|
Volume CXXXI, Number 24 |
 |
Health: for and from the people
JEFF BENSON, M.D.
Dear Students:
I've written each week about a variety of health problems
and concerns. Most of what I've written has aimed to inform and advise
you as individuals, making your own choices and seeking your own well-being.
Some has touched on our need to look out for each other, to help support
each other, as members of a common community. The health benefits of community
building, however, may far exceed this kind of one-on-one support.
Social scientists have long known that social cohesion is
a critical determinant of public health. Emile Durkheim, for instance,
compared suicide statistics in European countries over time, and concluded
that the lowest rates of suicide consistently occurred in societies exhibiting
the highest degrees of social integration.
More recently, case studies like Stewart Wolf's of the small
town of Roseto, PA, have shown that social cohesion can have a remarkable
effect on a variety of public health outcomes. Wolf found that until the
early 1960s, the Rosetans smoked as much as their neighbors, were just
as overweight and sedentary, consumed the same high-fat diets, but had
a 50 percent lower mortality rate from heart disease. The only features
that seemed to distinguish Roseto from neighboring towns were unusually
close family ties and cohesive community relationships. Roseto had more
than 2 1/2 times the number of civic associations per capita than its
neighbors, and most of them were locally-based, not branches of national
groups. By the mid-1960s, however, people began to look outside of Roseto
for work, and community group memberships began to decline. Older community
ways were gradually replaced by more modern behaviors. Most interesting,
homes in Roseto, which had always been built with porches facing the street,
were now built with porches at the back, overlooking private yards. By
the 1980's, Roseto's heart attack rate was exactly the same as its neighbors.
Public health researchers like Ichiro Kawachi study the relationship between "social capital" and individual health. Social capital consists of those features of social organization which bring people together for mutual benefit. It includes everything from a community's density of associational memberships, to levels of interpersonal trust and norms of reciprocity.
Kawachi has found that variations in these indicators of
social capital correlate strongly with mortality rates. In fact, a 10
percent increase in a community's sense of mutual trust is associated
with a 9 percent lower level of overall mortality!
Many of us here at Bowdoin are seeking to build a stronger
sense of community, to find ways to reach out to each other, to understand
and support each other. The more respect and concern we show one another,
and the more we are able to build a sense of trust and social obligation
amongst ourselves, then the greater will be our community's social capital
as well as our own individual well-being. There is much to learn, much
to be done, and much to gain, here, under the Pines.
Good luck to you all with papers and exams!
Take good care of yourselves. Have wonderful summers. And see you in the Fall!
Jeff Benson, M.D.
Dudley Coe Health Center