Although most countries in the European Union are richer and healthier than ever, health inequalities remain an important public health challenge. Health-related problems and premature death have disproportionately been reported in disadvantaged neighbourhoods. Neighbourhood social capital is believed to influence the association between neighbourhood deprivation and health in children and adolescents, making it a potentially interesting concept for policymakers.

Social capital has been related to various aspects of health. While literature suggests that men and women differently access and mobilize social capital, gender has received little attention within social capital research. This study examines whether the association between individual social capital and psychological distress is different for men and women. We made use of data from a representative sample of 1025 adults within 50 neighbourhoods of Ghent (Belgium), collected in the context of the cross-sectional Social capital and Well-being In Neighbourhoods in Ghent (SWING) Survey 2011. Six components of social capital were discerned: generalized trust, social support, social influence, social engagement and attachment, the volume of social capital and the mean occupational prestige in one’s network. Multilevel linear regression models were fitted to explore interactions between gender and these components of social capital. In accordance with previous research, men report lower levels of psychological distress than women (t = 4.40, p < 0.001). Regarding the gender gap in social capital, the findings are mixed. Only for half of the social capital variables (social support, social influence and volume of social capital), a significant gender difference is found, favouring men (t = 4.03, p < 0.001; t = 1.99, p < 0.001 and t = 4.50, p < 0.001 respectively). None of the analysed interaction terms between gender and social capital is significantly related to psychological distress. The analyses indicate that the association between individual social capital and psychological distress is similar for men and women. The relatively low level of gender stratification in Belgium might have influenced this finding. Furthermore, it is possible that social capital is not of greater importance for women in general, but mainly for women who are in an especially vulnerable social situation that deprives their access to alternative resources (e.g. unemployed women, single mothers). Future studies should seek to identify subgroups for whom social capital might be particularly influential, by transcending ‘simple’ dyads such as ‘men versus women’.

Little research has focused on the spatial distribution of social capital, despite social capital’s rising popularity in health research and policy. This study examines the neighborhood differences in social capital and the determinants that explain these differences.

Employing a multilevel perspective on the health effects of social capital, this study analyzes how individual and neighborhood differences in self-rated health in Ghent (Belgium), relate to individual and collective social mechanisms, when taking demographic and socioeconomic characteristics of individuals into account. This study estimates the health effects of social trust, informal social control and disorder at the neighborhood level and social support and network size at the individual level, using indicators indebted to both the normative and resource-based approaches to social capital. Instead of the mere aggregation of individual indicators of social capital, this study uses the key informant technique as a methodologically superior measurement of neighborhood social capital, which combined with a multilevel analysis strategy, allows to disentangle the health effects of individual and neighborhood social capital. The analysis highlights the health benefits of individual social capital, i.e., individual social support and network size. The study indicates that controlling for individual demographic and socioeconomic characteristics reduces the effect of the neighborhood-level counterparts and the neighborhood characteristics social trust and neighborhood disorder have significant, but small health effects. In its effects on self-rated health, social capital operates on the individual level, rather than the neighborhood level.

Investing in social capital has been put forth as a potential lever for policy action to tackle health inequity. Notwithstanding, empirical evidence that supports social capital’s role in the existence of health inequity is limited and inconclusive. Furthermore, social capital literature experiences important challenges with regard to (1) the level on which social capital is measured and analyzed; (2) the measurement of the concept in line with its multidimensional nature; and (3) the cross-cultural validity of social capital measurements. The Social capital and Well-being In Neighborhoods in Ghent (SWING) study is designed to meet these challenges. The collected data can be used to investigate the distribution of health problems and the association between social capital, health and well-being, both at the individual and at the neighborhood level. The main goals of the SWING study are (1) to develop a coherent multilevel dataset of indicators on individual and neighborhood social capital and well-being that contains independent indicators of neighborhood social capital at a low level of aggregation and (2) to measure social capital as a multidimensional concept. The current article describes the background and design of the SWING study. The SWING study started in 2011 and data were collected in three cross-sectional waves: the first in 2011, the second in 2012, and the third in 2013. Data collection took place in 142 neighborhoods (census tract level) in the city of Ghent (Flanders, Belgium). Multiple methods of data collection were used within each wave, including: (1) a standardized questionnaire, largely administered face-to-face interviews for neighborhood inhabitants (N = 2,730); (2) face-to-face interviews with key informants using a standardized questionnaire (N = 2,531); and (3) an observation checklist completed by the interviewers (N = 2,730 in total). The gathered data are complemented by data available within administrative data services. The opportunities and ambitions of the SWING study are discussed, together with the limitations of the database.

Background: In order to address the challenges of an ageing population the Belgian government decided to allocate resources to the creation of geriatric day hospitals (GDHs). Although GDHs are meant to be a strategy to support general practitioners (GPs) caring for the frail elderly, few Belgian GPs seem to refer to a GDH. This study aims to explore the barriers and facilitating factors of GPs' referral to GDHs.Methods: A qualitative study using focus group discussions (FGDs) was conducted. Fifteen FGDs were organized in the different Belgian regions (Flanders, Wallonia, Brussels).Results: Contextual factors such as the unsatisfactory cooperation between hospital and GPs and organizational barriers such as the lack of communication on referral procedures between hospital and primary health care (PHC) were identified. Lack of basic knowledge about the concept or the local organization of GDH seemed to be a problem. Unclear task descriptions, responsibilities and activities of a GDH formed prominent points of discussion in all FGDs. Nevertheless a lot of possible advantages and disadvantages of GDHs for the patient and for the GP were mentioned.Conclusions: In the case of poor referral to GDHs, focusing on improving overall collaboration between primary and secondary health care is essential. This can be achieved by actively delivering adequate information, permanent communication and more involvement of PHC in the organization and functioning of GDHs. The absence of a transparent health care system with delineated role definitions, seems to hinder the integration of new initiatives like GDHs in the care process. Strategies to enhance referral to GDHs should use a comprehensive approach.