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DOI :10.26650/JECS413503   IUP :10.26650/JECS413503    Tam Metin (PDF)

Sosyal Sermaye ve Sağlık Arasındaki İlişki: Ampirik Çalışmalar Ne Gösteriyor?

Temmuz Gönç Şavran

Neoliberal ekonomi politikaları sonucunda devletin sağlık hizmetleri sunma görevinden geri çekilmeye başlaması ve sağlık sistemlerinin giderek serbest piyasanın parçası olması, toplum sağlığını iyileştirmek için yapısal reformlar yapmak yerine birey ve grupların kaynaklarına odaklanan bir bakış açısını beraberinde getirmiştir. Bu durum sosyal sermaye ve sağlık arasındaki ilişkiye yönelik akademik ilginin artmasına neden olmuştur. Bu çalışma sosyal sermaye ve sağlık arasındaki ilişkiyi ortaya koyan ampirik çalışmaların incelenmesini, bulguların ve kavramsal şemaların genel hatlarıyla ortaya konmasını ve eleştirel sosyolojik bir gözle değerlendirilmesini amaçlayan bir derleme çalışmasıdır. Bu çalışmanın, Türkiye’de son derece az çalışılmış bu alanda yapılacak olan ampirik araştırmalar için bir çerçeve oluşturması hedeflenmektedir. Sosyal sermaye ve sağlık arasındaki ilişkiyi ortaya koyan nicel ampirik çalışmaların büyük çoğunluğunun işlemselleştirme sürecinde sağladığı kolaylık nedeniyle Putnam’ın tanımını temel aldıkları ve genel olarak sosyal sermaye kavramını bir bütün olarak değil, boyutları ve biçimleri üzerinden ele aldıkları gözlenmiştir. Araştırmaların sonuçları sosyal sermayenin farklı boyut ve biçimlerinin sosyal destek, sosyal etki, sosyal kontrol, sosyal katkı, maddi kaynaklara erişim, güven ve kolektif eylem yarattığını ve bunların her birinin sağlık üzerinde etkili olduğunu göstermektedir. Her ne kadar sosyal sermayenin bazı biçimleri sağlık açısından olumuz sonuçlar yaratabiliyorsa da genel olarak sosyal sermayenin birey ve topluluk düzeyinde sağlığı bir dereceye kadar iyileştirme kapasitesinin olduğu görülmektedir. Sosyal sermayeye erişim yollarından biri olan kültürel sermaye kavramından türetilen kültürel sağlık sermayesi kavramı da sağlık eşitsizliklerinin belirli boyutlarında bireylerin kullanabileceği bir savunma mekanizması olarak işlemektedir. 

Anahtar Kelimeler: Sosyal sermaye, kültürel sağlık sermayesi, sağlık
DOI :10.26650/JECS413503   IUP :10.26650/JECS413503    Tam Metin (PDF)

The Relation Between Social Capital and Health: What do Empirical Studies Show?

Temmuz Gönç Şavran

As a consequence of neoliberal economy politics, the states began to retreat from providing health services and health systems began to be a part of free markets. This resulted in a focus on individual and societal assets and resources instead of on structural reforms which could improve health. As a result, academic interest in the relationship between social capital and health increased. This study is a critical review article that will examine, summarize, and evaluate the findings and conceptual framework of the empirical studies on the relationship between social capital and health from a critical sociological perspective. Due to the lack of empirical studies on this subject in Turkey, this study also aims to provide a framework for anticipated empirical research in Turkey. The quantitative empirical studies which examine the relationship between social capital and health are mainly based on Putnam’s definition due to its convenient exposition of the operationalization process. These studies examine the dimensions and forms of social capital rather than discussing the concept in a holistic manner. The research shows that different dimensions and forms of social capital affect health by creating social support, social influence, social control, social participation, access to material resources, and trust and collective action, which all have more specific consequences on health. Although some forms of social capital may cause negative results on health, it seems that social capital in general has the potential to improve individual and societal health to some extent. Derived from cultural capital, cultural health capital is also an important concept within this topic. As one of the ways to access social capital, cultural health capital operates as a defense mechanism for individuals in certain processes as related to health inequalities. 

Anahtar Kelimeler: Social capital, cultural health capital, health

GENİŞLETİLMİŞ ÖZET


As a consequence of neoliberal economy politics, the states began to retreat from providing health services and health systems began to be a part of free markets. This resulted in a community health focus on individual and societal assets and resources instead of on structural reforms which could improve health. As a result, academic interest in the relationship between social capital and health increased. This study is a critical review article that will examine, summarize, and evaluate the empirical studies about the relationship between social capital and health from a critical sociological perspective. Due to the lack of empirical studies on this subject in Turkey, this study also aims to provide a framework for anticipated empirical research in Turkey. 

