Bridging the Divide: Does Social Capital Moderate the Impact of Polarization on Health?

Published date01 September 2022
Date01 September 2022
Subject MatterArticles
Political Research Quarterly
© 2021 University of Utah
Article reuse guidelines:
DOI: 10.1177/10659129211034561
Over the last two decades, partisan polarization has inten-
sified in America, sowing division in national politics and
local communities (Iyengar et al. 2019; Levendusky 2009;
Webster and Abramowitz 2017). Polarized political views
increasingly manifest as affective polarization, that is, the
tendency for individuals to view members of their own
party favorably but see the worst in members of the oppos-
ing party (Iyengar et al. 2019; Iyengar and Westwood
2014). Over a similar period, aggregate-level studies have
linked county-level presidential election voting prefer-
ences to changing health outcomes, where support for
Republican candidates correlate with higher mortality
rates (Bilal, Knapp, and Cooper 2017; Bor 2017), greater
opioid use (Goodwin et al. 2018), lower vaccination rates
(Bernstein et al. 2016), and higher obesity rates (Shin and
McCarthy 2013). Furthermore, individual-level studies
suggest increasing political polarization is linked to worse
poor overall health (Nayak et al. 2021). However, chang-
ing health outcomes in local communities have also been
connected to the changing structure of social capital—the
social ties in a community that enable trust, reciprocity,
and collective action—with higher levels of trust in
neighbors and residents associated with better physical
health, lower levels of chronic stress (Fujiwara and
Kawachi 2008; Lee and Kim 2013), better quality of life
(Kim and Kawachi 2007), and lower mortality rates
(Aldrich 2019). These findings raise the compelling pos-
sibility that if political polarization and social capital are
both associated with health outcomes, building a robust
social network could moderate the impact of political
polarization on an individual’s health.
This study examines physical and mental health out-
comes using a survey of 2,752 U.S. adults conducted
between December 23, 2019, and January 3, 2020, probing
the interaction effects of mass polarization and different
1034561PRQXXX10.1177/10659129211034561Political Research QuarterlyPanagopoulos et al.
1Department of Political Science, Northeastern University, Boston,
2Bouvé College of Health Sciences & School of Public Policy and
Urban Affairs, Northeastern University, Boston, MA USA
3Department of Economics, Northeastern University, Boston, MA
Corresponding Author:
Timothy Fraser, Department of Political Science, Northeastern
University, 960A Renaissance Park, 360 Huntington Ave., Boston, MA
02115, USA.
Bridging the Divide: Does Social
Capital Moderate the Impact of
Polarization on Health?
Costas Panagopoulos1, Timothy Fraser1,
Daniel P. Aldrich1, Daniel Kim2, and David Hummel3
Rising partisan polarization in the American public over the last decade has been linked to stress and anxiety, raising
questions about how communities and public health experts should respond. As the strength of an individual’s social
network correlates with better health outcomes, could building a diverse set of connections moderate the effect
of political polarization on an individual’s health? This study examines the role of social capital as a key intervening
variable in the relationship between polarization and health. Drawing on a nationally representative survey of 2,752
U.S. residents conducted in December 2019 compared with county-level data, we use negative binomial, logit, and
gamma models to examine the interaction between indicators of political polarization and bonding, bridging, and
linking social capital on physical and mental health outcomes. We find consistent evidence that bonding social ties
intervene to improve the physical and mental health of individuals in polarized communities, while bridging ties are
related to worse health for politically isolated residents. By highlighting the relationship between polarization, social
networks, and health, our findings shed light on how public health experts, and policymakers can improve health
outcomes in polarized communities.
