Trust and quality of life: A cross-sectional study of young women

Abstract

Background:

Trust is increasingly identified as a psychosocial determinant of well-being. However the relationship between trust and well-being outcomes has not been comprehensively examined, particularly in socially and economically transitioning countries such as Iran and among young women.

Aims:

This cross-sectional study examined the association between trust and the quality of life of young Iranian women.

Methods:

A total of 391 young Iranian women aged between 18 and 35 years (M: 27.3, standard deviation (SD): 4.8) were recruited through cluster convenience sampling to participate in this cross-sectional study. The measures used included the ‘Trust scale’ adapted from the British General Household Survey (GHS) Social Capital scale, and the Persian version of the WHOQOL-BREF (World Health Organization Quality of Life questionnaire - brief version).

Results:

The participants (n = 391, mean age of 27 years) reported a relatively low level of trust. For the participants, trust was positively associated with better quality of life (r = .24, p value: .01). The findings also showed that there is a significant difference between socio-demographic factors such as the level of religiosity, occupation and income with the domains of trust.

Conclusion:

Policies are needed to improve participation and reciprocity at the level of individuals and informal social groups, including local to broader communities in order to increase the sense of community belonging, improving trust and consequently quality of life.

Keywords

Trust social capital quality of life young women Iran

Introduction

Quality of life (QOL) is a broad concept shaped in complex ways by a person’s ‘physical health, psychological state, personal beliefs, social relationships and their relationship to salient features of their environment’ (Oort, Visser, & Sprangers, 2005: 629). The World Health Organization (WHO, 1997) defines QOL as ‘an individual’s perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns’ (p. 1). Most definitions of health, well-being and QOL suggest that society and social connections have a significant role in health and well-being (Fioto, 2002). Indeed, an increasing body of literature shows that positive psychosocial factors, such as sociability, trust and optimism, are among the most important determinants of QOL (Tokuda, Jimba, Yanai, Fujii, & Inoguchi, 2008). Among these factors, trust has a substantial role in predicting subjective well-being (Baron, Field, & Schuller, 2000). This is identified across various social science disciplines including sociology, psychology, public health and political science, reflecting the growing awareness in both research and policy of the importance of trust for both an individual’s and the broader society’s well-being (Ward & Meyer, 2009).

Trust is defined as the expectation that arises within a community of regular, honest and cooperative behavior, based on commonly shared norms on the part of other members of the community (Fukuyama, 1995: 26). Trust is central to almost all discussions on social capital (Baron et al., 2000), and it is a crucial factor in the development of strong social ties, which result in more supportive social networks characterized by material and emotional support (Leonard & Onyx, 2004; Mailath & Postlewaite, 2006). All forms of trust and strong relationships such as trust in institutions (e.g. government, workplaces, banks), trust in corporations, trust in neighbors, strangers, friends and family are essential for enhancing cooperation and social capital within a society (Leonard & Onyx, 2004). A nation’s well-being, as well as its ability to compete, is conditional upon the level of trust inherent in the society (Baron et al., 2000). Hence, communities with a high level of trust often require less contractual and legal regulation of their relations, as prior moral consensus gives members of the group a basis for mutual trust (Baron et al., 2000). In contrast, mistrust which is the interpretation of other’s behaviors as dishonest, unsupportive and self-seeking results in poor social networks and hampers the improvement, maintenance and the use of social support. Negative attitudes as well as distrust consequently negatively affect the psychological health and well-being of society (Tokuda et al., 2008).

Trust is important for health and well-being at both an individual and societal level, and is a basic factor for improving effective interpersonal relationships and community living (Mechanic & Meyer, 2000). Findings in the literature across a range of disciplines reveal that trust is an important component for the effective functioning of society, and thus for the improvement, maintenance and sustainability of the social quality of people’s lives (Ward & Meyer, 2009). For example, Tokuda et al. (2008) demonstrated that greater interpersonal trust increases the number of social ties with more perceived social support, and consequently leads to an individual experiencing a greater sense of well-being. Furthermore, in countries with high levels of social capital it has been shown that there is a connection between high levels of interpersonal trust with lower mortality (Skrabski, Kopp, & Kawachi, 2003), better physical and emotional health (Rose, 2000), and better health outcomes (Poortinga, 2006). For example, Helliwell and Wang’s (2011) study in Canada revealed that there is a strong link between social trust and two major global causes of death: suicide and traffic fatalities.

