Gender differences in the association between cognitive social capital, self-rated health, and depressive symptoms : a comparative analysis of Sweden and Ukraine

Abstract

BACKGROUND: Social capital is one of the social determinants of health, but there is still a lack of studies comparing its significance for health in different cultural settings. This study investigates and compares the relations between individual cognitive social capital and depressive symptoms and self-rated health in Sweden and Ukraine for men and women separately. STUDY DESIGN: Two cross-sectional nationally representative surveys of adult populations were used for the analysis. Data from the Ukraine's World Health Survey and the Sweden's National Public Health Survey were analyzed in this comparative study. METHODS: The independent variable, cognitive social capital, was operationalized as institutional trust and feelings of safety. Depressive symptoms and self-rated health were used as the outcome variables. Crude and adjusted odds ratios and the 95 % confidence intervals were calculated using logistic regression. The model also adjusted for socio-demographic and lifestyle variables. RESULTS: Institutional trust is higher in Sweden compared to Ukraine (31 % of the Swedes vs. 12 % of the Ukrainians reported high trust to their national government/parliament). There is a strong association between self-rated health and institutional trust for both sexes in Sweden (odds ratio/OR = 1.99; 95 % CI = 1.58-2.50 for women and OR = 1.82, CI = 1.48-2.24 for men who reported low institutional trust compared with those with high institutional trust) but only for women (OR = 1.88, CI = 1.12-3.15) in Ukraine. Trust thus seems to be more important for self-rated health of women and men in Sweden compared to their counterparts in Ukraine. Significant associations between depressive symptoms and institutional trust were not observed in either country after adjusting for socio-demographic and lifestyle factors. A lack of feeling of safety increased the odds of having depressive symptoms among women (OR = 1.97, CI = 1.41-2.76) and men (OR = 3.91, CI = 2.19-6.97) in Sweden. The same association was observed for poor self-rated health among Swedish women (OR = 2.15, CI = 1.55-2.99) and men (OR = 2.75, CI = 1.58-4.80). In Ukraine, a lack of feeling of safety did not show any significant association with self-rated health or depressive symptoms for men, but it increased the odds of depressive symptoms among women (OR = 1.72, CI = 1.13-2.62). CONCLUSIONS: In general, individual cognitive social capital is higher in Sweden than in Ukraine, and there is a stronger association between cognitive social capital and self-rated health in Sweden than in Ukraine. Interventions aiming to increase cognitive social capital for health promoting purposes might be favorable in Sweden, but this is not evidently the case in Ukraine.