A qualitative approach to bridging and bonding social capital: Experiences of a cohort of Chilean older people.

With particular focus on availability of family care, research on relationships in later life have often emphasized dynamics inside homes and connections with direct family members. However, a growing number of scholars recognize changes in family practices and the prominence of different types of non-kin ties that are as important as family to older people. Connidis has proposed a sociological approach to capture the realities of personal relationship in later life. Informed by Connidis' approach, we apply qualitative lenses to study social capital in analyzing 40 semi-structured interviews conducted with Chilean people aged 60-74 years. We used a thematic analysis to examine the circumstances under which older people mobilize help through different types of kin and non-kin ties as bonding or bridging social capital. Though literature on social capital describes friends and family members as bonding ties, our findings indicate that they play a double role as bonding and bridging social capital in their own unique way, depending on circumstances. Friends, in comparison to family ties, bridge the older person with a variety of worldviews and lifestyles, helping them to advance their wellbeing in the face of life transitions and challenges experienced with aging. Study participants associated seeking help from others with notions of material and physical dependency, laziness, and a commitment to return help. The preference to seek different types of support from a variety of relationships can be interpreted as a way to manage ambivalence within a larger socio-cultural context.

Public Policy and Experiences of Aging: Social Relationships and Social Integration in Chilean Policy on Aging.

This study uses an interpretive narrative approach to compare and contrast assumptions regarding social integration (participation in meaningful and multiple roles, and engagement in social networks) as promoted in the Chilean Comprehensive Policy for Positive Aging, with the expectations of interviewees aged 60 to 74 years. The Policy assumes specific forms of social integration by: offering different options of social integration to dependent vs. independent older people, encouraging autonomy and self-management, and assuming the primacy of family responsibility in older people's care. Both the Policy and the interviewees emphasize the value of autonomy and independence in old age; the latter, however, do not place family at the frontline when care is needed. Understanding the matches and gaps between policy assumptions and older people's expectations for social integration, including the role of family caregiving, can open new possibilities to prevent social isolation and promote different forms of social support that are valued by older adults for their emotional and practical benefit.

Child Health Care in Ireland.

The Irish health care system is based on a complex and costly mix of private, statutory, and voluntary provisions. The majority of health care expenditure comes from the state, with a significant proportion of acute hospital care funded from private insurance, but there are relatively high out-of-pocket costs for most service users. There is free access to acute hospital care, but not for primary care, for all children. About 40% of the population have free access to primary care. Universal preventive public health services, including vaccination and immunization, newborn blood spot screening, and universal neonatal hearing screening are free. Major health challenges include poverty, obesity, drug and alcohol use, and mental health. The health care system has been dominated for the last 5 years by the impact of the current recession, which has led to very sharp cuts in health care expenditure. It is unclear if the necessary substantial reform of the system will happen. Government policy calls for a move toward a patient-centered, primary care-led system, but without very substantial transfers of resources and investment in Information and Communication Technology, this is unlikely to occur.