politics, polarization, partisanship, social capital, health impacts, survey
2022, Vol. 75(3) 875–891
876 Political Research Quarterly 75(3)
forms of social capital on self-reported days of poor physi-
cal and mental health per month. By counting the number
of days in the last month that a person reports poor physical
health, or alternatively, poor mental health, a commonly
used health measure in the CDC’s Behavioral Risk Factor
Surveillance System (BRFSS), we can approximate an
individual’s overall quality of health. We hypothesize that
respondents in polarized communities will have worse
health outcomes depending on the types of social ties they
have built. If they have strong bonding social capital, or
close in-group ties built among members of the same race,
religion, class, gender, or age group (McPherson, Smith-
Lovin, and Cook 2001), we hypothesize they will have
worse health outcomes. Similarly, if respondents in polar-
ized communities have strong bridging social capital,
which refers to intergroup ties between members of differ-
ent racial, religious, class, gender, or age groups (Aldrich
2012; Putnam 2000), we hypothesize that this will also
lead to better health outcomes. This is because while bond-
ing ties connect individuals to echo chambers of similar
people who may sit far from the median position they
encounter in their daily lives, bridging ties connect them
with a diverse pool of opinions and viewpoints and help
them feel accepted and valued in their community. We find
evidence that respondents living in politically polarized
areas with weaker bonding networks of social trust tend to
report more days of poor physical and mental health per
month, while, in contrast to our expectations, politically
isolated respondents experience worse physical health
despite strong diverse, bridging, social networks.
This study makes three main contributions to the litera-
ture. First, while past studies examined aggregate-level
associations between partisanship and health (Bernstein
et al. 2016; Bilal, Knapp, and Cooper 2017; Inglehart and
Norris 2016), our data allow us to triangulate any such
effects at the individual level. Second, while past studies
investigated the effects of political partisanship and polar-
ization or social capital on health separately (Bor 2017;
Fujiwara and Kawachi 2008; Guo 2016), this study exam-
ines them together, where individuals’ social networks and
community partisan divides interact to shape health. Third,
this study builds on past findings about the Janus-faced
nature of social capital in community resilience (Aldrich
2012; Aldrich and Meyer 2015), showing that not all forms
of social capital interact substantially with polarization to
improve health. Instead, bonding social ties have the most
consistent booster effect on health outcomes, while bridg-
ing ties appear to exert more nuanced effects, and linking
ties were found to be less effective. By highlighting the
relationship between polarization, social networks, and
health, scholars, public health experts, and policymakers
can use community social capital improvement projects as
an intervention against declining health outcomes due to
Background and Hypotheses
This study examines how political polarization and social
capital interact to shape individuals’ physical and mental
health. Below, we review the extant literature on how (1)
health conditions and demographics, (2) policy, (3) parti-
san health behaviors, (4) political polarization, and (5)
social networks shape health outcomes.
Health Conditions and Social Determinants of
The most common explanations for divergent health
outcomes are health conditions, behaviors, and the
social determinants of health. First, tobacco consump-
tion, obesity, poor diet, alcohol and drug use, type II
diabetes, and high blood pressure were found to be the
top six causes of change in American life spans between
1990 and 2016 (Murray et al. 2013). Second, deaths of
despair and opioid-related deaths have heavily increased
mortality in high intensity drug trafficking areas in
Appalachia and New Mexico (Monnat 2018).
Third, epidemiologists now take seriously the
effects of the social determinants of health, which
refers to upstream societal factors including social and
economic conditions in which we are born, live, work
and play. These conditions, along with gender, race/
ethnicity, and socioeconomic position, shape our
behaviors, biology, and levels of stress, and ultimately
our levels of physical and mental health (Commission
on Social Determinants of Health, World Health
Organization 2008; Kim 2021). Race dramatically
shifts life expectancy, largely due to race-related dis-
crimination in work and health care access, health out-
comes associated with racial profiling and incarceration,
environmental exposure to stress and pollutants, life-
style differences, and long-term inequalities in educa-
tion and poverty (Sondik et al. 2010). Likewise, age
and gender shape health as well; areas with more
elderly residents experience greater mortality rates,
while women tend to have greater life expectancy than
men (Sondik et al. 2010). Finally, socioeconomic sta-
tus (SES) also shapes health outcomes, via poverty,
education, and SES-related stress (Mackenbach et al.
2017). An analysis of American Association of Retired
Persons (AARP) members from 1925 to 1945 showed
that educational attainment dramatically boosts over-
all health (Fletcher 2015), while increases in long-term
unemployment are associated with increased mortality,
due to stresses from covering expenses for family
when unemployed (Bender and Theodossiou 2014).
These social and economic conditions also impact
access to health care, which can also shape individual
behavior and stress.

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