Contextual effects of social integration and disintegration on health status: evidence from South Korea

BACKGROUND: Many studies have shown that various social integration variables represented by social capital are beneficial to communities, including collective health. However, the rapid decline in fertility rates and the breakup of familyism in developed countries require a new approach to social disintegration, but the literature is insufficient. Here, we explored the contextual effects of social integration and social disintegration on the health of individuals. METHODS: The research data consist of merged datasets of 6909 respondents who were quota-sampled by approximately 30 people from 229 local governments in Korea. The individual-level independent variable is a social integration measure consisting of 26 questions in four areas. The community-level independent variables are five integral and aggregate variables extracted from 81 indicators. The dependent variable is self-rated health status. Potential confounders are gender, age, annual income, educational attainment, district type, and the number of beds in medical institutions per 1000 people. RESULTS: The results showed that at the individual level, the higher the inclusive attitude of in- and out-of-networks, after adjusting for potential confounders, the less likely the respondent belongs to the unhealthy group (p < 0.001). At the community level, the higher the proportion of single-person households in a community after adjusting for potential confounders, the less likely the respondent belongs to the unhealthy group (p < 0.05). The effect size was 0.22. CONCLUSION: Thus far, social integration has been preferred, with the positive aspects of social capital being emphasized. However, this study shows that in some cases, social disintegration can instead positively influence an individual’s health. Therefore, further studies of the various conditions of social context effects on health are necessary.