Social capital as correlate, antecedent, and consequence of health service demand in China

- Do social activities and social capital in general affect individuals' health care consumption in China?
- We examine the relation between social interaction and health service demand in China.
- Strong cross-sectional and causal evidence that people who are socially “active” use more health care services.
- People of male gender, being single, having more years of education, and no health insurance coverage tend to avoid seeking health services.

Amid increasing interest in how social relationships play an important role in health and health behavior, it remains unclear whether social activities and social capital in general benefit individuals' health literacy and in turn affect their health care consumption. More specifically, this article proposes a research hypothesis to address the question: Do individuals who are strongly tied to other individuals within the social networks become more health conscious or literate and hence use more health services? This paper extends prior research on social support, health literacy and health care utilization to investigate the association between social interaction and health service demand. Using the China Health and Nutrition Survey, the paper provides cross-sectional evidence that people who are socially active and connected with their friends made more visits to health care providers. It also finds that people of male gender, being single, having more years of education, and no health insurance coverage tend to avoid seeking health services. The quasi-experimental study, which examines the events that exogenously intensified social interactions in some but not all Chinese provinces, indicates that social capital is more an antecedent than a consequence of health service needs.