The influence of social capital on health in Eight Former Soviet Countries: why does it differ?

Background: Previous research has identified the role of social capital in explaining variations in health in the countries of the former Soviet Union. We explore whether the benefits of social capital vary among these countries and why. Methods: We estimate the impact of micro social capital (trust, membership and social isolation) on individual health in each of eight former Soviet republics using instrumental variables to overcome methodological hazards such as endogeneity and reverse causality. We examine interactions with institutional variables (voice and accountability; effectiveness of the legal system; informal economy) and social protection variables (employment protection; old age and disability benefits; sickness and health benefits). Results: Most social capital indicators, in most countries, are associated with better health but the magnitude and significance of the impact differ between countries. Some of this variation can be explained by interacting social capital indicators with measures of institutional quality, with membership of organisations bringing greater benefit for health in countries where civil liberties are stronger, whereas social isolation has more adverse consequences where there is a large informal economy. A lesser amount is explained by the interaction of social capital indicators with selected measures of social protection. Conclusion: When considering interventions to improve social capital as a means of improving population health, it seems advisable to take into account the influence of macro contextual variables, in order not to over- or understate the likely impact of the intervention