Elsevier

Social Science & Medicine

Volume 66, Issue 3, February 2008, Pages 637-649
Social Science & Medicine

Social capital at work as a predictor of employee health: Multilevel evidence from work units in Finland

https://doi.org/10.1016/j.socscimed.2007.10.013Get rights and content

Abstract

The majority of previous research on social capital and health is limited to social capital in residential neighborhoods and communities. Using data from the Finnish 10-Town study we examined social capital at work as a predictor of health in a cohort of 9524 initially healthy local government employees in 1522 work units, who did not change their work unit between 2000 and 2004 and responded to surveys measuring social capital at work and health at both time-points. We used a validated tool to measure social capital with perceptions at the individual level and with co-workers’ responses at the work unit level. According to multilevel modeling, a contextual effect of work unit social capital on self-rated health was not accounted for by the individual's socio-demographic characteristics or lifestyle. The odds for health impairment were 1.27 times higher for employees who constantly worked in units with low social capital than for those with constantly high work unit social capital. Corresponding odds ratios for low and declining individual-level social capital varied between 1.56 and 1.78. Increasing levels of individual social capital were associated with sustained good health. In conclusion, this longitudinal multilevel study provides support for the hypothesis that exposure to low social capital at work may be detrimental to the health of employees.

Introduction

Social capital, described by Hanifan (1916) as “goodwill, fellowship, mutual sympathy, and social intercourse among a group of individuals who make up a social unit” as early as 1916, continues to attract attention in population health research. According to contemporary theorists, such as Coleman (1988) and Putnam (2000), social capital consists of those features of social organization which act as resources for individuals and facilitate collective action. These include networks of secondary associations, high levels of interpersonal trust and the norms of mutual aid and reciprocity. However, there remains controversy, whether the benefits of social capital accrue to individuals or groups (Kawachi, Kim, Coutts, & Surbamanian, 2004). Furthermore, it not clear whether social capital is a resource of individuals or communities. Taking into account that ecological studies have found associations between social capital and health, it is difficult to distinguish between compositional (i.e. individual) and contextual (i.e. group) effects of social capital on health. (Poortinga, 2006a). Thus, it has been suggested that the preferred unit of analysis for conceptualizing and measuring social capital is both an individual and ecological one (Szreter & Woolcock, 2004).

While studies in this field have traditionally focussed on social capital in residential or geographical areas, it has now been suggested that social capital at work should also be targeted (Baum & Ziersch, 2003; Kawachi, 1999). The workplace may constitute an important social unit in this respect because many people spend more waking hours at work than elsewhere, and workplace is a significant source of social relations. Compared to large geographic units, like states, workplaces might more appropriately capture the important social interactions and networks that constitute the core of social capital (Sundquist & Yang, 2006). Indeed, civic engagement and social connectedness can be found inside the workplace, not only outside of it (Putnam, 2000).

Analyses taking into account the multilevel structure of data comprising individuals in social units have been a major advancement in social capital research (Szreter & Woolcock, 2004; Yen & Syme, 1999). These techniques enable the inclusion of predictors at multiple levels and provide a flexible framework to examine not only group level differences (within and between groups), attributable to either contextual differences or compositional effects, but also interaction between variables of different levels. To date, several studies have examined social capital and self-rated health among working age population in a multilevel setting. Most studies have documented an association between higher social capital and better self-rated health at either individual level or aggregate level (Browning & Cagney, 2002; Franzini, Caughy, Spears, & Fernandez Esquer, 2005; Islam, Merlo, Kawachi, Lindström, & Gerdtham, 2006; Kavanagh, Bentley, Turrell, Broom, & Subramanian, 2006; Kavanagh, Turrell, & Subramanian, 2006; Kawachi, Kennedy, & Glass, 1999; Kim & Kawachi, 2006; Kim, Subramanian, & Kawachi, 2006; Lindström, Moghaddassi, & Merlo, 2004; Poortinga (2006a), Poortinga (2006b); Subramanian, Kawachi, & Kennedy, 2001; Subramanian, Kim, & Kawachi, 2002; Sundquist & Yang, 2006; Veenstra, 2005; Wen, Browning, & Cagney, 2003). In addition, some multilevel studies have reported a cross-level interaction with modifications of the effects of individual-level social capital by community-level social capital (Kim & Kawachi, 2006; Poortinga, 2006a; Subramanian et al., 2002). However, none of these studies specifically focussed on social capital at workplace. Furthermore, the cross-sectional study designs employed in previous studies prevented evaluation of the temporal order between exposure and response.

Given the limitations in previous research, it remains unclear whether social capital represents a consequence or an antecedent of health and how changes in individual or work unit social capital influence health. In the present study, we longitudinally examined the associations between social capital at work and change in social capital with health impairment among employees. To take into account the fact that individual employees are nested in social units comprised of work units, we used multilevel modeling.

Section snippets

Participants and study design

Data were derived from the Finnish 10-Town study, an on-going prospective cohort study exploring the relationships between behavioral and psychosocial factors and health among local government employees (Kivimäki, Vahtera, Elovainio, Virtanen, & Siegrist, 2007). The Ethics Committee of the Finnish Institute of Occupational Health approved the study. In 2000–2001, 32,299 full-time permanent or fixed-term employees aged 17–64 years responded to a postal survey on social capital and health

Results

As shown in Table 1, the study sample comprised mostly of women (79%), who also reported having statistically more individual level social capital at baseline than men (p<0.0001): the mean was 3.71 (S.D. 0.72) for women and 3.59 (S.D. 0.72) for men. In relation to occupational status, manual workers represented the smallest occupational group (14%) in the sample and they also reported the lowest level of individual social capital at baseline. The mean social capital was 3.57 (S.D. 0.77) for

Discussion

This longitudinal study of 9524 initially healthy employees in 1522 work units supports the status of social capital at work as a predictor of health. Individual level analysis showed that both a constantly low level of social capital and a decline in social capital were associated with the impairment of self-rated health. An increase in individual-level social capital from low to high was associated with sustained good health. These results were not attributable to participants’

Conclusion

This prospective study suggests that exposure to low social capital at work poses a risk of health impairment. This effect was not accounted for by the individual perceptions of social capital because the adverse effect was also evident in co-worker-assessed social capital. Our study extends the existing literature with evidence on the contextual effects of social capital on employee health.

Acknowledgments

This study was supported by the Academy of Finland (project 105195 and 117604), the Finnish Work Environment Fund (project 103432), the Local Governments Pensions Institution and the participating towns.

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