Social Capital And Using Strategy Of Social Health Resources

PurposeSocial capital is a kind of invisible capital which being used widely in each field of social development. Social capital was rooted from the intercross of sociology and economy science. It is essentially a kind of social relationship, including participation, reciprocity, network and common value, criterion and moral, contract relationship, which are based on trust. Social capital lies in social intercourse between persons or organizations, and reduces trade cost, realizes increment character of capital by organizing and distributing economic, human and information capital.This paper explored the promotion function of social capital on human health level by analyzing data materials form UNDP, community investigation materials in Wuhan urban residents, and social development of health institutions. The research results would deepen social medicine basic theory and advance the transformation of modern medical model. On the other hand, this paper researched the situation of China's health reform, and took social capital as an important health resource, brought forward strategy and measures to develop and use social capital to make up the shortage of government management and market mechanism, offered a new thought for health reform.MethodsThis paper used literature study method to make clear the basic connotation of social capital theory, and made out the math model of social capital by Structural Equation Modeling (SEM), from this model, we could know the social capital elements and the quantity relationship among them. By multi-stepwise regression analysis and non-condition Logistic regression analysis, the relationship between social capital and human health was analyzed. By descriptive analysis, the developing space of community social capital was made clear. By case study and results above, strategy of developing and using social capital was put forward finally.ContentsIn order to explore the function of social capital on health thoroughly, the research contents included: ①Research the relationship between indicators from health service, economic development, democracy, education, social development, living conditions and health level indicators (life expectancy at birth, infant mortality rate, maternal mortality ratio ). The data was from official report of 173 countries by 2000(UNDP Human Development Report, 2002). ②Establish math model of social capital and analyze the influence of social capital on health level of residents by field investigation on urban residents in 4 communities of Wuhan. ③Study on developing space of community social capital, which included the ascription to community, value and moral, the trust level to medical institutions and doctors, friendly and reciprocity among residents, the composing of social network, participation in community public affairs. ④Bring forward the developing strategy of social capital, including the design of macro system, culture of moral, social cooperation based on contract, building of community culture environment, encouraging community volunteer activities.ResultsThe research found out social capital could promote health level of population, at the same time, social capital was a kind of important health resource, which could serve on health development.①By analyzing the relationship between macro social capital and human health, the result showed that Life Expectancy at Birth had positive correlation with Birth Attended by Skilled Health Staff, Corruption Perceptions Index, Government Effectiveness, Urban Population As % of Total, and Telephone Mainline (per 1000 people); and had negative correlation with Exports As % of GDP. Infant Mortality Rate has positive correlation with Gini Index and Exports As % of GDP, had negative correlation with Adult Literacy Rate and Telephone Mainline (per 1000 people). Maternal Mortality Rate had positive correlation with Human Political Rights and Unemployment Rate, had negative correlation with Government Effectiveness and Telephone Mainline (per 1000 people).②Description of health situation of urban residents in Wuhan: two-week incidence rate is 37.91%; chronic disease prevalence rate is 60.93%; the composing of top three chronic diseases were hypertension(18.96%), vertebrae(12.09%), rheumatoid arthritis(9.53%); there were 53.49% informants had insomnia of different degree; 43.72% had intensity and anxiety; 40.47% had oppression and depression; and 19.77% felt life was meaningless.③ Establishment of social capital math model: social capital had strong relationship with moral and value, trust and safety, friendly and reciprocity of residents, social network, participation in public affairs, the correlation coefficient were 0.4144, -0.3363, 0.8970, 0.3932, 0.6613 accordingly.④Relationship between social capital and human health level: the social capital factors including "take part in medical insurance system", "know many people of living community", "engage neighbor to take care house when going out", "get well with workmates" all could promote health level of residents, OR value were 1.468, 1.370, 0.778, 0.669 accordingly. While "there are druggers in this community" was disadvantageous factor to health of residents, which was negative culture phenomenon of community life, and the OR value was 0.679.⑤There were 81% informants had rather strong ascription feeling to their community; 44.88% informants had consciousness of protecting public health, and 71.43% informants had enthusiasm of public health maintenance; 51.16% of them had consciousness of supervising public health; 72.79% would be community volunteers, 77.62% were willing to take part in public activities to promote community health level; 41.86% had ever participated health education organized by community health service institutions; 58.37% had donated for commonweal or philanthropy in the past year; and 20.56% had ever donated blood. So it could conclude that there was rather wide space to mobilize community residents serve for community public health development.⑥Research found that, most of the residents (74.12%) would rather trust national compositive hospitals, the trust level to community health service institutions was only 38.57%; the situation of residents trusting doctors in different level hospitals was increased with the level of hospitals, that was, 87.18% informants trusted doctors in province or ministry level hospitals; 81.78% trusted doctors in city level hospitals; 59.20% trusted doctors in regional hospitals; only 41.23% trusted doctors in community health service institutions. Residents showed widely nonconfidence to doctors in private hospitals or clinics, and the trust level were only 10.45% and 7.03% respectively.SuggestionsThe research brought forward policy suggestions as following:① Government should recognize the promotion function of social capital on human health, take social capital as important health resource and encourage the development and usage of social capital to make up the shortage of government macro management.② To design scientific, reasonable, equitable and fair macro policy and system, establish health guideline that put emphases on prevention, improve the justice degree of health service.③ To culture impartial value in whole society, enhance professional moral construction of health service. (4) Encourage social health resources to enter health market,import proper competition mechanism and activate the inner energy of health field to fit the. objective demand of market economy.(5) Create sustaining environment, encourage widely cooperation and establish network between health department and other departments, different medical institutions.(6) Culture organization civilization, manage medical institutions by scientific methods, mobilize the enthusiasm of all factors and improve working performance of medical organizations.⑦ Enhance the construction of community culture, encourage the development of non-governmental organizations and community volunteers.InnovationsThis subject was funded by National Natural Science Fund Committee (NSFC), viewed the foreland of international research field, and had innovations both in theory research and methodology.① Put forward social capital connotation and point of view on comprehending social capital theory combining the situation of China, and by studying the fact of health reform in China, bring forward the key field of social capital act on health development.② Deepen the social factors and health relation theory of social medicine science, offer a new thought of promoting human health from social capital theory aspect, accelerate the transformation of medical model to bio-psycho-social medical model.(3) Put forward social capital developing strategy from the design of policy, government function, allocation of resource to make up the shortage of government macro management by researching the situation of China's medical reform, and advanced the healthy expansion of health reform. ④ By using quantitative and qualitative analysis, and foreland researchmethodology in sociology------Structural Equation Modeling, social capital mathmodel was established, which conquered the shortage of simply using main-factor analysis method, and filled up the research space of analyzing social capital by quantity.