SSM: Population Health (Dec 2021)
Social capital, the miniaturization of community, traditionalism and mortality: A population-based prospective cohort study in southern Sweden
Abstract
Objectives: To investigate associations between social capital, miniaturization of community and traditionalism and all-cause, cardiovascular (CVD), cancer and other causes mortality. Study design: Prospective cohort study. Methods: The 2008 public health survey in Scania in the southernmost part of Sweden was conducted with a postal questionnaire posted to a stratified random sample aged 18–80. The response rate was 54.1%. The baseline survey was linked to 8.3-year prospective public death register data. Analyses were conducted with survival analyses, adjusting for relevant factors. Results: Among women 37.9% had low social participation and 37.8% low trust. Among men 40.9% had low social participation and 35.7% low trust. Low social capital (low social participation/low trust) and traditionalism (low social participation/high trust) have significantly higher total and cardiovascular mortality among women and men combined and among men, but not among women in the final models. The results for women are not significant in the full models for all-cause, CVD, cancer and all other causes mortality. Miniturization of community (high social participation/low trust) displays no statistically significant associations in the adjusted models. Social participation and trust, respectively, and total mortality show consistent Schoenfeld residuals over 8.3 years. Conclusions: The associations between low social capital, traditionalism and mortality are stronger for men than for women, and may be partly mediated by health-related behaviors.