. "Paper Contribution I: Public Health and Safety in Context: Lessons from Community-Level Theory on Social Captial." Promoting Health: Intervention Strategies from Social and Behavioral Research. Washington, DC: The National Academies Press, 2000.
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Promoting Health: Intervention Strategies from Social and Behavioral Research
ronments has resulted in the publication of two recent review articles (Roberts, 1999; Yen and Syme, 1999) and a collection of classic and contemporary works on neighborhoods and health (Kawachi et al., 2000).
The goal of this paper is to make sense of current knowledge on health and public safety in local communities. We do so by drawing on the concept of “social capital” to unpack what it is about neighborhoods, above and beyond the status and attributes of the individuals who live there, that might lead to various health outcomes. Indeed, despite the wide range of evidence documenting relationships between community socioeconomic status and health, we still know very little about what these associations mean. As we shall elaborate, the basic idea of social capital provides a possible clue. According to James Coleman, social capital is a resource stemming from the structure of social relationships, which in turn facilitates the achievement of specific goals (Coleman 1990:300). Such resources, be they actual or potential, are often linked to durable social networks (Bourdieu 1986:249). Putnam defines social capital more expansively to include not only the networks themselves, but also shared norms and mutual trust, which “facilitate coordination and cooperation for mutual benefit” (1993:36).
In short, social capital is a resource that is realized through relationships (Coleman 1990:304), as compared to physical capital, which takes observable material form, and human capital, which rests in the skills and knowledge acquired by an individual. Whatever the specific formulation, social capital is not an attribute of individuals but rather a property of a social structure, such as an organization, an extended family, or a community (Coleman 1990; Bourdieu 1986). This paper employs the concept of social capital as a mode of inquiry into why community environments may be consequential for health. We review theoretical formulations on what social capital means at the community level, criticisms and weaknesses of the concept, and recent theoretical innovations. We also highlight research frontiers and promising community-level strategies that put social capital to work in promoting health. Before articulating social capital in more detail, we first note the regularities in prior empirical research that motivate its consideration.
A BRIEF HISTORY OF COMMUNITY HEALTH RESEARCH
The study of community environments and health-related outcomes actually has a long lineage in both sociology and public health. In sociology, the urban ecological approach of the “Chicago School” brought neighborhood-centered research to the fore of the discipline during the early 20th Century.3 One influen-
We set aside a detailed discussion of equally longstanding debates on how to define “neighborhood.” The traditional definition of neighborhood, as proposed by Robert Park, referred to an ecological subsection of a larger community—a collection of both people and institutions occupying a spatially defined area that is conditioned by a set of ecological, cultural, and political forces (Park, 1916:147–154). Neighborhoods are ecological units nested within successively larger communities (1916:114). That is, there is no one neighborhood, but many neighborhoods that vary in size and complexity depending on the social phenomenon of interest and the ecological structure of the larger community. In most cities there exist local community or city planning areas that, although relatively large, usually have well-known names and borders such as freeways, parks, and major streets. For example, Chicago has 77 local community areas averaging about 40,000 persons that were designed to correspond to socially meaningful and natural geographic boundaries. Some boundaries have undergone change over time, but these areas are widely recognized by administrative agencies and local institutions. Census tracts refer to smaller and more socially homogeneous areas of roughly 3,000–5,000 residents on average; their boundaries are usually, but not always, drawn to take into account major streets, parks, and other geographical features. A third and even smaller area more likely to approximate common notions of a “neighborhood ” is the block group—a set of blocks averaging approximately 1,000 residents. Although widely used in empirical research, the fact remains that community or planning areas, census tracts, and block groups all offer flawed operational definitions of neighborhood. In addition, social networks are potentially boundless in physical space.