Two theoretical strands of social capital, and total, cardiovascular, cancer and other mortality: A population-based prospective cohort study

Research output: Contribution to journalArticle


The aim is to prospectively investigate both the “cohesion” and “network” perspectives of social capital in relation to total, cardiovascular (CVD), cancer and all other causes mortality. The 2008 public health survey in Scania was a postal questionnaire with three letters of reminder, and it was answered in the Autumn by 28,198 respondents (55% participation) aged 18–80 from a stratified random sample of the population register. This baseline was connected with the national causes of death registry (Dödsorsaksregistret) with a more than five-year follow-up August 27- November 14 (depending on individual response) to December 31, 2013 (946 deaths). The analyses were performed in multiple adjusted survival (Cox-) regression models. Results show that low social participation, common to both theoretical perspectives, had consistently high hazard rate ratios (HRRs) of total, CVD, cancer and other morality, and that HRRs of total and CVD mortality remained statistically significant even after adjustments for all covariates including health behaviors, BMI, unmet healthcare needs and self-rated health, HRR 1.28 (1.08–1.52) and HRR 1.79 (1.28–2.50), respectively. In contrast, low social support, specific to the “network” perspective, showed no significant associations with mortality, except for low emotional and instrumental support and other causes mortality for which HRRs remained significant adjusted for demographics and socioeconomic status (SES). Generalized trust in other people, specific to the “cohesion” perspective, showed statistically significant HRRs for total and other causes mortality until adjustments for health-related behaviours and BMI, although not after complete adjustments, and significant HRRs for CVD and cancer mortality before adjustment for health behaviours. In conclusion, low social participation is consistently associated with all forms of mortality, and particularly total and CVD mortality. Social participation represents a strong core of social capital theory, and items should measure both variety of social contact surfaces and intensity.


External organisations
  • Region Skåne, Primary health care
  • University of Gothenburg
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Public Health, Global Health, Social Medicine and Epidemiology


  • Generalized trust in other people, Mortality, Prospective cohort, Social capital, Social participation, Social support, Sweden
Original languageEnglish
Article number100337
JournalSSM - Population Health
Publication statusPublished - 2019 Apr 1
Publication categoryResearch