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© 2005 American Public Health Association
DOI: 10.2105/AJPH.2005.075044
LETTER |
Richard M. Carpiano is a Robert Wood Johnson Foundation Health and Society Scholar in the Department of Population Health Sciences, University of Wisconsin, Madison. Brian Kelly is with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, and the Center for HIV Educational Studies and Training, Hunter College, New York.
Correspondence: Requests for reprints should be sent to Richard M. Carpiano, PhD, Department of Population Health Sciences, University of Wisconsin, Madison, 707 WARF Office Bldg, 610 N Walnut St, Madison, WI 53726-2397 (e-mail: carpiano{at}wisc.edu).
Kushner and Sterk1 presented an interesting assessment of whether Durkheim’s Suicide2 should be cited as evidence that low social cohesion yields greater morbidity and mortality—in other words, that lack of "social capital" is detrimental to population health. The authors highlight several crucial issues: enthusiasm for social capital should not overshadow the need for material provisions, public health applications of social capital have been "promiscuous," and social capital is no panacea for societal ills. However, their article raises 2 fundamental issues that present challenges to some of their own conclusions and highlight some of the problems with the use of the social capital construct within public health.
First, in their critique of Durkheim’s typology, the authors quickly dismiss Durkheim’s concern for altruistic and fatalistic suicide resulting from excessive integration. Although downplayed by Durkheim, these components are still pivotal to his thinking on social solidarity. Consequently, Kushner and Sterk ignore Durkheim’s concern for balance, in which levels of social integration achieve an "organic equilibrium" of cohesion and individuality to prevent social pathology.3 The high suicide rates among women and military personnel that Kushner and Sterk cite as evidence of excessive integration leading to suicide actually support Durkheim’s argument that both too little and too much integration can be detrimental.2(p217)
Second, Kushner and Sterk’s article contributes to a tendency within public health to conflate social cohesion and social capital. In their discussion of social capital, the authors, like many in public health, emphasize network ties, norms of reciprocity, and trust—all of which are consistent with Putnam’s conception of social capital4 (the most popular conception of social capital in the field of public health5) and a social cohesion framework6—but ignore the fourth element of social capital: other forms of capital (economic, human, cultural, etc.) within the network itself. Other social capital theorists (e.g., Bourdieu, Coleman) accommodate the need to consider other forms of capital to fully understand how social capital operates within societies.7–9 Although Kushner and Sterk acknowledge that social capital cannot be a substitute for material resources, they nonetheless reinforce the conflation of social capital with social cohesion.
Although Durkheim’s scholarship is flawed (e.g., his conception of gender leans toward biological determinism), his discussion of social solidarity is a stimulating starting point for the study of positive and negative aspects of social cohesion and social capital and their relevance to population health. Certainly, the concept of social capital has Durkheimian—and (often ignored) Marxist9—roots, but would Durkheim view social capital as many within public health do? We are not certain he would.
Acknowledgments
The authors wish to thank Stephanie Robert and Margaret Weden for their helpful comments.
References
1. Kushner HI, Sterk CE. The limits of social capital: Durkheim, suicide, and social cohesion. Am J Public Health. 2005;95:1139–1143.
2. Durkheim E. Suicide. New York, NY: Free Press; 1951.
3. Durkheim E. Division of Labor in Society. New York, NY: Free Press; 1997.
4. Putnam RD. Bowling Alone: The Collapse and Revival of American Community. New York, NY: Simon & Schuster; 2000.
5. Moore S, Shiell A, Hawe P, Haines VA. The privileging of ideas: citation practices and the translation of social capital into public health. Am J Public Health. 2005;95(8):1330–1337
6. Carpiano RM. Toward a neighborhood resource-based theory of social capital for health: can Bourdieu and sociology help? Soc Sci Med. Published online as 10.1016/j.socscimed.2005.05.020.
7. Bourdieu P. The forms of capital. In: Richardson JG, ed. Handbook of Theory and Research for the Sociology of Education. New York, NY: Greenwood Press; 1986:241–258.
8. Coleman JS. Social capital in the creation of human capital. Am J Sociol. 1988;94:S95–S121.
9. Portes A. Social capital: its origins and applications in modern sociology. Annu Rev Sociol. 1998;24:1–24.[CrossRef][Web of Science]
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