دانلود رایگان مقاله انگلیسی سرمایه اجتماعی، نابرابری درآمد و شیب اجتماعی در سلامت خود در آمریکای لاتین - الزویر 2018

ABSTRACT

Latin America is the most unequal region in the world. The current sustainable development agenda increased attention to health inequity and its determinants in the region. Our aim is to investigate the social gradient in health in Latin America and assess the effects of social capital and income inequality on it. We used crosssectional data from the World Values Survey and the World Bank. Our sample included 10,426 respondents in eight Latin American countries. Self-rated health was used as the outcome. Education level was the socioeconomic position indicator. We measured social capital by associational membership, civic participation, generalized trust, and neighborhood trust indicators at both individual and country levels. Income inequality was operationalized using the Gini index at country-level. We employed fixed effects logistic regressions and cross-level interactions to assess the impact of social capital and income inequality on the heath gradient, controlling for country heterogeneity. Education level was independently associated with self-rated health, representing a clear social gradient in health, favoring individuals in higher socioeconomic positions. Generalized and neighborhood trust at country-level moderated the effect on the association between socioeconomic position and health, yet favoring individuals in lower socioeconomic positions, especially in lower inequality countries, despite their lower individual social capital. Our findings suggest that collective rather than individual social capital can impact the social gradient in health in Latin America, explaining health inequalities.

5. Conclusion

In LAC, there is a clear social gradient in health, independent of country-level heterogeneity and individual-level social capital. Collective social capital at country-level—especially generalized trust—had a positive moderating effect on the health gradient, favoring the bottom of the social ladder, especially in lower income inequality countries in the region. Discrepancies in collective social capital could therefore explain health inequalities and indicate policy targets as we aim at reducing health inequalities.