The empirical studies which examine the relationship between social capital and health generally examine the dimensions and forms of social capital rather than studying the concept as a whole. The results of these studies show that different dimensions and forms of social capital have the potential to partially reduce health inequalities and improve individual and societal health. Individual social capital may affect health by creating social support, social influence, social control, social participation, and material resources. These outputs may have both positive and negative consequences on people’s behaviors, skills, and habits. Collective social capital creates material resources, trust, and collective action that may increase health by influencing norms, environments, and health information. Cognitive social capital (the perceived trust and reciprocity of people) and structural social capital (civil participation patterns) are found to be related to perceived physical pain and depression. Vertical and horizontal social capital is found to be related to oral and mental health. There are two forms of vertical social capital: bonding (depending on ties based on similarities) and bridging social capital (depending on ties that intersect similarities); these are also found to be related to depression and perceived health status. In addition, some studies emphasize cultural capital as a means to access social capital. Deriving from cultural capital, the concepts of health related cultural capital and cultural health capital are developed. Cultural health capital consists of cultural skills, competence, behaviors, attitudes, and interaction styles of patients and physicians. It helps patients use strategies to protect themselves from discrimination in the health seeking process. Cultural health capital is also important because it provides concrete examples for interaction among different forms of capital. 

Although these results are quite valuable, there are a number of points that require criticism. First, splitting social capital into its dimensions and forms helps research make more decisive measurements. However, it weakens the contextual and whole comprehension of social capital in general. In addition, some quantitative empirical studies use different variables in order to measure the same concepts. From a social science perspective, this may not constitute a ground for criticism; however, most of this research is from health sciences, which has a positivist root. These studies may be expected either to adopt a wider perspective of science, which would advocate for qualitative research to complete their results, or to strictly follow the quantitative methodological rules for comparison and reliability. While Putnam provides a facilitating framework for operationalization as seen in these studies, Bourdieu provides a framework for linking different forms of capital, which is extremely important for health related studies. Another point is the danger of focusing on the relationship between social capital and health. First, as seen in the literature, there are some adverse effects of social capital on health. Therefore, emphasizing the positive results of social capital and implementing politics that rely on these notions may have unexpected and undesirable consequences. Second, the increasing interest in social capital and health relationship is a consequence of changing health politics on a global scale. This change mainly involves the downsizing of the State and abstains from making structural interventions to improve health at a societal level. The relationship between social capital and health is absolutely important, but it is also important not to use it in order to legitimize the neoliberal health discourse, which leaves people deprived of State support. 


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Gönç Şavran, T. (0001). Sosyal Sermaye ve Sağlık Arasındaki İlişki: Ampirik Çalışmalar Ne Gösteriyor?. Journal of Economy Culture and Society, 0(57), 53-91. https://doi.org/10.26650/JECS413503


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Gönç Şavran T. Sosyal Sermaye ve Sağlık Arasındaki İlişki: Ampirik Çalışmalar Ne Gösteriyor?. Journal of Economy Culture and Society. 0001;0(57):53-91. https://doi.org/10.26650/JECS413503


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Gönç Şavran, T. Sosyal Sermaye ve Sağlık Arasındaki İlişki: Ampirik Çalışmalar Ne Gösteriyor?. Journal of Economy Culture and Society, [Publisher Location], v. 0, n. 57, p. 53-91, 0001.


Chicago: Author-Date Style

Gönç Şavran, Temmuz,. 0001. “Sosyal Sermaye ve Sağlık Arasındaki İlişki: Ampirik Çalışmalar Ne Gösteriyor?.” Journal of Economy Culture and Society 0, no. 57: 53-91. https://doi.org/10.26650/JECS413503


Chicago: Humanities Style

Gönç Şavran, Temmuz,. “Sosyal Sermaye ve Sağlık Arasındaki İlişki: Ampirik Çalışmalar Ne Gösteriyor?.” Journal of Economy Culture and Society 0, no. 57 (Nov. 2024): 53-91. https://doi.org/10.26650/JECS413503


Harvard: Australian Style

Gönç Şavran, T 0001, 'Sosyal Sermaye ve Sağlık Arasındaki İlişki: Ampirik Çalışmalar Ne Gösteriyor?', Journal of Economy Culture and Society, vol. 0, no. 57, pp. 53-91, viewed 24 Nov. 2024, https://doi.org/10.26650/JECS413503


Harvard: Author-Date Style

Gönç Şavran, T. (0001) ‘Sosyal Sermaye ve Sağlık Arasındaki İlişki: Ampirik Çalışmalar Ne Gösteriyor?’, Journal of Economy Culture and Society, 0(57), pp. 53-91. https://doi.org/10.26650/JECS413503 (24 Nov. 2024).


MLA

Gönç Şavran, Temmuz,. “Sosyal Sermaye ve Sağlık Arasındaki İlişki: Ampirik Çalışmalar Ne Gösteriyor?.” Journal of Economy Culture and Society, vol. 0, no. 57, 0001, pp. 53-91. [Database Container], https://doi.org/10.26650/JECS413503


Vancouver

Gönç Şavran T. Sosyal Sermaye ve Sağlık Arasındaki İlişki: Ampirik Çalışmalar Ne Gösteriyor?. Journal of Economy Culture and Society [Internet]. 24 Nov. 2024 [cited 24 Nov. 2024];0(57):53-91. Available from: https://doi.org/10.26650/JECS413503 doi: 10.26650/JECS413503


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Gönç Şavran, Temmuz. “Sosyal Sermaye ve Sağlık Arasındaki İlişki: Ampirik Çalışmalar Ne Gösteriyor?”. Journal of Economy Culture and Society 0/57 (Nov. 2024): 53-91. https://doi.org/10.26650/JECS413503



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