Social capital in primary health care
Abstract
The ownership of capital is considered an advantage, and social capital may be viewed, simplistically, as the advantage gained by an individual or a group of individuals (such as a community) as a result of being part of a social network (Hean et al., 2002).
An elderly patient being given a lift to a surgery by her daughter, for example, has received practical support by virtue of the fact that she is part of a family network. It is not only practical support that is gained this way, however. An isolated parent, who has no friends to commiserate with the diffi culties in coping with a young crying baby, for example, is at a disadvantage compared to the person who can tap into informational, emotional and social support, quite apart from any practical help that may be available.
At a more general level, there is an advantage for those living in communities where everyone knows and trusts their neighbours, extending a helping hand in times of need in the realistic expectation that, when the situation is reversed, the favour will be returned. At this quite simple level, these situations will be very familiar to anyone working in primary health care. They are not only markers of advantage (or not) but are practical examples of social inequalities that in uence health. It is well recognized that service use in areas or by individuals vary according to the kinds of family and social networks available, and their accompanying local mores and norms.
The activities of promoting and developing trusting, supportive networks as local resources are considered essential by some in primary care, like health visitors or community development workers (Cowley and Billings, 1999a). However, such activities have, at times, been considered somewhat peripheral to the ‘main business’ of professional health care, which may be characterized as the diagnosis, treatment and care of people with medical problems (Cowley and Billings, 1999b). Even when prevention of such problems is recognized, the ability to demonstrate any beneficial health outcomes from the rather