{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T10:51:16Z","timestamp":1793011876062,"version":"4.5.0"},"reference-count":40,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>While the association between economic connectedness and social mobility has now been documented, the potential linkage between community-level economic connectedness and population health outcomes remains unknown.<\/jats:p><\/jats:sec>Objective<\/jats:title>To examine the association between community social capital measures (defined as economic connectedness, social cohesion, and civic engagement) and population health outcomes (defined across prevalence of diabetes, hypertension, high cholesterol, kidney disease, and obesity).<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This cross-sectional study included communities defined at the zip code tabulation area (ZCTA) level in all 50 US states. Data were collected from January 2021 to December 2022.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Multivariable regression analyses were used to examine the association between population health outcomes and social capital. Adjusted analyses controlled for area demographic variables and county fixed effects. Heterogeneities within the associations based on the racial and ethnic makeup of communities were also examined.<\/jats:p><\/jats:sec>Results<\/jats:title>In this cross-sectional study of 17\u202f800 ZCTAs, across 50 US states, mean (SD) economic connectedness was 0.88 (0.32), indicating friendship sorting on income; the mean (SD) support ratio was 0.90 (0.10), indicating that 90% of ties were supported by a common friendship tie; and the mean (SD) volunteering rate was 0.08 (0.03), indicating that 8% of individuals within a given community were members of volunteering associations. Mean (SD) ZCTA diabetes prevalence was 10.8% (2.9); mean (SD) high blood pressure prevalence was 33.2% (6.2); mean (SD) high cholesterol prevalence was 32.7% (4.2), mean (SD) kidney disease prevalence was 3.0% (0.7), and mean (SD) obesity prevalence was 33.4% (5.6). Regression analyses found that a 1% increase in community economic connectedness was associated with significant decreases in prevalence of diabetes (\u22120.63%; 95% CI, \u22120.67% to \u22120.60%); hypertension (\u22120.31%; 95% CI, \u22120.33% to \u22120.29%); high cholesterol (\u22120.14%; 95% CI, \u22120.15% to \u22120.12%); kidney disease (\u22120.48%; 95% CI, \u22120.50% to \u22120.46%); and obesity (\u22120.28%; 95% CI, \u22120.29% to \u22120.27%). Second, a 1% increase in the community support ratio was associated with significant increases in prevalence of diabetes (0.21%; 95% CI, 0.16% to 0.26%); high blood pressure (0.16%; 95% CI, 0.13% to 0.19%); high cholesterol (0.16%; 95% CI, 0.13% to 0.19%); kidney disease (0.17%; 95% CI, 0.13% to 0.20%); and obesity (0.08%; 95% CI, 0.06% to 0.10%). Third, a 1% increase in the community volunteering rate was associated with significant increases in prevalence of high blood pressure (0.02%; 95% CI, 0.01% to 0.02%); high cholesterol (0.03%; 95% CI, 0.02% to 0.03%); and kidney disease (0.02%; 95% CI, 0.01% to 0.02%). Additional analyses found that the strength of these associations varied based on the majority racial and ethnic population composition of communities.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this study, higher economic connectedness was significantly associated with better population health outcomes; however, higher community support ratios and volunteering rates were both significantly associated with worse population health. Associations also differed by majority racial and ethnic composition of communities.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.31087","type":"journal-article","created":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T15:36:13Z","timestamp":1692977773000},"page":"e2331087","source":"Crossref","is-referenced-by-count":22,"title":["Community Social Capital and Population Health Outcomes"],"prefix":"10.1001","volume":"6","author":[{"given":"Sebastian","family":"Linde","sequence":"first","affiliation":[{"name":"Medical College of Wisconsin, Department of Medicine, Division of General Internal Medicine, Milwaukee"},{"name":"Center for Advancing Population Sciences, Medical College of Wisconsin, Milwaukee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard E.","family":"Egede","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin, Department of Medicine, Division of General Internal Medicine, Milwaukee"},{"name":"Center for Advancing Population Sciences, Medical College of Wisconsin, Milwaukee"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2023,8,25]]},"reference":[{"issue":"1","key":"zoi230897r8","doi-asserted-by":"publisher","first-page":"1990","DOI":"10.1186\/s12889-021-12009-8","article-title":"The association between obesity and quality of life: a retrospective analysis of a large-scale population-based cohort study.","volume":"21","author":"Stephenson","year":"2021","journal-title":"BMC Public Health"},{"issue":"8","key":"zoi230897r9","doi-asserted-by":"publisher","first-page":"2081","DOI":"10.1007\/s11136-019-02173-1","article-title":"The impact of progressive chronic kidney disease on health-related quality-of-life: a 12-year community cohort study.","volume":"28","author":"Wyld","year":"2019","journal-title":"Qual Life Res"},{"issue":"9","key":"zoi230897r10","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1001\/jama.2020.0734","article-title":"US