Linking social capital and mortality in the elderly: a Swedish national cohort study.

OBJECTIVES Our objective was to examine the association between neighborhood linking social capital (a concept describing the amount of trust between individuals and societal institutions) and all-cause and cause-specific mortality in the elderly. DESIGN The entire Swedish population aged 65+, a total of 1,517,336 men and women, was followed from 1 January 2002 until death, emigration, or the end of the study on 31 December 2010. Small geographic units were used to define neighborhoods. The definition of linking social capital was based on neighborhood voting participation rates, categorized into three groups. Multilevel logistic regression was used to estimate odds ratios (ORs) and between-neighborhood variance in three different models. RESULTS The results showed an overall association between linking social capital and all-cause mortality. The significant OR of 1.53 in the group with low linking social capital decreased, but remained significant (OR=1.27), after accounting for age, sex, family income, marital status, country of birth, education level, and region of residence. There were also significant associations between linking social capital and cause-specific mortality in coronary heart disease, psychiatric disorders, cancer, stroke, chronic lower respiratory diseases, type 2 diabetes, and suicide. CONCLUSION There are associations between low linking social capital and mortality from chronic disorders and suicide in the elderly population. Community support for elderly people living in neighborhoods with low levels of linking social capital may need to be strengthened.