Degrees of "Social Capital" Predict Higher Rates of Sexually Transmitted
Diseases, According to Emory University Study
amount of trust, reciprocity and cooperation among community members
working together to achieve common goals referred to as "social capital"
by behavioral scientists -- is a predictor of sexually transmitted infectious
diseases and risky sexual behaviors, according to research by Emory
University investigators. The investigators found that lower amounts
of social capital were associated with higher rates of AIDS and other
sexually transmitted diseases, as well as with higher rates of risky
adolescent sexual behaviors. The research was reported Thursday at the
14th International AIDS Conference in Barcelona, Spain.
"Although the amount of social
capital in a particular society previously has been correlated with
violence and mortality, its relationship to infectious diseases has
received little attention," said David Holtgrave, Ph.D., professor of
behavioral science and health education in Emory's Rollins School of
Public Health, and one of the study investigators. "In making that connection
for the first time, we found that social capital is a very good predictor
of infectious diseases including AIDS and sexually transmitted diseases,
as well as a predictor of adolescent risk for these diseases."
In 1999, in 48 of 50 states
(excluding Alaska and Hawaii), the investigators examined the relationship
between social capital, poverty and income inequality, AIDS case rates
and STD rates (syphilis, gonorrhea and chlamydia). They found that social
capital was a significant predictor of all four diseases, explaining
between 25% and 45% of the variance in the rate of each disease. They
also found that social capital was a significant predictor of 10 out
of 14 behavioral variables, including current sexual activities, early
sexual debut, and greater number of partners. Poverty and income inequality
were much less strong predictors of these disease and behavior outcomes.
In order to measure social
capital, the investigators used Putnam's measure of state-level social
capital. That measure is a composite of 14 different variables, including,
among others things, the number of social organizations in a state;
the reported level of participation in those social activities with
friends; the extent to which individuals report trusting each other;
and overall voting rates.
The investigators measured
disease rates using the Centers for Disease Control and Prevention (CDC)
surveillance system measures of state-level AIDS cases, gonorrhea, syphilis,
and chlamydia. Behavioral outcome measures were obtained through the
CDC's Youth Risk Behavior Survey, which includes seven aspects of adolescent
HIV-related sexual risk behavior.
"Our findings tell us that
the amount of trust and cooperation in a society social capital
should be considered in the development of HIV and STD prevention interventions,"
Dr. Holtgrave said. "We also have to extend our study of social capital
beyond sexually transmitted diseases to all the nationally notifiable
infectious diseases, including, among others, tuberculosis and hepatitis."