Although some studies have measured trust as a main component of cognitive social capital (Foxton & Jones, 2011), much of the research has been undertaken in western industrialized nations (De Silva, Huttly, Harpham, & Kenward, 2007; Harpham, Grant, & Thomas, 2002; Mitchell & Bossert, 2007; Yip et al., 2007). In transitioning countries such as Iran, there has been very limited research into the potential role of trust in subjective well-being of specific populations such as young women. Given the structure of such societies including the particular expectations and restrictions placed upon women in general, and young women in particular (Assaad & Roudi-Fahimi, 2007), it would be interesting to understand how trust relates to this population’s perceptions about QOL. In this study, the relationship between trust and QOL has been investigated. Specifically, using a cross-sectional design, the research examines (1) the level of trust among young Iranian women, (2) the association between socio-demographic and socio-economic factors with trust and (3) the correlation between trust and QOL. Understanding the extent and features of this association for young Iranian women could inform the development of intervention studies to target those determinants that have the greatest effect on their QOL and well-being.

Method

Participants

The analysis presented here was conducted on 391 young Iranian women, with the mean age of 27 years (standard deviation (SD): 4.8), who were all from Shiraz, one of the biggest cities in Iran. The majority of participants (78%) were of Fars ethnicity, and 96% were Muslim of which 40.4% had an average level of religiosity. Most of the participants (76.4%) had a university degree, and 48% of them had paid employment. About half of the participants were single. Demographic characteristics of participants are summarized in Table 1.

Table 1.

Socio-demographic and socio-economic variables of participants.

		Frequency	%
Ethnicity	Fars	305	78
	Tork	39	10
	Lor	40	10
	Other	5	1.3
	Missing	2	0.7
Religious affiliation	Shia	375	95.5
	Sunni	11	2.8
	Other	3	0.8
	Missing/NA	2	0.6
Level of religiosity	Very religious (following religious practices very often/often)	18	4.6
	Moderately religious (following religious practices occasionally)	58	40.4
	Not very religious (following religious practices rarely)	136	34.8
	Not religious at all (never following religious practices)	71	18.2
	NA	8	2
Education	Postgraduate	60	15.3
	Degree	239	61.1
	Diploma/certificate	73	18.7
	Secondary school	14	3.6
	Primary school	4	1
	NA	1	0.3
Occupation	Managerial	37	8.8
	Professional	51	13.7
	Clerical	85	21.7
	Labors	6	1.5
	Home duty	68	17.4
	Unemployed	36	7.7
	Student	96	24
	Missing	18	4.6
Type of occupation	Government	61	15.6
	Private	132	33.8
	NA	198	50.6
Marital status	Single	192	49.1
	Married	178	45.5
	Divorced	7	1.8
	Widow	5	1.3
	NA	9	2.3

Procedure

This study was carried out between February and June 2013. Multi-stage cluster sampling was used for data collection in the city of Shiraz. Shiraz is organized into 10 major districts. In stage one, 5 of these districts were randomly selected as sampling locations. In stage two, important community locations were randomly chosen within each of the 5 sampling locations (e.g. public and private universities, public and private workplaces, religious locations, health-care centers and public places). Recruiting at these different locations promoted diversity in the sample. In the final stage, 420 young women were recruited out of approximately 500,000 women aged 18–35 years in Shiraz (Iran Census Population, 2011) through convenience sampling. The estimated sample size required was 383 considering the Alpha error of 5%. To encourage completion of the surveys, the researcher who had the same language as the participants was available to answer questions and provide assistance. Of the 420 surveys which were distributed, 391 were returned which was a response rate of 93%.

Measures

Participants responded to a number of questionnaires to assess the constructs being investigated. The data collection instrument comprised three sections including QOL, trust and control variables.

Indicators of QOL

QOL was assessed using the Persian version of WHOQOL-BREF (World Health Organization Quality of Life questionnaire - brief version). It has satisfactory reliability and validity for use with Iranian populations (Karimlou, Zayeri, & Salehi, 2011). The WHOQOL-BREF has 26 items grouped under four domains: physical, psychological, social and environmental. The use and analysis procedures for the WHOQOL-BREF have been well documented (WHO, 1997).

