Association of social capital measures with utilization of health care services among residents of the Alabama Black Belt

African Americans are disproportionately affected by diabetes and hypertension, which are causes of kidney failure, coronary heart disease, and stroke. The communities evaluated in this study are located in the Black Belt region of Alabama, which is a region of 18 counties in Southern Alabama characterized by high poverty rates, high unemployment, and poor access to education and medical care, and life expectancy 5.3 years less than the national average. The purpose of this intervention was to determine if a community-based health intervention using community health advisors as disseminators of health information could be effective in decreasing the incidence of chronic disease related risk factors among community members and increase the use of community support and resources. Residents from twenty communities in seven counties within Alabama's Black Belt completed surveys which assessed various dimensions of social capital and chronic disease related knowledge, attitudes, and behaviors including pursuit of health examinations and screenings. Surveys were administered before and after the intervention. At baseline, 1,380 household surveys were completed. The mean age of participants was 50.8 years, 87.0% were African Americans, 67.2% were women, 69.8% had a high school diploma or less education, and 58.4% reported an annual household income of $25,000 or less. Community trust was significantly associated with more recent dental exams, eye exams, cholesterol screenings, and mammograms. Further analyses will be conducted using baseline and post-intervention measures. Implications of these findings for community-based risk-reduction interventions will be discussed.