There is growing evidence that aspects of social capital produce benefits in terms of health and wellbeing and assist in reducing health inequities. This knowledge has been amplified by the WHO Commission on the Social Determinants of Health
Social capital theory holds that social connections embody value to both individuals and society as a whole, therefore social networks and relationships between people are important resources. Beyond this central idea, competing theories about social capital highlight its complexity in terms of different kinds of resources operating on different levels, with sometimes contradictory effects
[3, 4]. This complexity has not prevented considerable interest in social capital theory within public health during the past few decades, neither has it slowed the development of strategies based on social capital theory to address health inequities at the community level. These approaches draw on growing evidence that social capital, in the context of broad policy approaches, can have significant impacts on health and wellbeing
. The application of theory to practice tends to be uneven, however, largely reflecting the difficulty of translating complex, abstract ideas into coherent programs with clearly defined health outcomes. If the potential value of social capital as a way of working is to be realised there is a need to focus more directly on this process of how theory is successfully or unsuccessfully translated into practice.
This paper reports on a study which aimed, firstly, to develop an understanding of how social capital theory informs government programs designed to reduce health inequities, and then sought to explore how this knowledge can be used to enable its effective application. It describes the background to the study and then outlines the design of the collaborative research process with government partners which led to practical outcomes in the form of guides to support community-based practice in initiatives designed to reduce health inequities. The paper proceeds to show how analysis of the findings in partnership with a representative group of policy makers and senior managers responsible for implementing the programs identified key lessons about the factors enabling these pathways.
Social capital theory and health
Resources associated with social and economic status and their availability to individuals and groups have long been linked to health and wellbeing. According to the Commission on the Social Determinants of Health
 a complex web of social and economic processes is responsible for health inequities, or systematic differences in health status between socio-economic, gender, race and geographic groupings. Strategies to improve health and wellbeing involve action at a range of levels: from healthy public policies to create the conditions for health, shaping opportunities and access to resources for individuals and communities, to supportive local environments which encourage and strengthen community action and develop individual skills. These aspects are characterised by the Commission for the Social Determinants of Health, respectively, as ‘macro’ , ‘meso’ and ‘micro’ level policy interventions that are necessary to reduce health inequities
. Social capital theory is commonly associated with ‘micro’ level community-based interventions, although theorists vary in emphasis, two of the most influential being Putnam
 and Bourdieu
Putnam’s concern with social cohesion and efficiency leads to a definition of social capital as ‘the features of social organisation such as networks, norms and social trust that facilitate coordination and cooperation for mutual benefit’
 (p 67). Bourdieu
 stresses the value of social capital as a resource enabling individual access to a range of other capitals, including economic and cultural capital, through the mobilisation and leverage of social networks. Although both interpretations rely on relational (membership in social organisations and networks) and material (the resources that flow from being part of the group) elements, they have different implications in terms of devising pathways to health and healthy equity. For Putnam, the stocks of norms and trust within communities are assets that may be turned into health outcomes by facilitating the modelling of positive behaviours, regulating and controlling negative behaviours and supporting collective action for shared benefit. Through such social processes as ‘collective socialisation’ , ‘informal social control’ and ‘collective efficacy’ , features of social capital are thought to lead to a more cohesive, productive and healthier society
 by comparison is concerned with power and the ways in which advantage and disadvantage are reproduced and maintained within socio-economic groups through such networks. Unlike Putnam, for whom individual behaviour contributes to creating more coherent and safer societies, Bourdieu engages with the relationship between social capital and social inequity, focusing on how society can support individuals through enabling more equal access to resources
Evidence for the linkages between social capital and health
Evidence for the links to health and wellbeing outcomes has been growing in recent decades at the micro, meso and macro levels
[1, 10–13]; although the issue of measurement remains controversial. Most relevant to this discussion are findings in relation to community level interventions, consistently demonstrating that networks can be an important resource for health, with strong social supports linked to improved health outcomes and reduced mortality rates. Distinctions have been made between three different types of social networks and the sorts of social capital they provide (bonding, bridging and linking). Close personal networks producing trust, reciprocity and belonging have been found to create an effective buffer from stress
, often referred to as ‘bonding social capital’
; The effect is thought to be strengthened by ‘bridging’ (between different social groupings) and ‘linking’ (vertical connections) social capital; networks enabling opportunities for democratic and civic involvement and linking to people and institutions in power that may be leveraged against material or financial gain
[5, 9]. At the neighbourhood level there is some evidence that areas with higher social capital have better health outcomes
Mobilising social capital through public policy
The growing evidence for features of social capital as determinants of health and wellbeing has simultaneously highlighted its potential as a pathway to other determinants, and therefore its relevance to a range of policy sectors including welfare, education, families and communities, employment, housing, urban development and planning and justice. While securing its broad public policy appeal, this diversity has arguably added to the controversy about definition, measurement, means of mobilisation and expected outcomes
As Castiglione et al.
 (p 6) note, ‘the attractiveness of social capital for policy making lies both in the generally positive connotation that is often attributed to social capital’s presence in society, and in its causal role in the production of social and individual goods.’ Thus although interest in social capital waxes and wanes, its associated ideas continue to be cited as justification for government programs in Australia and elsewhere as a means of improving the lives of individuals and whole communities. Less evident, however, is how it is interpreted and implemented in practice, yet this is clearly crucial for its promise to be realised. This paper reports on a study which contributed to redressing this imbalance by examining the question of how social capital is interpreted and applied in policies and programs designed to improve health from the perspective of policy actors and community practitioners.