Indicators of trust

Trust was measured using the sub-scale available through the British General Household Survey (GHS) Social Capital scale. The GHS trust scale has 20 items comprising four domains of trust: trust in the media, trust in institutions, trust in one’s neighborhood and general trust measured on a Likert scale (1 = strongly disagree to 5 = strongly agree). Higher scores on each of the domains indicate higher levels of trust with a sum of the domain scores yielding a global measure of perceived trust. The scale provides data at both the individual and societal level (Foxton & Jones, 2011). In preparing the current study questionnaire, a process of item review through an expert panel and piloting of the instrument ensured that the instrument was population appropriate.

The reliability and validity of the trust scale were tested by Confirmatory Factorial Analysis (CFA) using IBM Statistical Package for the Social Sciences (SPSS) AMOS 21. This element of the research found that the scale, with some modifications, has acceptable construct validity and composite reliability (χ² = 2.231 and RMSEA = .056) for the population of interest (Salehi, Harris, Marzban, & Coyne, 2014).

Control variables

Socio-demographic and socio-economic variables were considered as the control variables in this study. Socio-demographic variables included in the study were age, ethnicity, religious affiliation, religiosity, marital status, parental status and number of children. Socio-economic variables included were education, education of partner, occupation and income. Level of religiosity was measured through a single question about how religious participants consider themselves to be with response options ranging from 1 (not religious at all; never following religious practices) to 4 (very religious; following religious practices very often/often) (Rieger, 2008).

Analytic strategy

The SPSS version 20.0 was used. Mean with standard deviation were calculated as descriptive statistics. Mean scores between groups were compared using t-test and analysis of variance (ANOVA). Correlations between trust domains, QOL and control variables were calculated using Pearson’s correlation coefficients. Multiple linear regressions were used to examine whether trust predicts QOL.

Results

Findings show that the level of agreement with trust items for all domains of trust is low (less than 50% of subjects rated the item as: agree/completely agree), except for the item ‘trust in banks’ (Table 2). In addition, the mean score of all domains of trust is low among young Iranian women (Table 4).

Table 2.

Level of group agreement with trust items.

Highest agreement (≥75% subjects)	Moderate agreement (66%–74% subjects)	Bare agreement (50%–65% subjects)	Disagreement (<50% subjects)
		Trust in banks (54.6%)	Watching/listening to TV/radio regularly (40.4%)
			Reading newspaper regularly (27.6%)
			TV/radio is worthy to watch/listen (33.5%)
			Newspaper is worthy to read (30.5%)
			Newspaper is reliable source of information (20.4%)
			TV/radio is a reliable source of information (24%)
			Trust in Government (25.3%)
			Trust in Parliament (25.6%)
			Trust in Civil service (36.6%)
			Trust in Police (42.1%)
			Trust in Courts (34.6%)
			Trust in Local council (28.3%)
			Trust in my employer (37.9%)
			My neighbors are helpful (33.2%)
			Most people can be trusted (18.4%)
			People take advantage of you (14.1%)
			A lost wallet will be returned (44.2%)
			Ethnic unity in neighborhood (39.9%)
			Trust in neighborhood (24%)

Group agreement defined as ≥50% of subjects rated the item as: agree/completely agree. Group disagreement: <50% of subjects rated the item as: agree/completely agree.

Findings of t-test and ANOVA show that there is a significant difference between the domains of trust with demographic variables such as ethnicity, level of religiosity, occupation and type of employment. Greater trust in media was found among participants with a high level of religiosity (vs a low level of religiosity). Higher trust in institutions was also recognized among participants with a high level of religiosity (vs a low level of religiosity), and participants with public jobs (vs private job holders). Greater trust in one’s neighborhood was recognized among the Tork ethnic group (vs Lor), participants with a higher level of religiosity (vs a low level of religiosity), and unemployed groups (vs employed groups). Higher general trust was recognized among the Tork ethnic groups (vs Fars and Lor), students (vs managerial/administration), and unemployed groups (vs employed groups) (Table 3).

Table 3.

