Wednesday, May 25, 2011

Why should we become more engaged in civil society? For health, that's why!

I am an intense believer in the social determinants of health and looking at health problems through a social-ecological lens (i.e. determinants of health exist at multiple social levels of influence and are not just attributable to the individual or to the healthcare system). I think this is why I’ve also gotten incredibly interested in politics – from this perspective, government policies can influence population and environmental health.  An interesting social determinant of health, social capital, has made me realize how we as individuals can collectively make a difference in shaping the quality of our shared spaces, and potentially overall community health – through influencing policies and working with government.

Social capital, a concept originating from the work of Robert Putnam, among others, embodies the norms of reciprocity (gift giving with the expectation of receiving), social and civic participation and trust in society. Another, complimentary view is that social capital refers to the network of social relationships that provide access to resources. Regardless of the definition, when you have more of these things you have more social capital (sometimes called cohesion). Although both definitions are relevant, I am speaking more to the former definition in the discussion that follows.

Richard Wilkinson was the first to introduce social capital to studies on health. He found that societies that are more socially cohesive, with smaller income gaps (more egalitarian) have higher life expectancies and lower infant mortality rates. Other authors have found that societies with higher levels of income inequality and lower social cohesion have higher levels of crime and violence and higher mortality rates. At a more local level, it has been found that residents who are more involved in the community tend to be happier where they live, regardless of the physical quality of their homes.  Some studies have even found that as the level of social cohesion in an area increases, the prevalence of obesity decreases. 

Social capital is complex – these studies show how it may influence health. An obvious explanation is that it improves the quality of our immediate social and physical environments, as well as society at large. One caveat is that social capital itself can be shaped by many different factors operating at many different levels of social organization (e.g. at the neighbourhood/community, region, province, and country level), which thus impacts the quality of our spaces. Social capital therefore, is not a one-way street, rather an intricate web of interaction.

Open space in question, complete with dog

My plan is to add to social capital and hopefully improve the quality of my neighbourhood, by becoming more civically engaged. I’ve read a lot lately about how greenspace can potentially be beneficial for mental and physical health, and how it is also good for the environment (I have blogged a bit about this too). I enjoy being outdoors in natural areas – it makes me happy – and I also have a dog, with no back-yard.  Unfortunately there are no dog parks or interesting greenspaces within walking distance of my home.  I often take my dog to an open space close by. It’s a piece of land that separates two suburban neighbourhoods, with trees and a man-made marsh that was constructed to deal with street water runoff. Other neighbourhood residents also bring their dogs, kids toboggan down the banks of the marsh in the winter, and residents of houses bordering the space often use it as their personal dumping ground (a pet-peeve of mine discussed in a previous post). There is no landscaping and the space is never maintained.

Neighbours like to use it as their own personal dump

I would really like to have this space converted into a dog-friendly park (that is maintained), with perhaps a community composter (since everyone dumps their s**t anyway), and even a community vegetable garden. Although, my partner brought to my attention that probably dog parks and food don’t mix – I’ll have to think the vegetable garden through a little bit more…

I really had no idea how to go about making this happen until I read an interesting post on the City of Gatineau’s website:  

“Ville de Gatineau is revising its land use and development plan. Would you care to share your thoughts about how your neighbourhood or the city should develop? This is the time! This revision will extend over three years, with meetings scheduled to start this spring!

This first meeting for my area is this June the 6th. I plan to go to see how I can voice my ideas and connect with others who may share my view and/or be able to help me. This will be the first time (other than voting in various elections) that I am involved in the running of my community. I’ll keep you updated as to how this pans out. And I urge everyone else to do the same. Finally, I will not be a hypocrite, especially with respect to my own research!  

Leal C, & Chaix B (2011). The influence of geographic life environments on cardiometabolic risk factors: a systematic review, a methodological assessment and a research agenda. Obesity reviews : an official journal of the International Association for the Study of Obesity, 12 (3), 217-30 PMID: 20202135

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