Introduction

The Labour government is placing increasing emphasis on the reduction of inequalities in health in the UK, in response to growing evidence of a widening gulf in life expectancy between the richest and the poorest sections of society.¹ In this paper, we seek to encourage pharmacy practice researchers (PPR) to address this agenda, through exploring the notion of social capital in relation to pharmacy.

Health inequalities and the role of community pharmacy in social capital

The policy consensus is that inequalities in health are rooted in differences in the material conditions of life¹. Pharmacy commentators acknowledge that this includes "the wider determinants of health status, such as poverty, pollution, housing and education."² We believe that pharmacy may be able to play a crucial role in this area through fostering social capital. Social capital refers to the institutions, relationships, and norms that shape the quality and quantity of a society's social interactions.³ Research increasingly suggests that higher levels of social capital foster health maintenance, through improving social connectivity and levels of social cohesion. For example, research shows that the lower the trust among citizens, the higher the average mortality rate.⁴ Within health promotion there is a long tradition of developing relational ties and networks,⁵ which are seen to build problem-solving capacities and to impact on health. These literatures emphasise the influence of 'place' on health, and there are now calls for more place-related initiatives to address health inequalities through developing social capital.⁶

How might PPR respond? There is anecdotal evidence that community pharmacy plays an important role in the maintenance of social cohesion, providing a space for individuals to develop networks of trust and mutual support.⁷ One example might be the development of CHAT centres by Lloyds Pharmacy. Furthermore, there is evidence that pharmacies provide pastoral care which includes the provision of support and understanding.⁷ It is pharmacy's location at the centre of many communities which may allow it make a unique contribution to social capital. Historically, this aspect of pharmacy has been overlooked in PPR. We believe that researchers need to engage with the social capital agenda. In so doing, pharmacy may become increasingly important in the debate about health inequalities.

References

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