Mean scores in trust by socio-demographics.

Socio-demographic factors	Subcategory	Trust in media		Trust in institutions		Trust in neighborhood		General trust
Socio-demographic factors	Subcategory	Mean (SD)	F/T	Mean (SD)	F/T	Mean (SD)	F/T	Mean (SD)	F/T
Ethnicity	Fars	–	–	11.5 (2.67)	3.157*	6.1 (1.80)	3.89*	–	–
	Tork	–		12.7 (2.70)		7 (1.61)		–
	Lor	–		11.3 (1.91)		5.8 (1.22)		–
	Other	–		12.8 (1.64)		6 (1)		–
Religious affiliation	Shia	–	–	11.6 (2.63)	3.66*	–	–	–	–
	Sunni	–		11.1 (2.08)		–		–
	Other	–		7.6 (3.21)		–		–
Level of religiosity	Very religious	23 (4.74)	28.97***	12.4 (3.08)	7.51***	–	–	49.5 (20.16)	13.34***
	Moderately religious	19.3 (5.05)		12.3 (2.48)		–		43.2 (19.27)
	Not very religious	16.5 (4.99)		11.2 (2.62)		–		34.2 (18.07)
	Not religious at all	13.9 (4.60)		10.8 (2.68)		–		27.4 (12.13)
Occupation	Managerial	–		–	–	5.5 (1.72)	3.03**	–	–
	Professional	–		–		5.9 (1.34)		–
	Clerical	–		–		6.3 (1.70)		–
	Labor	–		–		4.8 (2.31)		–
	Home duty	–		–		6.5 (1.54)		–
	Unemployed	–		–		6.4 (1.54)		–
	Student	–		–		6.5 (1.60)		–
Paid employment	Yes	–		11.3 (2.72)	−2.28*	5.9 (1.65)	−3.26**	–	–
Paid employment	No	–		11.9 (2.57)		6.5 (1.55)		–
Type of occupation	Public	–		–	–	–	–	41.8 (19.86)	2.35*
Type of occupation	Private	–		–		–		35.4 (16.50)

SD: standard deviation.

p < .05; **p < .01; ***p < .001.

Table 4 presents the correlation coefficients between all variables. There were high positive correlations between trust domains. Positive correlations were presented between domains of QOL and trust domains, while negative correlations were presented between both trust in the media and trust in institutions with income per individual and income per household. Although these correlations are reported as low, due to the sample size (391), the value for correlation can be shown to be statistically significant (Kay, 2009). In addition, according to the original hypothesis of the current study, it is noted that a finding of a significant p value dealing with a correlation between trust domains and well-being outcomes (r ≤ .30) did confirm the research hypothesis.

Table 4.

Correlation test of trust, QOL and income.

	Trust in media	Trust in institutions	Trust in neighborhood	General trust
Trust in media	–	–	–	–
Trust in institutions	0.603***	–	0.446***	0.355***
Trust in neighborhood	0.427***	–	–	–
General trust	0.308***	–	0.572***	–
Physical QOL	0.135**	0.140**	0.198***	0.202***
Psychological QOL	0.253***	0.282***	0.309***	0.259***
Social QOL	0.145**	0.223***	0.188***	–
Environmental QOL	0.313***	0.317***	0.350***	0.291***
Income per household	−0.191**	−0.185**	–	–
Income per individual	−0.196**	−0.178**	–	–
Mean	17.5 (range: 6–30)	37.2 (range: 7–80)	11.6 (range: 4–20)	6.2 (range: 2–10)
SD	5.4	18	2.6	1.6

QOL: quality of life; SD: standard deviation.

p < .05; **p < .01; ***p < .001.

Multiple linear regressions were performed for socio-economic, socio-demographic and trust domains as predictors of QOL. Table 5 displays the relationships of the domains of QOL and trust. With the effect of potential confounding factors considered, the general prediction models for all components of QOL and trust were statistically significant (p < .001). The highest F ratio belongs to psychological QOL (14.45), and the lowest F ratio to social QOL (4.44). Among different domains of trust, general trust was a significant predictor of physical QOL with a regression coefficient of .142 (95% confidence interval (CI): 0.003, 0.218). The relationship between physical QOL and trust seems to be positive; however, there appears to be a negative relationship between physical QOL and confounding factors. General variance of physical QOL explained by trust domains was 62%.

