Challenges and opportunities for local development initiatives to influence social capital for health promotion purposes: theoretical and empirical support

High levels of social capital in local communities, that is, strong civic engagement, reciprocity norms and trust between community members, are believed to constitute well- functioning, flourishing and healthy environments by promoting collective as well as individual goods. This chapter gives an overview of the relationship between social capital and health, reviews the literature on health effects of area-specific social capital and discusses the challenges and opportunities for local development initiatives to influence social capital for health promotion purposes. Our review indicates that there is strong theoretical and empirical support for a positive effect on health of area-specific social capital. However, a major challenge is the balancing between developments of bonding versus bridging social capital, since too much or ‘negative’ bonding social capital may result in increased social exclusion and distrust and have negative effects on health. For bridging and health-promoting social capital to become mobilized there is a need for strong political will and structural support. Local development initiatives must therefore strive for broad involvement of local people, organizations, politicians and authorities, in a combined top-down and bottom-up approach. The chapter also highlights opportunities for local development initiatives to influence area-level social capital. Investments in the physical environment that facilitate social interactions and safety among residents are essential. Planning and designing attractive meeting places and green areas may increase social capital, as will efforts to improve an area’s reputation. In addition, organizing community activities that are perceived as meaningful and attractive may promote development of supportive social networks. Local associations and activities with a conscious and clear inclusive strategy may specifically facilitate the development of bridging social capital. Such efforts will have the potential to increase participation, social interaction and social connections as well as trust and solidarity between people, and in the long run promote health at area level.