Social Cohesion and Health

J. Lavis and Greg Stoddart

Department of Economics Working Papers from McMaster University

Abstract: More social cohesion has been posited to lead to "more" health; less social cohesion has been posited to lead to "less" health. As well, government performance may influence or be influenced by both social cohesion and health. After defining each of these constructs, we describe changes in measures of these constructs over time (between 1981 and 1990) in Canada, the individual-level factors that are associated with high levels of these measures in Canada, and how these levels compare with those in other G7 countries. We then develop a conceptual framework within which relationships between social cohesion and health can be considered and present the results of new empirical research regarding these relationships in G7 countries. Finally, we synthesize and critically appraise empirical research to inform discussions about the strength of some of these relationships, specifically those involving selected pathways through the determinants of health. We conclude that social cohesion can have significant health consequences (through, for example, known health determinants like income distribution, employment and working conditions, and social support) and that the concepts related to social cohesion don't need reconciliation so much as they need links to the "right" policy environment.

Date: 1999-10
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