Table 5.

Multiple linear regressions predicting quality of life (QOL).

	Predictors	Regression coefficient (95% CI)	F value of model	% variance explained by model
Physical QOL			5.56***	63.0
	Trust in media	.009 (−0.025, 0.043)
	Trust in institutions	.003 (−0.008, 0.015)
	Trust in neighborhood	.088 (−0.002, 0.178)
	General trust	.142* (0.003, −0.218)
	Age	−.270 (−0.066, 0.11)
	Ethnic	−.380** (−0.638, −1.220)
Psychological QOL			14.45***	13.2
	Trust in media	.020 (−0.020, 0.060)
	Trust in institutions	.019** (0.006, 0.033)
	Trust in neighborhood	.165** (0.059, 0.271)
	General trust	.144 (−0.020, 0.307)
	Age	−.051* (−0.096, −0.006)
	Ethnic	−.223 (−0.527, 0.081)
Social QOL			4.44***	5.2
	Trust in media	−.002 (−0.043, 0.039)
	Trust in institutions	.021** (0.007, −0.035)
	Trust in neighborhood	.120* (0.012, 0.229)
	General trust	−.052 (−0.219, 0.116)
	Age	−.022 (−0.068, 0.24)
	Ethnic	−.143 (−0.454, 0.169)
Environmental QOL			13.41***	16.1
	Trust in media	.016 (−0.022, 0.053)
	Trust in institutions	.021** (0.009, 0.034)
	Trust in neighborhood	.180*** (0.081, −0.279)
	General trust	.149 (−0.004, 0.302)
	Age	−.031 (−0.073, 0.011)
	Ethnic	−.175 (−0.459, 0.110)
The general facet QOL			7.48***	9.2
	Trust in media	−.001 (−0.053, 0.050)
	Trust in institutions	.017 (0.000, 0.034)
	Trust in neighborhood	.104 (−0.033, 0.240)
	General trust	.228* (0.018, 0.437)
	Age	−.096** (−0.153, −0.038)
	Ethnic	−.466* (−0.856, −0.076)

CI: confidence interval.

p < .05; **p < .01; *** p < .001.

Trust in institutions and trust in one’s neighborhood were positively related to psychological QOL with a regression coefficient of .01 (95% CI: 0.006, 0.033) and .165 (95% CI: 0.059, 0.271) respectively. No significant relationship was observed among other trust domains and psychological QOL. Weight combined of trust domains explained about 13.2% variance in psychological QOL. Trust in institutions and trust in one’s neighborhood were also significant predictors of social QOL with a coefficient correlation of .021 (95% CI: 0.007, −0.035) and .120 (95% CI: 0.012, 0.229) respectively. General trust was a predictor of 5.2% variance in social QOL. The same relationship was observed between trust in institutions and trust in one’s neighborhood and environmental QOL, with a significant positive relationship with a coefficient of regression of .021 (95% CI: 0.009, 0.034) and .180 (95% CI: 0.081, −0.279). The total variance of environmental QOL explained by the trust domains in this model was 16.1%. The general facet of QOL was also significantly predicted by general trust with a regression coefficient of .228 (95% CI: 0.018, 0.437).

It can be predicted by this regression model that QOL can be significantly predicted by the four domains of trust. It seems that trust in the media was not a significant predictor of any of the QOL domains. Trust in institutions and trust in one’s neighborhood were significant predictors of psychological, social and environmental QOL, while general trust was a strong predictor of physical QOL, and the general facet of QOL. Generally, the variance of QOL, explained by combined weight of trust domains varied between 5.2% and 62%.

Discussion

This study investigated young Iranian women’s level of trust in their society. The findings show that the level of trust in all four domains is low among young Iranian women. However, trust in institutions had the lowest score in comparison with the three other domains, followed by general trust, trust in media and trust in one’s neighborhood. The findings of this study are not completely supportive of the Kiani (2012) study in Isfahan (one of the biggest cities in Iran) which found that the majority of the Iranian respondents had an average level of social trust. The difference between these findings could be due to the population and area differences between the studies, as well as the instrument of trust used. Interestingly, the current study’s findings are consistent with studies undertaken in more highly industrialized and democratic societies such as the United States of America and the United Kingdom (Gilson, 2003; Mechanic & Meyer, 2000). There is strong evidence suggesting that modern social developments have led to the erosion of both interpersonal trust and institutional trust in such countries (Mechanic & Meyer, 2000). The present study suggests that a low level of trust is an issue that may exist across many societies irrespective of level of industrialization, governance or cultural differences.

