 59	170	49.6	44.4;54.8	1.87	1.41;2.50	1.77	1.30;2.41
≥ 60	132	45.5	39.9;51.2	1.60	1.18;2.16	1.48	1.06;2.09
p of linear trend				0.001		0.011
Economic status
A or B (higher)	145	34.9	30.2;39.7	1.0	–	1.0	–
C	261	46.0	42.0;50.1	1.59	1.22;2.06	1.29	0.97;1.70
D or E (lower)	50	50.5	40.8;60.2	1.90	1.22;2.96	1.26	0.77;2.05
p of linear trend				< 0.001		0.141
Body mass index
Normal (< 25 kg/m²)	129	37.7	30.5;42.9	1.0	–	1.0	–
Overweight (25-29.9 kg/m²)	157	38.0	33.3;42.7	1.01	0.75;1.36	1.00	0.73;1.37
Obese (≥ 30 kg/m²)	170	52.1	46.8;57.5	1.80	1.32;2.45	1.52	1.09;2.12
p of linear trend				< 0.001		0.011
Walking difficulty
None	415	40.6	37.6;43.7	1.0	–	1.0	–
Difficulty	41	68.3	55.9;80.8	3.15	1.80;5.51	1.94	1.08;3.48
Medical consultation in the previous 12 months
No	45	24.7	17.6;31.8	1.0	–	1.0	–
Yes	411	45.7	42.5;48.9	2.56	1.79;3.68	2.29	1.56;3.35
Undertake physical activity during leisure time
Yes	98	31.6	26.2;37.1	1.0	–	1.0	–
No	358	46.4	43.0;49.9	1.88	1.42;2.48	1.78	1.32;2.39
Fruit and vegetable consumption
≥ 5 days a week	149	37.3	32.5;42.2	1.0		1.0	–
< 5 days a week	307	45.0	41.3;48.7	1.37	1.06;1.77	1.54	1.16;2.05
Tobacco user
No	361	41.6	38.3;44.9	1.0	–	1.0	–
Yes	95	44.6	38.0;51.2	1.13	0.84;1.53	1.19	0.85;1.66
Alcohol Abuser
No	385	43.6	40.3;46.8	1.0	–	1.0	–
Yes	71	36.0	29.1;42.9	0.73	0.53;1.01	0.97	0.67;1.39

Variable	n	Crude	Model 1^b	Model 2^c	Model 3^d	Model 4^e	Model 5^f	Model 6^g
Variable	n	OR (95%CI)	OR (95%CI)	OR (95%CI)	OR (95%CI)	OR (95%CI)	OR (95%CI)	OR (95%CI)
Number of friends
≥ 4	534	1.0	1.0	1.00	1.0	1.0	1.0	1.0
0 to 3	574	1.54 (1.21;1.96)	1.39 (1.08;1.80)	1.34 (1.03;1.74)	1.35 (1.05;1.75)	1.38 (1.06;1.78)	1.39 (1.07;1.80)	1.31 (1.01;1.70)
Borrowed money^a
≥ 1	784	1.0	1.0	1.0	1.0	1.0	1.0	1.0
None	297	1.32 (1.01;1.73)	1.17 (0.88;1.56)	1.13 (0.85;1.51)	1.14 (0.86;1.52)	1.16 (0.87;1.54)	1.17 (0.88;1.56)	1.10 (0.83;1.47)
Trust in people
Positive	455	1.0	1.0	1.0	1.0	1.0	1.0	1.0
Negative	626	1.11 (0.87;1.42)	1.04 (0.81;1.35)	1.00 (0.77;1.29)	1.01 (0.78;1.32)	1.04 (0.80;1.34)	1.04 (0.81;1.35)	0.97 (0.75;1.26)
Frequency of help given
Always/Almost always	492	1.0	1.0	1.0	1.0	1.0	1.0	1.0
Sometimes/Rarely/Never	589	1.29 (1.01;1.64)	1.30 (1.01;1.68)	1.24 (0.96;1.60)	1.28 (0.99;1.65)	1.28 (0.99;1.65)	1.30 (1.01;1.68)	1.21 (0.94;1.57)
Security in the neighborhood
Safe	740	1.0	1.0	1.0	1.0	1.0	1.0	1.0
Violent/Medium	341	1.53 (1.18;1.97)	1.33 (1.01;1.74)	1.27 (0.97;1.68)	1.30 (0.99;1.71)	1.32 (1.00;1.73)	1.33 (1.01;1.74)	1.25 (0.94;1.65)
Community participation
Participated	521	1.0	1.0	1.0	1.0	1.0	1.0	1.0
Did not participate	560	1.42 (1.11;1.80)	1.39 (1.07;1.80)	1.31 (1.01;1.70)	1.34 (1.03;1.74)	1.38 (1.06;1.79)	1.39 (1.07;1.80)	1.26 (0.97;1.65)

Mediator effect	Beta a × Beta b	Sobel Test (Z)	p
Physical activity during leisure time
Number of friends	0.212	2.07	0.04
Financial help	0.192	1.71	0.085
Trust in people	0.223	2.16	0.030
Frequency of help given	0.298	2.65	0.008
Security in the neighborhood	0.242	2.11	0.034
Community participation	0.352	2.86	0.004
Fruit and vegetable consumption
Number of friends	0.143	1.80	0.072
Financial help	0.148	1.69	0.089
Trust in people	0.121	1.58	0.113
Frequency of help given	0.089	1.24	0.214
Security in the neighborhood	0.125	1.52	0.127
Community participation	0.214	2.33	0.019
Tobacco user
Number of friends	0.090	1.29	0.197
Financial help	0.061	1.02	0.306
Trust in people	0.038	0.79	0.431
Frequency of help given	0.138	1.37	0.169
Security in the neighborhood	0.058	1.01	0.310
Community participation	0.065	0.09	0.877
Alcohol Abuser
Number of friends	0.008	0.28	0.781
Financial help	0.001	0.13	0.890
Trust in people	0.003	0.21	0.832
Frequency of help given	0.022	0.25	0.800
Security in the neighborhood	0.006	0.24	0.810
Community participation	0.001	0.15	0.877

Faculdade de Saúde Pública da Universidade de São Paulo Avenida Dr. Arnaldo, 715, 01246-904 São Paulo SP Brazil, Tel./Fax: +55 11 3061-7985 - São Paulo - SP - Brazil
E-mail: revsp@usp.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Correspondence:Mathias Roberto Loch. Departamento de Educação Física. Universidade Estadual de Londrina Rod. Celso Garcia Cid, PR 445 Km 380. 86057-970 Londrina, PR, Brasil.E-mail: mathiasuel@hotmail.com