Does greater individual social capital improve the management of hypertension? Cross-national analysis of 61 229 individuals in 21 countries

Benjamin Palafox, Yevgeniy Goryakin, David Stuckler, Marc Suhrcke, Dina Balabanova, Khalid F. Alhabib, Alvaro Avezum, Ahmad Bahonar, Xiulin Bai, Jephat Chifamba, Antonio L. Dans, Rafael Diaz, Rajeev Gupta, Romaina Iqbal, Noor Hassim Ismail, Manmeet Kaur, Mirac V. Keskinler, Rasha Khatib, Annamarie Kruger, Iolanthe M. KrugerFernando Lanas, Scott A. Lear, Wei Li, Jia Liu, Patricio Lopez-Jaramillo, Nasheeta Peer, Paul Poirier, Omar Rahman, Rajamohanan K. Pillai, Sumathy Rangarajan, Annika Rosengren, Sumathi Swaminathan, Andrzej Szuba, Koon Teo, Yang Wang, Andreas Wielgosz, Karen E. Yeates, Afzalhussein Yusufali, Salim Yusuf, Martin McKee

Research output: Contribution to journalArticle

2 Citations (Scopus)

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.

Original languageEnglish
Article numbere000443
JournalBMJ Global Health
Volume2
Issue number4
DOIs
Publication statusPublished - 1 Jan 2017

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Hypertension
Organizations
Health
Statistical Models
Epidemiology
Social Capital

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

Does greater individual social capital improve the management of hypertension? Cross-national analysis of 61 229 individuals in 21 countries. / Palafox, Benjamin; Goryakin, Yevgeniy; Stuckler, David; Suhrcke, Marc; Balabanova, Dina; Alhabib, Khalid F.; Avezum, Alvaro; Bahonar, Ahmad; Bai, Xiulin; Chifamba, Jephat; Dans, Antonio L.; Diaz, Rafael; Gupta, Rajeev; Iqbal, Romaina; Ismail, Noor Hassim; Kaur, Manmeet; Keskinler, Mirac V.; Khatib, Rasha; Kruger, Annamarie; Kruger, Iolanthe M.; Lanas, Fernando; Lear, Scott A.; Li, Wei; Liu, Jia; Lopez-Jaramillo, Patricio; Peer, Nasheeta; Poirier, Paul; Rahman, Omar; Pillai, Rajamohanan K.; Rangarajan, Sumathy; Rosengren, Annika; Swaminathan, Sumathi; Szuba, Andrzej; Teo, Koon; Wang, Yang; Wielgosz, Andreas; Yeates, Karen E.; Yusufali, Afzalhussein; Yusuf, Salim; McKee, Martin.

In: BMJ Global Health, Vol. 2, No. 4, e000443, 01.01.2017.

Research output: Contribution to journalArticle

Palafox, B, Goryakin, Y, Stuckler, D, Suhrcke, M, Balabanova, D, Alhabib, KF, Avezum, A, Bahonar, A, Bai, X, Chifamba, J, Dans, AL, Diaz, R, Gupta, R, Iqbal, R, Ismail, NH, Kaur, M, Keskinler, MV, Khatib, R, Kruger, A, Kruger, IM, Lanas, F, Lear, SA, Li, W, Liu, J, Lopez-Jaramillo, P, Peer, N, Poirier, P, Rahman, O, Pillai, RK, Rangarajan, S, Rosengren, A, Swaminathan, S, Szuba, A, Teo, K, Wang, Y, Wielgosz, A, Yeates, KE, Yusufali, A, Yusuf, S & McKee, M 2017, 'Does greater individual social capital improve the management of hypertension? Cross-national analysis of 61 229 individuals in 21 countries', BMJ Global Health, vol. 2, no. 4, e000443. https://doi.org/10.1136/bmjgh-2017-000443
Palafox, Benjamin ; Goryakin, Yevgeniy ; Stuckler, David ; Suhrcke, Marc ; Balabanova, Dina ; Alhabib, Khalid F. ; Avezum, Alvaro ; Bahonar, Ahmad ; Bai, Xiulin ; Chifamba, Jephat ; Dans, Antonio L. ; Diaz, Rafael ; Gupta, Rajeev ; Iqbal, Romaina ; Ismail, Noor Hassim ; Kaur, Manmeet ; Keskinler, Mirac V. ; Khatib, Rasha ; Kruger, Annamarie ; Kruger, Iolanthe M. ; Lanas, Fernando ; Lear, Scott A. ; Li, Wei ; Liu, Jia ; Lopez-Jaramillo, Patricio ; Peer, Nasheeta ; Poirier, Paul ; Rahman, Omar ; Pillai, Rajamohanan K. ; Rangarajan, Sumathy ; Rosengren, Annika ; Swaminathan, Sumathi ; Szuba, Andrzej ; Teo, Koon ; Wang, Yang ; Wielgosz, Andreas ; Yeates, Karen E. ; Yusufali, Afzalhussein ; Yusuf, Salim ; McKee, Martin. / Does greater individual social capital improve the management of hypertension? Cross-national analysis of 61 229 individuals in 21 countries. In: BMJ Global Health. 2017 ; Vol. 2, No. 4.
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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.",
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AU - Palafox, Benjamin

AU - Goryakin, Yevgeniy

AU - Stuckler, David

AU - Suhrcke, Marc

AU - Balabanova, Dina

AU - Alhabib, Khalid F.

AU - Avezum, Alvaro

AU - Bahonar, Ahmad

AU - Bai, Xiulin

AU - Chifamba, Jephat

AU - Dans, Antonio L.

AU - Diaz, Rafael

AU - Gupta, Rajeev

AU - Iqbal, Romaina

AU - Ismail, Noor Hassim

AU - Kaur, Manmeet

AU - Keskinler, Mirac V.

AU - Khatib, Rasha

AU - Kruger, Annamarie

AU - Kruger, Iolanthe M.

AU - Lanas, Fernando

AU - Lear, Scott A.

AU - Li, Wei

AU - Liu, Jia

AU - Lopez-Jaramillo, Patricio

AU - Peer, Nasheeta

AU - Poirier, Paul

AU - Rahman, Omar

AU - Pillai, Rajamohanan K.

AU - Rangarajan, Sumathy

AU - Rosengren, Annika

AU - Swaminathan, Sumathi

AU - Szuba, Andrzej

AU - Teo, Koon

AU - Wang, Yang

AU - Wielgosz, Andreas

AU - Yeates, Karen E.

AU - Yusufali, Afzalhussein

AU - Yusuf, Salim

AU - McKee, Martin

PY - 2017/1/1

Y1 - 2017/1/1

N2 - 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.

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