Social Capital at School and Healthrisk Behaviors among Adolescents
Minoru Takakura
School of Health Sciences, University of the Ryukyus
Social Capital and Well-being in Okinawa and Japan from the Perspectives of the Life Course
2014 EWC/EWCA International Conference in Okinawa
September 19, 2014
Kaneohe, Pacific Hotel Okinawa

Background Since health-risk behaviors such as tobacco and alcohol

use are often established during youth, preventativeinterventions at an early stage are needed.
 To develop effective intervention programs,
understanding the determinants of health-risk behaviors
is important.
 In recent years, particular interests in public health are
the effects of social determinants of health and healthrelated behaviors.
 This study focuses on social capital as a potential social
determinant of health-risk behaviors.

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Background
Although different definitions of social capital have been
proposed, most of them generally define it as “resourcescomposed of or derived from trust, and/or norms, and/ornetworks, which facilitate collective actions” (Inaba 2013).
 Social capital includes structural components such as networkand social participation, and cognitive components such astrust and norms. These components are treated both as anindividual attribute and/or a group attribute.
 Several systematic reviews have suggested that higher
individual-level social capital with both cognitive andstructural components has mostly positive associations withgood health outcomes. However, associations between
contextual-level social capital and health outcomes wereinconclusive (Kim et al. 2008; De Silva et al. 2005; Lindström 2008).
3

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Why social capital research in school?
School as a well-defined entity

Students spend most of their daytime hours at school.
 Schools is the main place where students interact with theirfriends and teachers, and this may be important for students’social support systems.
 Schools also can be a particularly important context for setting
norms and values that may affect students’ health and healthrelated behaviors.


School is plausibly an important place to generate social
capital for students.
 Although investigations of social capital and youth health havebeen increasing, few studies have used school as a reference
area unit to examine social capital for students.
4M TakakuraThe purpose of this study
 To examine the effects of cognitive social capital at boththe individual and school level on health-risk behaviors,such as cigarette and alcohol use, by measuring aggregate
student responses to generalized trust (i.e., social trust)in Japanese high school students.

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Data We conducted a cross-sectional survey in 2008, using aself-administered anonymous questionnaire to obtain awide range of health, sociodemographic, andpsychosocial information from students.
 The study sample consisted of 3,248 students in grades10 through 12 (aged 15-18 years) enrolled in 29 publichigh schools selected from across Okinawa, with aprobability proportional to the number of schools.

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Measures
Health-risk behaviors (adapted Youth Risk Behavior Survey)Current cigarette use (students who smoked cigarettes at least one day
in the past month before the survey)Current alcohol use (students who consumed an alcoholic beverage atleast one day in the past month before the survey)

Cognitive social capital at the individual level was measured bya generalized trust question.

“Generally speaking, would you say most people can be trusted?”

“Yes” and “It depends” responses as high trust and “No” as low trust.

Cognitive social capital at the contextual level was measured
by aggregated school-level individual responses.

7

We calculated the proportion of students in each school whoresponded high trust.

M Takakura Covariates

Several sociodemographic factors shown to be potential
confounders served as control variables.
 Grade, school type (general or vocational), school location(urban or rural), family structure (living with both parents orother), parent’s educational level, and municipal unemploymentrate (neighborhood-level socioeconomic status).

 Data analysis8

Due to the hierarchical nature of the data, a multilevel
logistic regression model was performed, separately bygender.

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Prevalence of current cigarette use bysociodemographic variable
40%

Total 8.6%

35%
30%
25%
20%
15%
n.s.

10%
5%
0%

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Prevalence of current alcohol use bysociodemographic variable
40%

Total 20.1%

35%
30%
25%

n.s.

20%
15%
10%5%0%

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Ecological relations between cognitive social capitaland current cigarette and alcohol at the school level

r＝-.478, n=29

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r＝-.328, n=29

Associations of individual- and contextual-levelsocial capital with current cigarette use
School level
Low social capital (X1)
Covariates (X2)

Unemployment rate of neighborhood

Individual level
Low social capital (x1)
Covariates (x2..n)OR=2.0

Grade, school type, school location,family structure, parental education level

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Current cigarette use (y)Associations of individual- and contextual-levelsocial capital with current alcohol use
School level
Low social capital (X1)
Covariates (X2)

Unemployment rate of neighborhood

Individual level
Low social capital (x1)
Covariates (x2..n)OR=1.5

Grade, school type, school location,family structure, parental education level

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Current alcohol use (y)Students with low trust could notreceive social support, and would be
more likely to adopt unhealthy coping
behaviors.

Associations of individual- and contextual-levelsocial capital with current cigarette use
Holding constant a student’s own levelof social trust, students attending
schools where students overall tend totrust in other people are less likely tosmoke, but this association was notstatistically significant.

School level
Low social capital (X1)
Covariates (X2)

Unemployment rate of neighborhood

OR=1.3 [n.s.]Contextual effects ?

Individual level
Low social capital (x1)
Covariates (x2..n)OR=2.0

Grade, school type, school location,family structure, parental education level

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Current cigarette use (y)Associations of individual- and contextual-levelsocial capital with current alcohol use
Adolescent drinking is more tolerated inJapanese society. If drinking alcohol
can be regarded as being sociallyacceptable, the contextual effects ofsocial capital at school on adolescentdrinking via norm regulation and othersocial controls may be attenuated.

School level
Low social capital (X1)
Covariates (X2)

Unemployment rate of neighborhood

OR=1.1 [n.s.]Contextual effects ×

Individual level
Low social capital (x1)
Covariates (x2..n)OR=1.5

Grade, school type, school location,family structure, parental education level

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Current alcohol use (y)Conclusion
This study demonstrated the individual effect of social trust on thelevels of cigarette and alcohol use among Japanese high school
students.
 This study suggests a contextual effect of social trust at school level
on levels of cigarette use, but the association is inconclusive because
it did not reach statistical significance.
 There was also no association between contextual-level trust andalcohol use.
 This study expands the research on social capital and health inneighborhoods to schools, and provides important implications forschool health promotion strategies. Our findings suggest that highlevels of cognitive social capital at schools are crucial when
implementing school-based smoking prevention interventions.
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Thank you for your attention

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