This study presents evidence of an association between trust and QOL across all four domains. Young Iranian women with a greater sense of trust are more likely to report higher QOL in comparison to those with lower trust. These results are consistent with previous studies (Engström, Mattsson, Järleborg, & Hallqvist, 2008; Helliwell & Wang, 2010; Hibino et al., 2012; Mechanic & Meyer, 2000; Ward & Meyer, 2009; Rose, 2000; Sarkiunaite, Bartkute, Jasinskas, Dilys, & Jurgelenas, 2012; Subramanian, Kawachi, & Kennedy, 2001; Tokuda et al., 2008). Furthermore, some studies have revealed that there is a link between higher trust and better physical health (Rose, 2000) and lower mortality (Skrabski et al., 2003). For example, Subramanian, Kim, and Kawachi’s (2002) study conducted in the United States of America with 144,692 people in 39 states found that lower levels of trust were associated with higher rates of major causes of death, including heart disease, cancers, infant mortality and violent deaths, including homicide. A multilevel analysis in a longitudinal study of social capital and self-rated health also found an association between trust and self-rated health (Snelgrove, Pikhart, & Stafford, 2009). This suggests that living in an area with high levels of trust is beneficial to one’s health. Some of the previously identified multilevel studies based on cross-sectional data also found significant protective effects of social trust (Engström et al., 2008; Kavanagh, Bentley, Turrell, Broom, & Subramanian, 2006) which is supported with findings of this study.

In this study, it was suggested that demographic and socio-economic factors may also affect the level of trust and well-being of individuals. The significant factors that positively influenced trust in this study include ethnicity, level of religiosity, income, employment status, type of employment (public or private) and occupation.

In this study, greater trust in the media and institutions was found among participants with a higher level of religiosity and participants with public employment. Furthermore, the correlations confirmed the inverse relationship between trust in the media, and trust in institutions with income per individual and income per household. Results suggest that with increased income there are decreased levels of trust in the media and institutions. This finding is in contrast with Gallo, Smith, and Cox (2006) who revealed that individuals with a higher socio-economic status may find their society more compassionate, and also have a higher level of trust, compared with those with a lower socio-economic status. Similarly, Kiani (2012), Glaeser, Laibson, Scheinkman, and Soutter (2000) and Paxton (2002) indicated that there is a significant positive relationship between socio-economic status and trust. According to these studies, it seems that socio-economic status shapes an individual’s level of access to networks and resources which results in higher levels of trust (Gallo et al., 2006). The contrast in findings between these studies and the current research could be linked to the different scales used. All of these studies focused on interpersonal trust as the individual level of trust, while in this study the negative correlation between income and trust is related to trust in the media and institutions which are at a societal level. Alternatively, living in a less industrialized and/or less democratic society where the media and public institutions are closely aligned with government policies impacts on the relationship between socio-economic status and the level of trust in the media and institutions.

Greater trust in one’s neighborhood was recognized among the Tork ethnic group, participants with higher levels of religiosity and the unemployed. Greater general trust was also recognized among the Tork ethnic group, students and the unemployed. This finding revealed that not only at the societal level but also at the individual level of society, trust is higher among participants who have higher levels of religiosity and low socio-economic status. The findings of this study in terms of the relationship between trust and ethnicity are in line with Kim, Subramanian, and Kawachi’s (2006) study which showed evidence of cross-level interactions between community social capital and individual race/ethnicity on self-rated health. Drukker, Buka, Kaplan, McKenzie, and Van Os’s (2005) also found that contextual social capital was associated with better self-rated health among children in Maastricht and among a Hispanic sample in Chicago, but not among non-Hispanic children in Chicago. Therefore, these two studies and the present study emphasize the relationship between the components of social capital, such as trust and ethnicity.