health care spending by payer and health condition, 1996-2016.","volume":"323","author":"Dieleman","year":"2020","journal-title":"JAMA"},{"issue":"1","key":"zoi230897r12","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1111\/obr.v20.1","article-title":"Neighbourhood social capital and obesity: a systematic review of the literature.","volume":"20","author":"Carrillo-\u00c1lvarez","year":"2019","journal-title":"Obes Rev"},{"key":"zoi230897r14","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2019.112360","article-title":"Social capital and physical health: An updated review of the literature for 2007-2018.","volume":"236","author":"Rodgers","year":"2019","journal-title":"Soc Sci Med"},{"issue":"21","key":"zoi230897r15","doi-asserted-by":"publisher","first-page":"2249","DOI":"10.1056\/NEJMsa0706154","article-title":"The collective dynamics of smoking in a large social network.","volume":"358","author":"Christakis","year":"2008","journal-title":"N Engl J Med"},{"issue":"11","key":"zoi230897r16","doi-asserted-by":"publisher","first-page":"2170","DOI":"10.2105\/AJPH.2011.300282","article-title":"Social network concordance in food choice among spouses, friends, and siblings.","volume":"101","author":"Pachucki","year":"2011","journal-title":"Am J Public Health"},{"issue":"7","key":"zoi230897r17","doi-asserted-by":"publisher","first-page":"426","DOI":"10.7326\/0003-4819-152-7-201004060-00007","article-title":"The spread of alcohol consumption behavior in a large social network.","volume":"152","author":"Rosenquist","year":"2010","journal-title":"Ann Intern Med"},{"issue":"6","key":"zoi230897r18","doi-asserted-by":"publisher","first-page":"1895","DOI":"10.1093\/ije\/dyu212","article-title":"Social capital, mortality, cardiovascular events and cancer: a systematic review of prospective studies.","volume":"43","author":"Choi","year":"2014","journal-title":"Int J Epidemiol"},{"key":"zoi230897r19","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.socscimed.2013.02.007","article-title":"The relationship between five different measures of structural social capital, medical examination outcomes, and mortality.","volume":"85","author":"Muennig","year":"2013","journal-title":"Soc Sci Med"},{"issue":"11","key":"zoi230897r20","doi-asserted-by":"publisher","first-page":"2092","DOI":"10.2105\/AJPH.2007.114348","article-title":"The effect of widowhood on mortality by the causes of death of both spouses.","volume":"98","author":"Elwert","year":"2008","journal-title":"Am J Public Health"},{"issue":"7","key":"zoi230897r21","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1056\/NEJMsa050196","article-title":"Mortality after the hospitalization of a spouse.","volume":"354","author":"Christakis","year":"2006","journal-title":"N Engl J Med"},{"key":"zoi230897r22","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.socscimed.2016.02.001","article-title":"Double-jeopardy: the joint impact of neighborhood disadvantage and low social cohesion on cumulative risk of disease among African American men and women in the Jackson Heart Study.","volume":"153","author":"Barber","year":"2016","journal-title":"Soc Sci Med"},{"key":"zoi230897r23","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1016\/j.ypmed.2017.11.028","article-title":"Social capital and obesity among adults: longitudinal findings from the Montreal neighborhood networks and healthy aging panel.","volume":"111","author":"Wu","year":"2018","journal-title":"Prev Med"},{"issue":"12","key":"zoi230897r24","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1111\/josh.12213","article-title":"School social capital and body mass index in the National Longitudinal Study of Adolescent Health.","volume":"84","author":"Richmond","year":"2014","journal-title":"J Sch Health"},{"issue":"4","key":"zoi230897r25","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1056\/NEJMsa066082","article-title":"The spread of obesity in a large social network over 32 years.","volume":"357","author":"Christakis","year":"2007","journal-title":"N Engl J Med"},{"issue":"1","key":"zoi230897r26","first-page":"99","article-title":"Identifying the social capital influencing diabetes control in Japan.","volume":"80","author":"Yamada","year":"2018","journal-title":"Nagoya J Med Sci"},{"issue":"6","key":"zoi230897r27","doi-asserted-by":"publisher","first-page":"1312","DOI":"10.20960\/nh.776","article-title":"Relationship between social support networks and diabetes control and its impact on the quality of life in older community-dwelling Mexicans.","volume":"33","author":"Mendoza-N\u00fa\u00f1ez","year":"2016","journal-title":"Nutr Hosp"},{"issue":"6","key":"zoi230897r28","doi-asserted-by":"publisher","first-page":"1309","DOI":"10.1007\/s10903-015-0308-8","article-title":"Neighborhood social cohesion and prevalence of hypertension and diabetes in a South Asian population.","volume":"18","author":"Lagisetty","year":"2016","journal-title":"J Immigr Minor Health"},{"issue":"7921","key":"zoi230897r29","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1038\/s41586-022-04996-4","article-title":"Social capital I: measurement and associations with economic mobility.","volume":"608","author":"Chetty","year":"2022","journal-title":"Nature"},{"issue":"7921","key":"zoi230897r30","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1038\/s41586-022-04997-3","article-title":"Social capital II: determinants of economic