Social capital's association with self-reported health outcomes in the rural south: variations by demographic subgroup.

Background: Limited information is known about how social capital is associated with self-reported measures of health in rural settings. Even less is known about how these associations may vary within demographic subgroups. While a large body of research demonstrates that social capital is associated with a variety of health outcomes, additional knowledge is needed to create appropriate interventions for rural communities in the United States. Methods: A mail-in population-level survey was conducted across six counties in the rural southern United States as part of a broader health equity initiative. Multivariable logistic regression models were run to assess how five domains of social capital (trust, diversity of interaction, reciprocity, civic engagement and voting behaviors) were associated with health status, physical distress and mental distress. Results: Social capital domains were positively associated with good health status, infrequent physical distress (defined as <14 days per month) and infrequent mental distress (defined as <14 days per month) for most subgroups. However, there were little to no significant findings among Black individuals and young adults. Conclusions: These findings suggest that social capital may not operate equally across demographic subgroups, particularly for Black individuals and young adults. Social capital may not be related for some subgroups and domains, or new measures may need to be developed to better represent how social capital operates. Public health practitioners should be particularly attuned to these groups as social capital interventions are trialed in rural communities.