A multilevel analysis of association between neighborhood social capital and depression: evidence from the first South African National Income Dynamics Study.

BACKGROUND: As neuropsychiatric disorders account for a great proportion of the total burden of disease in sub-Saharan Africa, depression is rapidly emerging as a public health issue in South Africa. Given the divisions enforced by a legacy of the apartheid spatial and economic policies, features of communities such as neighborhood-level social capital may play a critical role in depression. However, the extent to which neighborhood-level social capital is associated with depression in South Africa at the population-level is unknown.

METHODS: Data from the first wave of the South African National Income Dynamics Study (SA-NIDS) was used to examine the association between the neighborhood-level social capital and individual depression using multilevel regression models.

RESULTS: There was a negative association between neighborhood-level social capital and depression score with social trust and neighborhood preference accounting for this association. Structural social capital, namely civic participation, was not related to depression. Individual predictors, including social class, self-rated health status and education, were strong covariates of depression.

LIMITATIONS: The cross-sectional design of the study limits our understanding of the temporal order of social capital and depression.

CONCLUSIONS: In post-apartheid South Africa, low social capital remains an important social determinant of health, including depression outcome. This is in addition to individual determinants related to class such as unemployment, education and social class which play an important role in influencing depression. Further research utilizing a longitudinal study design is warranted to examine the association between social capital and depression in South Africa.