connectedness.","volume":"608","author":"Chetty","year":"2022","journal-title":"Nature"},{"key":"zoi230897r31","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssmph.2019.100425","article-title":"Social capital and health: a systematic review of systematic reviews.","volume":"8","author":"Ehsan","year":"2019","journal-title":"SSM Popul Health"},{"issue":"8","key":"zoi230897r34","doi-asserted-by":"publisher","first-page":"1025","DOI":"10.1093\/aje\/kwu018","article-title":"Multilevel regression and poststratification for small-area estimation of population health outcomes: a case study of chronic obstructive pulmonary disease prevalence using the behavioral risk factor surveillance system.","volume":"179","author":"Zhang","year":"2014","journal-title":"Am J Epidemiol"},{"issue":"4","key":"zoi230897r35","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1007\/s40615-020-00844-1","article-title":"Prevalence of comorbidities and risks associated with COVID-19 among Black and Hispanic populations in New York City: an examination of the 2018 New York City Community Health Survey.","volume":"8","author":"Arasteh","year":"2021","journal-title":"J Racial Ethn Health Disparities"},{"issue":"8","key":"zoi230897r36","doi-asserted-by":"publisher","first-page":"768","DOI":"10.1056\/NEJMms2025396","article-title":"How structural racism works\u2014racist policies as a root cause of US racial health inequities.","volume":"384","author":"Bailey","year":"2021","journal-title":"N Engl J Med"},{"issue":"24","key":"zoi230897r37","doi-asserted-by":"publisher","first-page":"2389","DOI":"10.1001\/jama.2019.19365","article-title":"Prevalence of diabetes by race and ethnicity in the United States, 2011-2016.","volume":"322","author":"Cheng","year":"2019","journal-title":"JAMA"},{"issue":"1","key":"zoi230897r38","doi-asserted-by":"publisher","first-page":"258","DOI":"10.2337\/dci20-0053","article-title":"Social determinants of health and diabetes: a scientific review.","volume":"44","author":"Hill-Briggs","year":"2020","journal-title":"Diabetes Care"},{"issue":"1","key":"zoi230897r39","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.51201","article-title":"Association of neighborhood racial and ethnic composition and historical redlining with built environment indicators derived from street view images in the US.","volume":"6","author":"Yang","year":"2023","journal-title":"JAMA Netw Open"},{"issue":"2","key":"zoi230897r40","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1016\/j.jacc.2022.05.010","article-title":"Historical neighborhood redlining and contemporary cardiometabolic risk.","volume":"80","author":"Motairek","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"zoi230897r13","doi-asserted-by":"crossref","DOI":"10.1093\/acref\/9780199976720.001.0001","volume-title":"A Dictionary of Epidemiology","author":"Porta","year":"2014"},{"key":"zoi230897r1","unstructured":"Centers for Disease Control and Prevention (CDC). PLACES: local data for better health. Accessed September 15, 2022. https:\/\/www.cdc.gov\/places\/index.html"},{"key":"zoi230897r2","unstructured":"Centers for Disease Control and Prevention (CDC). National state diabetes trends. Accessed July 11, 2023. https:\/\/www.cdc.gov\/diabetes\/library\/reports\/reportcard\/national-state-diabetes-trends.html"},{"key":"zoi230897r3","unstructured":"Centers for Disease Control and Prevention (CDC). Adult obesity facts. Accessed July 11, 2023. https:\/\/www.cdc.gov\/obesity\/data\/adult.html"},{"key":"zoi230897r4","unstructured":"Centers for Disease Control and Prevention (CDC). Hypertension prevalence among adults aged 18 and over: United States, 2017-2018. Accessed July 11, 2023. https:\/\/www.cdc.gov\/nchs\/products\/databriefs\/db364.htm"},{"key":"zoi230897r5","unstructured":"Centers for Disease Control and Prevention (CDC). Kidney disease surveillance system. Accessed July 11, 2023. https:\/\/nccd.cdc.gov\/CKD\/default.aspx"},{"key":"zoi230897r6","unstructured":"Centers for Disease Control and Prevention (CDC). Health and economic costs of chronic diseases. Accessed July 11, 2023. https:\/\/www.cdc.gov\/chronicdisease\/about\/costs\/index.htm"},{"key":"zoi230897r7","unstructured":"Centers for Disease Control and Prevention (CDC). Chronic diseases in America. Accessed July 11, 2023. https:\/\/www.cdc.gov\/chronicdisease\/resources\/infographic\/chronic-diseases.htm"},{"key":"zoi230897r11","unstructured":"Healthy People 2030. Social determinants of health. Accessed July 11, 2023. https:\/\/health.gov\/healthypeople\/priority-areas\/social-determinants-health"},{"key":"zoi230897r32","unstructured":"Opportunity Insights. Social capital and economic mobility. Accessed September 15, 2022. https:\/\/opportunityinsights.org"},{"key":"zoi230897r33","unstructured":"Agency for Healthcare Research and Quality (AHRQ). Social determinants of health database. Accessed September 15, 2023. https:\/\/www.ahrq.gov\/sdoh\/data-analytics.html"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2808751\/linde_2023_oi_230897_1692305832.39939.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T15:36:24Z","timestamp":1692977784000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2808751"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,25]]},"references-count":40,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2023,8,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2023.31087","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,25]]}}}