Public Policy Center, University of Nebraska


Date of this Version



Published in Social Science & Medicine 105 (2014), pp. 30–37; doi: 10.1016/j.socscimed.2014.01.003.


Copyright © 2014 Elsevier Ltd. Used by permission.


Research from across disciplines has demonstrated that social and political contextual factors at the national and subnational levels can impact the health and health behavior risks of individuals. This paper examines the impact of state-level social capital and ideology on individual-level health out-comes in the United States. Leveraging the variation that exists across states in the United States, the results reveal that individuals report better health in states with higher levels of governmental liberalism and in states with higher levels of social capital. Critically, however, the effect of social capital was moderated by liberalism such that social capital was a stronger predictor of health in states with low levels of liberalism. We interpret this finding to mean that social capital within a political unit—as indicated by measures of interpersonal trust—can serve as a substitute for the beneficial impacts that might result from an active governmental structure.