Given the ageing of society, public health interventions that enhance social capital are becoming increasingly important. However, the understanding of the mechanisms behind the negative aspects of social capital is limited. For example, increased social cohesion within a community can lead to increased concern about one’s reputation, which, in turn, can hinder help-seeking behavior. To deepen the understanding of this “dark side,” our interdisciplinary team of psychologists and social epidemiologists launched a sub-project within the Japan Gerontological Evaluation Study (JAGES), a large-scale population-based survey. Our multilevel analysis revealed that in communities with high social cohesion, people’s increased concern for their reputation was linked to a greater reluctance to seek help and increased depressive symptoms. This mechanism counteracted the positive health effects of social cohesion. Importantly, this negative effect was observed only among individuals with lower levels of education, not those with university/college education.
Kuan-Ju Huang, Yukiko Uchida, Kosuke Takemura, Shintaro Fukushima, Jun Aida, Masamichi Hanazato, Mariko Kanamori. (2025). Paradoxical effects of community social cohesion on mental health and help-seeking among older adults: The role of reputation concern and socioeconomic status, Social Science & Medicine, 380:18234.
https://doi.org/10.1016/j.socscimed.2025.118234
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