According to this study, a significant difference between personal features such as age, education, marital status, parental status, number of children and education of partner and trust was not found. This is consistent with Kiani (2012).

Limitations

Although this study has been completed in one of Iran’s largest cities of Shiraz in 10 different areas, the sample may not be representative of other cities in Iran and should be extrapolated to other cities with caution. The second limitation of this study is related to participants with public jobs as they may have answered questions cautiously compared to other groups, in particular those questions regarding trust in the media and institutions.

Conclusion and recommendations

The results of this study suggest that trust is an important psychosocial determinant of well-being and closely linked with QOL. Therefore, it is concluded that trust is important for health and well-being at both an individual and societal level and is a fundamental factor for enhancing effective interpersonal relationships and community living.

In order to improve trust in societies, this study suggests improving social participation, not only at the level of individuals and informal social groups, but also at the formal organizational level, community and even nationally. Consequently, the development/improvement in participation in different groups results in an increasing number of social networks and more reciprocity that consequently increase social support (Leonard & Onyx, 2004). Beyond these immediate advantages, individuals gain a sort of assurance, a sense that they belong to a caring community where help will be provided. Hence through these social networks and reciprocity, individuals learn trust, and as relationships develop, favors may be asked for, offered and returned (Leonard & Onyx, 2004). Furthermore, policies and strategies that are sensitive to cultural differences among countries and within communities is imperative; therefore, it is also recommended that further studies comparing differences across cultures and country boundaries be a priority.

Footnotes

Funding

This study was part of a PhD project supported by Griffith University. The project also received a PhD Researcher Grant from Population and Social Health Research Program, Griffith Health Institute.

References

Assaad

Roudi-Fahimi

(2007). Youth in the Middle East and North Africa: Demographic opportunities or challenge. Washington, DC: Population Reference Bureau.

Baron

Field

Schuller

(2000). Social capital: Critical perspectives. New York, NY: Oxford university press.

De Silva

M. J.

Huttly

S. R.

Harpham

Kenward

M. G

. (2007). Social capital and mental health: A comparative analysis of four low income countries. Social Science & Medicine, 64, 5–20.

Drukker

Buka

S. L.

Kaplan

McKenzie

Van Os

. (2005). Social capital and young adolescents’ perceived health in different sociocultural settings. Social Science & Medicine, 61, 185–198.

Engström

Mattsson

Järleborg

Hallqvist

(2008). Contextual social capital as a risk factor for poor self-rated health: A multilevel analysis. Social Science & Medicine, 66, 2268–2280.

Fioto

(2002). Social isolation: Important construct in community health. Geriatric Nursing, 23(1), 53–55.

Foxton

Jones

(2011). Social capital indicators review. Newport, UK: Office for National Statistics.

Fukuyama

(1995). Trust: The Social Virtues and the Creation of Prosperity. New York: Free Press.

Gallo

L. C.

Smith

T. W.

Cox

C. M.

(2006). Socioeconomic status, psychosocial processes, and perceived health: An interpersonal perspective. Annals of Behavioral Medicine, 31, 109–119.

10.

Gilson

(2003). Trust and the development of health care as a social institution. Social Science & Medicine, 56, 1453–1468.

11.

Glaeser

E. L.

Laibson

D. I.

Scheinkman

J. A.

Soutter

C. L.

(2000). Measuring trust. The Quarterly Journal of Economics, 115, 811–846.

12.

Harpham

Grant

Thomas

(2002). Measuring social capital within health surveys: Key issues. Health Policy and Planning, 17, 106–111.

13.

Helliwell

J. F.

Wang

(2010). Trust and well-being. Cambridge, MA: National Bureau of Economic Research.

14.

Helliwell

J. F.

Wang

(2011). Trust and wellbeing. International Journal of Wellbeing, 1(1), 42–78.

15.

Hibino

Takaki

Ogino

Kambayashi

Hitomi

Shibata

Nakamura

(2012). The relationship between social capital and self-rated health in a Japanese population: A multilevel analysis. Environmental Health and Preventive Medicine, 17, 44–52.

16.

Iran Census Population. (2011). Population by sex and major age group. Tehran: Author.

17.

