Communicative Social Capital and Collective Efficacy as Determinants of Access to Health-Enhancing Resources in Residential Communities

Abstract

This article contributes to the burgeoning literature on the social determinants of health disparities. The authors investigate how communication resources and collective efficacy, independently and in combination, shape residents’ access to health enhancing resources (including healthcare services, sources of healthier food options, and public recreation spaces) in their communities. Using random digit dial telephone survey data from 833 residents of South Los Angeles communities the authors show that communicative social capital—that is, an information and problem-solving resource that accrues to residents as they become more integrated into their local communication network of neighbors, community organizations, and local media—plays a significant role in access to health resources. This relationship is complicated by individuals’ health insurance and health status, as communicative social capital magnifies the sense of absence of resources for those who are in worse health and lack insurance. Communicative social capital builds collective efficacy, which is positively related to access to health-enhancing resources, but it also mediates the negative relationship between communicative social capital and access to health resources. Residents with richer stores of communicative social capital and collective efficacy report better access to health resources. The authors conclude with a discussion of implications of these findings and suggestions for future research.

Acknowledgments

The authors thank the two anonymous reviewers for their constructive feedback, as well as Drs. Jack McLeod, Katya Ognyanova, Nancy Chen, and Vikki Katz for their thoughtful comments on earlier versions of the article.

Notes

¹Details regarding the construction of ICSN have been reported in Kim and Ball-Rokeach (2006a) and Kim et al. (2011). See the Appendix for a brief discussion.

²One of the key advantages to the approach recommended by Preacher and Hayes (2008) is that it makes any violations of the assumption of normal distribution of variables’ scores less problematic. Bootstrapping methods are used to generate confidence intervals for estimates of the product of the coefficients a and b (i.e., the coefficient for the relationship between the independent variable and the mediator and the coefficient of the relationship between the mediator and the outcome, respectively), for the indirect or mediated effects.