Dear Students:
Much of what we do every day at the health center involves one-on-one interactions with you as individuals. We evaluate you clinically and try to inform and advise you. We approach you as young adults who are seeking your own well-being and try to help you learn how best to make the choices that will meet your own needs. We also try to reach out to you in support and encourage you to reach out to each other.
As I've written a few times before, when this kind of mutual support becomes community building, the health benefits for us all become huge.
Just this week, The Boston Globe reported on a recent study comparing the health of Americans and Britons (May 3). The bottom line: Americans are typically twice as unhealthy as their English counterparts. Twice as ill, even controlling for age, race, social class, smoking, and obesity. Twice as ill, despite spending more than twice as much per capita on health care.
"'Everybody should be discussing it,' says epidemiologist Michael Marmot, one of the study's co-authors. 'Why isn't the richest country in the world the healthiest country in the world?'"
Marmot's own explanation is not medical. He points to increasing economic disparities and financial insecurity since the mid-1970s, among all but the top fifth of Americans.
Public health commentators like Stephen Bezruchka have argued that the degree of social hierarchy, the gap between those on top and those on the bottom, directly predicts a society's health status. They point out that hierarchy is not conducive to building relationships of mutual support, sharing, trust, caring, and community. These relationships are the building blocks of what is called social capital.
Social capital is a measure of people's participation in their community, their sense of trust, their inclination to cooperate for mutual benefit. It includes everything from a community's density of associational memberships, levels of interpersonal trust, and norms of reciprocity.
Public health researchers like Ichiro Kawachi study the relationship between social capital and individual health. Kawachi has found that variations in these indicators of social capital correlate strongly with mortality rates. In fact, a 10 percent increase in a community's sense of mutual trust is associated with a nine percent lower level of overall mortality!
Social scientists have long known that social cohesion is a critical determinant of public health. Emile Durkheim, for instance, compared suicide statistics in European countries over time and concluded that the lowest rates of suicide consistently occurred in societies exhibiting the highest degrees of social integration.
How is social capital created on a college campus? By individuals joining together as a campus community, finding ways to reach out to each other, to try to understand and support each other, to show respect and concern for each other, and to build a sense of trust and social obligation amongst themselves.
It can be so simple. Like noticing that a friend really does need some help with his mood swings.
Or less simple. Like making sure that your friends are drinking safely at a party.
Or quite complicated. Like breaking away from a culture that idealizes distorted body images and lifestyle expectations. Like breaking open the silence of sexual assault. Like reasserting control over all that tries to depersonalize human intimacy.
These kinds of efforts can be part of building a true sense of community here at Bowdoin. Maybe they add up to some kind of obligation to each other. They certainly build up our shared stores of social capital.
That can be life-changing and might literally become life-saving.
Good luck to you all with papers and exams!
Take good care of yourselves. Have wonderful summers.
See you in the fall!
Jeff Benson, MD
Dudley Coe Health Center