Causal Effect Of Multiform Social Capital On The Health Of Chinese Adults

Social factors are considered as key determinants of individual health.Under the background of rapid social transition,Chinese adults' health is facing multiple challenges,such as the accelerated accumulation of multiple health risks or exposures,the growing health gap between urban and rural areas,imperfect universal health care system,and insufficient health services and resources that cannot meet the growing health needs of the population.The population health issue brought by social change has been attached great importance to by the central government,and the recently implemented “Healthy China” strategy places particular emphasis on the social determinants of health.Among numerous social determinants of health,social capital has been paid more and more attention because it is embedded in social connections,and its positive health effects have also been observed or confirmed by many prior studies.However,there are still some knotty challenges in social capital and health research,such as unclear conceptualization and operationalization of social capital,endogenous relationships between social capital and health,contradictions between the changing connotation and manifestation of social capital and relatively fixed operationalization of it,and so forth.At the same time,due to the differences in measures,study population and estimation methods,the estimated results in prior studies are also mixed,and we can hardly know exactly what health effects social capital can bring.Based on the social capital theory and a comprehensive review of prior research on social capital,this study attempts to rebuild the framework of social capital measurement from a new perspective.Based on the subjects and environment of social capital,three social capital forms,including individual-oriented,family-oriented and online socializing social capital,is obtained from the data of China Family Panel Studies(CFPS)from 2010 to 2018 to evaluate the health effect of multiform social capital among Chinese adults.Self-rated health(SRH),two-week prevalence(TWP)and depression are used as measures of individual health to ensure relative comprehensiveness of health measurement.Fixed-effect(FE)model,propensity socre matching(PSM),and Heckman sample selection model are used to address potential endogenity confounding in model estimation and yield more unbiased health effects of social capital.Simultaneously,sex and urban-rural heterogeneity in the health effect of social capital,as well as the interaction between offline and online socializing social capital when it comes to health,are also examined.It is observed that,as an important individual-oriented social capital,trust has a strong and positive health effect,but there are some differences in the health effect between general and special trust.Both general and special trust can improve SRH and reduce depression among Chinese adults.General trust can also significantly reduce TWP,but special trust only has a weaker reducing effect on TWP,it is neighbor trust rather than cadre or doctor that can reduce TWP;that is,bonding trust can improve physical health but bridging trust cannot.Furthermore,general trust can improve rural males' SRH rather than rural females',but it can improve urban females' SRH rather than urban males'.Cadre trust has the strongest positive effect on males' health and the weakest effect on rural females' health,which indicates the promorion effect of special trust on health partly depends on the connection between the two groups.In addition,trust can also positively influence individual health behaviors,and special trust plays a more positive role than general trust.Second,family-oriented social capital also shows a positive health effect to some extent,but its positive health effect is smaller than that of general and special trust,and excessive New Year visit network and daily social interaction will in turn show a non-significant or even negative health effect.More family-oriented social capital is related to a higher probability of TWP among females,but it can improve their SRH and reduce their depression.A larger New Year visit network of relatives can help reduce rural adults' depression rather than urban adults',but New Year visit network of friends is not associated with depression in all subgoups.More family-oriented social capital can sometimes increases health risk behaviors such as smoking and drinking,which can help us understand the negative health effect of family-oriented social capital more or less.Third,online socializing social capital shows a small health effect in general,which has almost no impact on SRH,and can only slightly reduce the probability of TWP and the level of depression.However,the health effect of online socializing social capital is more embodied in the interaction with offline social capital.Online socializing social capital can obviously reduce the level of depression among adults with less general trust and neighborhood cohesion,but it is associated with elevated depression among those with more neighborhood cohesion.The health effect of online socializing social capital is much smaller than that of offline social capital such as trust and neighborhood cohesion,but online socializing social capital plays a complementary role in health promotion when offline social capital is scarce.Finally,by comparing the results from basic regression models with the results from causal inference models,it is found that those basic regression models that do not take endogeneity into account tend to overestimate the positive health effect of social capital and yield more false positive estimates.Because individuals with more positive traits usually have more social capital,and these people are usually healthier.The endogenous confounding resulted from this positive selection phenomenon will exaggerate the positive relationship between social capital and health.Therefore,we should pay attention to and try to address the endogeneity problem when we investigate the relationships between social capital and health.This study has important theoretical and practical implications.Based on the classical classification scheme of social capital,this study obtains a new classification method social capital with a wider range of connotation,and further investiage the causal effect of multiform social capital on health,adding new research evidence to related areas.On this basis,this study also provide some insights for the future development of social capital and health research,that is,further social capital and health research should keep a wathchful eye on life course theory,spatial analysis,machine learing and major social events.We also provide some useful empirical evidence and suggestions for promoting the health of Chinese,that is,the cultivation of social capital should be paid more attention so as to reduce the interpersonal disconnection or isolation caused by social transition;some good traditions and customs in China should be kept to help maintain relationships and cohesion within and outside the family;online social capital,as well as the collaborative development between online and offline social capital,should be paid more attention to.