Institute for Health, Health Care Policy, and Aging Research, Rutgers University, 30 College Avenue, New Brunswick, NJ 08903, USA
McKenzie et al (2002) illustrate how emerging conceptions of social capital can help psychiatric researchers study links between social context and the prevalence, course and outcome of psychiatric conditions. Two further considerations deserve a place in this discussion. First, the premise that social capital is a property of groups rather than of individuals (McKenzie et al, 2002: p. 280) does not enjoy an unqualified consensus. Work by Princeton sociologist Alejandro Portes (1998) summarises the case against insisting that social capital be treated as a group attribute. A more individualist approach draws attention to the important distinction between the social relationships that allow a person to make claims on resources held by others and the resources themselves. A family's struggle to find a job for a recently hospitalised relative may be eased somewhat when they live in a community with trusting social relationships, but this effect is more limited in a resource-poor community. (For example, Portes (2000) found that alleged effects of social capital on the academic achievement of immigrant children in the USA are drastically reduced when proper controls are used for parental socio-economic status.)
Second, McKenzie et al note that high social capital may be found in bad groups, such as the Mafia, and in homogeneous groups that restrict the freedom of members or exclude outsiders and minorities. This analysis of negative consequences can be expanded by an individual-oriented discussion of a dilemma familiar to clinicians working with socially marginal populations. Individuals may indulge in apparently irrational spending sprees to buy food, drugs or alcohol for companions because these allow them to make future claims for reciprocity when times are lean (Dordick, 1997). The resulting mutual obligations can make it difficult for even a highly motivated person to enter (or re-enter) the social mainstream because he or she is vulnerable to criticism for breaking ranks with compatriots (Bourgois, 1995) or to claims on cash resources saved to facilitate an exit (for tuition, a new apartment, etc.). Programmes serving these populations need to devise strategies to help patients manage this dynamic aspect of social capital, even as they focus on recovery.
REFERENCES
Bourgois, P. (1995) In Search of Respect: Selling Crack in El Barrio. New York: Cambridge University Press.
Dordick, G. (1997) Personal Relations and Survival among New York's Homeless. Philadelphia, PA: Temple University Press.
McKenzie, K., Whitley, R. & Weich, S.
(2002) Social capital and mental health. British
Journal of Psychiatry, 181,
280-283.
Portes, A. (1998) Social capital: its origins and applications in modern sociology. Annual Review of Sociology, 24, 1-24.[CrossRef]
Portes, A. (2000) The two meanings of social capital. Sociological Forum, 15, 1-12.[CrossRef]
Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK
The problem with the emerging concept of social capital is that it is in danger of trying to be all things to all people. Dr Walkup is correct to point to the view of Portes and others that social capital can be individual. I do not think that this approach is particularly useful. Social capital is not a thing, it is a way of trying to describe a number of social processes. It is a theory that helps us understand what is happening in a society. Although there may be analogous processes occurring at group and individual levels, conceptualising them as the same thing is problematic.
Theories of causation argue that causes at different levels are often governed by different rules and need different methods of investigation. An example would be the effects of smoking on health. This can be investigated at a number of levels; there would be the cellular level (the effects of nicotine on the cell), the individual level (physical and psychological effects of smoking and addiction) and the group level (what increases smoking levels in one group compared with another).
One would not try to employ the concept of cellular biology to investigate groups of people and one would not try to use group or systems approaches to investigate the individual. Moreover, the factors that increase the level of smoking in a group may not be the same as those that increase an individual's risk of smoking-related disease.
Given that group social processes are likely to affect health in different ways from individual processes, it would not seem helpful to consider social capital as a single entity that works at both levels. A choice has to be made and the choice of the majority is to conceive of social capital as operating at an ecological or group level and to consider effects at an individual level as social networks.
Dr Walkup is correct to point to the differences between the social relationships that allow a person to call on resources, and the resources themselves. However, the theory of social capital as an ecological variable does allow for this. Bonding and bridging social capital describe factors at the community level, but the concept of vertical social capital attempts to describe the ability of a community to facilitate access to resources from those in power.
Clearly, in our individualised world our interventions tend towards helping people decrease their risk of illness and their risk of relapse, and improve their participation in the world. The exciting difference about ecological conceptualisations is that they are about how society decreases the risk of illness and relapse of its population and how society facilitates the participation of the individual. These approaches aim for the same outcome but they are not the same thing and will need different conceptualisations, investigations and interventions.
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