Karimlou

Zayeri

Salehi

(2011). Psychometric Properties of the Persian Version of the World Health Organization’s Quality of Life Questionnaire (WHOQOL-100). Archives of Iranian Medicine, 14(4), 281.

18.

Kavanagh

A. M.

Bentley

Turrell

Broom

D. H.

Subramanian

S. V.

(2006). Does gender modify associations between self rated health and the social and economic characteristics of local environments? Journal of Epidemiology and Community Health, 60, 490–495.

19.

Kay

(2009). Wanted: Guidelines for reporting correlations. Advances in Physiology Education, 33(2), 134.

20.

Kiani

(2012). Social trust and social network in Iran. International Journal of Trade, Economics and Finance, 3, 458–463.

21.

Kim

Subramanian

S. V.

Kawachi

(2006). Bonding versus bridging social capital and their associations with self rated health: A multilevel analysis of 40 US communities. Journal of Epidemiology and Community Health, 60, 116–122.

22.

Leonard

Onyx

(2004). Social capital and community building: Spinning straw into gold. London, England: Janus Publishing Company.

23.

Mailath

G. J.

Postlewaite

(2006). Social assets. International Economic Review, 47, 1057–1091.

24.

Mechanic

Meyer

(2000). Concepts of trust among patients with serious illness. Social Science & Medicine, 51, 657–668.

25.

Mitchell

Bossert

(2007). Measuring dimensions of social capital: Evidence from surveys in poor communities in Nicaragua. Social Science & Medicine, 64, 50–63.

26.

Oort

Visser

Sprangers

(2005). An application of structural equation modeling to detect response shifts and true change in quality of life data from cancer patients undergoing invasive surgery. Quality of Life Research, 14, 599–609.

27.

Paxton

(2002). Social capital and democracy: An interdependent relationship. American Sociological Review, 67, 254–277.

28.

Poortinga

(2006). Social capital: An individual or collective resource for health? Social Science & Medicine, 62, 292–302.

29.

Rieger

(2008). Religion Monitor 2008. Muslim religiousness in Germany: Overview of religious attitudes and practices. Gütersloh, Germany: Religion Monitor, Bertelsmann Foundation.

30.

Rose

(2000). How much does social capital add to individual health? A survey study of Russians. Social Science & Medicine, 51, 1421–1435.

31.

Salehi

Harris

Marzban

Coyne

(2014). Confirmatory factor analysis of scales trust, and control-self-efficacy of young Iranian women. Journal of Social Indicators. Doi: 10.1007/s11205-014-0808-2

32.

Sarkiunaite

Bartkute

Jasinskas

Dilys

Jurgelenas

(2012). Link between social capital and quality of life. Transformations in Business and Economics, 11, 139–153.

33.

Skrabski

Á.

Kopp

Kawachi

. (2003). Social capital in a changing society: Cross sectional associations with middle aged female and male mortality rates. Journal of Epidemiology and Community Health, 57, 114–119.

34.

Snelgrove

J. W.

Pikhart

Stafford

(2009). A multilevel analysis of social capital and self-rated health: Evidence from the British Household Panel Survey. Social Science & Medicine, 68, 1993–2001.

35.

Subramanian

S. V.

Kawachi

Kennedy

B. P.

(2001). Does the state you live in make a difference? Multilevel analysis of self-rated health in the US. Social Science & Medicine, 53, 9–19.

36.

Subramanian

S. V.

Kim

D. J.

Kawachi

(2002). Social trust and self-rated health in US communities: A multilevel analysis. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 79(4 Suppl. 1), S21–S34.

37.

Tokuda

Jimba

Yanai

Fujii

Inoguchi

(2008). Interpersonal trust and quality-of-life: A cross-sectional study in Japan. PLoS ONE, 3(12), e3985.

38.

Ward

Meyer

(2009). Trust, social quality and wellbeing: A sociological exegesis. Development and Society, 38(2), 339–363.

39.

World Health Organization. (1997). Measuring quality of life. Author. Retrieved from http://www.who.int/mental_health/media/en/76.pdf

40.

Yip

Subramanian

S. V.

Mitchell

A. D.

Lee

D. T. S.

Wang

Kawachi

(2007). Does social capital enhance health and well-being? Evidence from rural China. Social Science & Medicine, 64, 35–49.