The Role of Community Social Capital in Reducing the Prevalence of Serious Mental Illness
- Presenter:
Chair: Richard Scheffler; Discussant: Chris Seplaki Mon June 5, 2006 15:30-17:00 Room 313
Authors: Richard M. Scheffler (rscheff@berkeley.edu) and Timothy T. Brown (tbpetris@berkeley.edu, Nicholas C. Petris Center on Health Care Markets and Consumer Welfare, School of Public Health, University of California at Berkeley.
Title: The Role of Community Social Capital in Reducing the Prevalence of Serious Mental Illness.
Rationale. Community social capital has been theorized to positively affect individual mental health through its effects on information flows and social norms regarding social support. However, three recent reviews of this topic have found that the research literature to date suffers from methodological weaknesses.
Objectives: The objective of this paper is to estimate the association of community social capital on the likelihood of an individual suffering from serious mental illness.
Methodology: We estimate a mental health production function focusing on the association of community-level social capital (CSC) and serious mental illness. We use a new validated measure of community-level social capital, the Petris Social Capital Index, which is based on an actual ecological measure of CSC rather than on an aggregation of individual survey responses. We measure CSC at the level of the Metropolitan Statistical Area (MSA) in order to capture the effects of CSC in both the areas of an individual’s residence and employment. Our measure of serious mental illness is a reliable and valid indicator of serious mental illness: the Kessler K6. We link our measure of CSC to individual-level data on 48,222 adults in 48 MSAs for the years 1999-2001 and control for individual-level demographics, individual-level social capital, and MSA-level fixed effects. Lagged CSC is used rather than contemporaneous CSC in order to avoid endogeneity. We test contemporaneous individual-level social capital (ISC) for endogeneity, using instrumental variables and include tests that show the strength and exogeneity of our instruments. All estimates are conducted using linear probability models and sensitivity tests are conducted estimating the same specifications using probit models.
Results: We find that the level of CSC is inversely related to the probability of an individual having serious mental illness. However, CSC is subject to strong diminishing returns and only has an effect for the bottom quartile of individuals who live in those MSAs with the lowest levels of CSC. The effect was also only found when including MSA-level fixed effects, indicating the presence of strong omitted variable bias when MSA-level fixed effects are not included.
Conclusions: Community social capital is potentially an important environmental mediator of serious mental illness.
Disclosure information: This research was supported by the Center for Health Research at the University of California at Berkeley and the Centers for Disease Control and Prevention, Atlanta, GA through Cooperative Agreement Number U48/cCU 909706. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention. The authors are employees of the University of California at Berkeley and have no conflict of interest with regard to this project.
