The Role of Social Capital in Moderating Health Disparities Among Rural Communities in Yobe State: A Structural Equation Modelling Approach

Background: Social capital, encompassing trust, social networks, and reciprocal norms, has theoretical relevance to health disparities reduction in resource-constrained rural settings. Its empirical relationship with health outcomes in conflict-affected areas of the North East geopolitical zone has not been examined using structural equation modelling approaches. This study tests a structural model of social capital as a moderator of health disparities in rural Yobe State. Methodology: A community-based study enrolled 520 adults from 26 rural communities through multistage cluster sampling. Social capital was measured using the adapted Onyx-Bullen Social Capital Scale. Health outcomes spanning self-rated health, healthcare utilisation, and chronic disease burden were assessed with validated tools. Structural equation models were constructed and tested using AMOS version 26. Results: Social capital demonstrated significant direct effects on self-rated health and healthcare utilisation. Cognitive social capital moderated the relationship between poverty and health outcomes more strongly than structural social capital. Community trust and participation in collective decision-making were the strongest social capital predictors of health. Conclusion: Social capital represents an independent and modifiable determinant of health disparities in rural Yobe State. Family medicine community health programmes should leverage existing social networks and community governance structures as platforms for health-promoting interventions. Keywords: social capital, health disparities, rural communities, Yobe State, structural equation modelling