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Does Greater Individual Social Capital Improve the Management of Hypertension? Cross-National Analysis of 61 229 Individuals in 21 Countries Publisher



Palafox B1 ; Goryakin Y2 ; Stuckler D3 ; Suhrcke M4 ; Balabanova D1 ; Alhabib KF5 ; Avezum A6 ; Bahonar A7 ; Bai X8 ; Chifamba J9 ; Dans AL10 ; Diaz R11 ; Gupta R12 ; Iqbal R13 Show All Authors
Authors
  1. Palafox B1
  2. Goryakin Y2
  3. Stuckler D3
  4. Suhrcke M4
  5. Balabanova D1
  6. Alhabib KF5
  7. Avezum A6
  8. Bahonar A7
  9. Bai X8
  10. Chifamba J9
  11. Dans AL10
  12. Diaz R11
  13. Gupta R12
  14. Iqbal R13
  15. Ismail N14
  16. Kaur M15
  17. Keskinler MV16
  18. Khatib R17
  19. Kruger A18
  20. Kruger IM18
  21. Lanas F19
  22. Lear SA20
  23. Li W8
  24. Liu J8
  25. Lopezjaramillo P21
  26. Peer N22
  27. Poirier P23
  28. Rahman O24
  29. Pillai RK25
  30. Rangarajan S26
  31. Rosengren A27
  32. Swaminathan S28
  33. Szuba A29
  34. Teo K26
  35. Wang Y8
  36. Wielgosz A30
  37. Yeates KE31
  38. Yusufali A32
  39. Yusuf S26
  40. Mckee M1
Show Affiliations
Authors Affiliations
  1. 1. Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, London, United Kingdom
  2. 2. Organization for Economic Cooperation and Development, Paris, France
  3. 3. Department of Policy Analysis and Public Management, Dondena Research Centre, University of Bocconi, Milan, Italy
  4. 4. Centre for Health Economics, University of York, York, United Kingdom
  5. 5. Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
  6. 6. Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil
  7. 7. Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
  8. 8. National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
  9. 9. College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
  10. 10. UP College of Medicine, University of the Philippines Manila, Manila, Philippines
  11. 11. Estudios Clinicos Latino America, Rosario, Argentina
  12. 12. Eternal Heart Care Centre and Research Institute, Jaipur, India
  13. 13. Departments of Community Health Sciences and Medicine, Aga Khan University, Karachi, Pakistan
  14. 14. Department of Community Health, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
  15. 15. School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
  16. 16. Department of Internal Medicine, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
  17. 17. Department of Public Health Sciences, Loyola University Medical Center, Maywood, IL, United States
  18. 18. Africa Unit for Transdisciplinary Health Research, North-West University, Potchefstroom, South Africa
  19. 19. Universidad de La Frontera, Temuco, Chile
  20. 20. Simon Fraser University, Burnaby, BC, Canada
  21. 21. Research Institute FOSCAL, Santander, Colombia
  22. 22. South African Medical Research Council, Durban, South Africa
  23. 23. Institut universitaire de cardiologie et de pneumologie de Quebec, Quebec, Canada
  24. 24. Independent University, Dhaka, Bangladesh
  25. 25. Department of Pediatrics, Dr SMCSI Medical College Karakonam, Trivandrum, India
  26. 26. Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada
  27. 27. Department of Molecular and Clinical Medicine, University of Gothenburg, Goteborg, Sweden
  28. 28. St John's Research Institute, Bangalore, Karnataka, India
  29. 29. Division of Angiology, Wroclaw Medical University, Wroclaw, Poland
  30. 30. University of Ottawa, Ottawa, ON, Canada
  31. 31. Department of Medicine, Queen's University, Kingston, ON, Canada
  32. 32. Hatta Hospital, Dubai Health Authority/Dubai Medical University, Dubai, United Arab Emirates

Source: BMJ Global Health Published:2017


Abstract

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. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved.
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