RT Journal Article
SR Electronic
T1 Does greater individual social capital improve the management of hypertension? Cross-national analysis of 61 229 individuals in 21 countries
JF BMJ Global Health
FD BMJ Publishing Group Ltd
SP e000443
DO 10.1136/bmjgh-2017-000443
VO 2
IS 4
A1 Benjamin Palafox
A1 Yevgeniy Goryakin
A1 David Stuckler
A1 Marc Suhrcke
A1 Dina Balabanova
A1 Khalid F Alhabib
A1 Alvaro Avezum
A1 Ahmad Bahonar
A1 Xiulin Bai
A1 Jephat Chifamba
A1 Antonio L Dans
A1 Rafael Diaz
A1 Rajeev Gupta
A1 Romaina Iqbal
A1 Noorhassim Ismail
A1 Manmeet Kaur
A1 Mirac V Keskinler
A1 Rasha Khatib
A1 Annamarie Kruger
A1 Iolanthe M Kruger
A1 Fernando Lanas
A1 Scott A Lear
A1 Wei Li
A1 Jia Liu
A1 Patricio Lopez-Jaramillo
A1 Nasheeta Peer
A1 Paul Poirier
A1 Omar Rahman
A1 Rajamohanan K Pillai
A1 Sumathy Rangarajan
A1 Annika Rosengren
A1 Sumathi Swaminathan
A1 Andrzej Szuba
A1 Koon Teo
A1 Yang Wang
A1 Andreas Wielgosz
A1 Karen E Yeates
A1 Afzalhussein Yusufali
A1 Salim Yusuf
A1 Martin McKee
YR 2017
UL http://gh.bmj.com/content/2/4/e000443.abstract
AB Introduction Social capital, characterised by trust, reciprocity and cooperation, is positively associated with a number of health outcomes. We test the hypothesis that among hypertensive individuals, those with greater social capital are more likely to have their hypertension detected, treated and controlled.Methods Cross-sectional data from 21 countries in the Prospective Urban and Rural Epidemiology study were collected covering 61 229 hypertensive individuals aged 35–70 years, their households and the 656 communities in which they live. Outcomes include whether hypertensive participants have their condition detected, treated and/or controlled. Multivariate statistical models adjusting for community fixed effects were used to assess the associations of three social capital measures: (1) membership of any social organisation, (2) trust in other people and (3) trust in organisations, stratified into high-income and low-income country samples.Results In low-income countries, membership of any social organisation was associated with a 3% greater likelihood of having one’s hypertension detected and controlled, while greater trust in organisations significantly increased the likelihood of detection by 4%. These associations were not observed among participants in high-income countries.Conclusion Although the observed associations are modest, some aspects of social capital are associated with better management of hypertension in low-income countries where health systems are often weak. Given that hypertension affects millions in these countries, even modest gains at all points along the treatment pathway could improve management for many, and translate into the prevention of thousands of cardiovascular events each year.