Home is where the governing is: social capital and regional health governance

The relationship between the civic nature of a community and effective political governance by regional health boards in Canada is explored. A model is proposed that identifies components of social capital such as trust, commitment and identity, associationalism, civic participation and collaborative problem-solving. These concepts are then theoretically linked to effective governance, in particular to reflection of health needs, policy implementation, population health, fiscal responsibility and administrative efficiency. The generalizability of this model is discussed, as are current research directions and policy implications for governments. The conclusion is that governments might want to incorporate a dual perspective encompassing both the political institutions and the community structure.