The effect of individual- and organizational-level social capital on the wellbeing of older people in Taiwan

Submission note: A thesis submitted in total fulfilment of the requirements for the degree of Doctor of Philosophy to the School of Allied Health, Faculty of Health Sciences, La Trobe University, Bundoora.

During the past ten years, the Taiwanese government has invested more than $AUS 9 billion in aged care policies. The Building Community Care Centres Practice Plan was one of these policies which, had led to the establishment of 1,805 community care centres (CCCs) in 2013. The aims of CCCs are to enhance older people’s participation and interaction in their local neighbourhood, increase their prospects of receiving welfare services, and enhance their opportunities to live in the local community instead of residential care institutions. Little research has considered the effectiveness of CCCs, and there is no evidence about the impact of CCCs on the wellbeing of older people. Using social capital theory this research examined the wellbeing of CCC users compared to non-users, and explored the association between participants’ social relationships and wellbeing. The research utilised a mixed-method design. Two-hundred CCC users, 204 non-users, and 17 CCC managers were surveyed. In addition a total of 37 people from across these three groups participated in six focus groups. The research found CCC users had higher levels of individual social capital (ISC) and wellbeing than non-users. The findings confirmed the influence of ISC on wellbeing and identified five factors associated with ISC. These were tolerance of xvi diversity, contribution to the community, connections with family and friends, feelings of trust and safety, and participation in local community. These factors were also reflected in the qualitative data, which found CCC users had greater interaction with others in their neighbourhoods and received more support from social networks than non-users. CCC managers pointed to two key strategies used to enhance CCC users’ wellbeing and social connections; use of activities designed to foster social interaction, and cooperation with health professions. Findings from this research provide strong evidence of the benefits of using CCCs for older people in Taiwan.