Do Societal Ties Matter? the Role of Associational Participation in Shaping Health and Health Inequalities in Advanced Welfare States

Health inequalities are shaped by various individual and societal level factors. Researchers have long recognized the importance of individual social position in shaping health outcomes and increasingly look to macro-level factors, including social policies, to explain health outcomes and inequalities. At the micro-level, the focus has been on various factors, including social location, social capital, and lifestyle choices. At the macro-level, we have often looked at the welfare state as a key institution in shaping inequalities. While both streams of research are important, they do not capture the interaction between individuals and society in determining health and health inequalities. In this paper, our main interest is on whether and how individuals are tied to society through their participation in various voluntary associations (e.g. religious, civil, or political) and whether the impact of such social capital varies by the type of welfare state. Using data from the World Values Surveys and the European Values Study, combined with national-level indicators for the welfare state, we test the impact of organizational OR associational participation on health and health inequalities in advanced, industrialized nations. We use Hierarchical Linear Modeling to evaluate how the welfare state and organizational OR associational participation impact health and health inequalities, with a focus on whether participation matters more in certain kind of welfare states. Our preliminary results indicate that participation in voluntary associations may matter more for health in weaker welfare states, possibly compensating for the positive health effects that a more encompassing welfare state may provide. This line of research highlights the importance of moving beyond an understanding of macro-level indicators of health toward an approach that evaluates how individuals are embedded in a specific welfare context and how this interaction impacts health and health inequalities.