Social Irresponsibility in Management
J. Scott Armstrong
The Wharton School, University of Pennsylvania

Abstract
Previously published research suggested that the typical manager may be expected to
harm others in his role as a manager. Further support for this was drawn from the
Panalba role-playing case. None of the 57 control groups in this case were willing to
remove a dangerous drug from the market. In fact, 79% of these groups took active
steps to prevent its removal. This decision was classified as irresponsible by 97% of the
respondents to a questionnaire. Because the role exerts such powerful effects, an
attempt was made to modify subject’s perceptions of their role so that managers would
feel responsible to all of the firm’s interest groups. Some subjects were told that board
members should represent all interest groups; other subjects were placed on boards of
directors where the different groups were represented. Subjects in both groups also
received information on the impact of the decisions upon stockholders, employees, and
customers. The percentage of irresponsible decisions was reduced under these
conditions as only 22% of the 116 groups selected the highly irresponsible decision.
Keywords: obedience to authority, Panalba, role-playing, social accounting, social
responsibility, stakeholder theory
“Social responsibility” is difficult to define. What should a manager do? It is easier to look at the
problem in terms of what he should not do.– i.e., at “social irresponsibility.” A socially irresponsible act
is a decision to accept an alternative that is thought by the decision maker to be inferior to another
alternative when the effects upon all parties are considered. Generally this involves a gain by one
party at the expense of the total system.
To determine whether the above definition agrees with common-sense notions of social
irresponsibility, a convenience sample of 71 subjects (faculty members, managers, and students) was
asked on a self-administered questionnaire to “define a socially irresponsible act in 25 words or less.”
Much variability was found in the responses, and about 12% of the subjects were unable to provide any
response. However, about 33% of the respondents suggested definitions that were similar to the above
definition.
Although this definition is accepted by many, there is still some ambiguity about the meaning of
social irresponsibility. Therefore, a second definition was used; this stated that an act was irresponsible if
a vast majority of unbiased observers would agree that this was so.
J. Scott Armstrong, “Social Irresponsibility in Management,” Journal of Business Research, 5 (September, 1977),
185-213. Reprinted with permission of Elsevier North-Holland Inc.
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To avoid problems arising from the above definitions, extreme cases of irresponsibility are examined
in this article. It focuses upon cases where great harm is caused to the system, and where almost all
unbiased observers are in agreement that an irresponsible act has occurred.
The current system is examined in the first section. What is the role of management and how is it
perceived by managers? This provides clues as to whether socially irresponsible decisions might be
expected under the current system. Evidence is drawn from previously published studies.
An alternative view of the role of management is described in the second section. This “stakeholder
role” is designed to reduce the likelihood of irresponsible acts.
The third section describes a role-playing experiment, which was used to study three questions:
1. Will management act in an irresponsible manner under the current system?
2. Are there individual differences that may help to identify people who are less likely to
commit irresponsible acts?
3. What changes in the system might reduce the level of irresponsibility?
Results are then provided from almost 2,000 subjects from 10 countries.
Social Irresponsibility Under the Current System
Many managers act in their own selfish interests. This often leads to irresponsible behavior. This
investigation, however, studies whether managers may commit irresponsible acts when they behave
according to the expectations of their role. Do they do harm when they try to do good? A review of
the empirical evidence, in particular the work of Milgram [42], suggests that they do. The evidence is
consistent with Reich’s [56] viewpoint that “Evil now comes about not necessarily when people violate
what they understand to be their duty, but more and more often, when they are conscientiously doing
what is expected of them.”
The Role of the Manager. The U.S. legal system advocates a “stockholder role” for managers. This
role, summarized by Berle in the Dodd-Berle exchange of the 1930s [3, 4] states that the manager is
directly accountable only to the stockholder. This was stated in an emphatic way by Rostow [59]:
The law books have always said that the board of directors owes a singleminded
duty of unswerving loyalty to the stockholders, and only to the
stockholders.
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Henn’s [27] Handbook of the Law of Corporations states that the duty of management is to be
obedient and loyal (to the stockholder). Finally, Blumberg [7], in his review of legal trends, finds little
change since the 1920s in the legal primacy of stockholder interests.
In other words, the legal system has relieved the manager of responsibility for assessing the impact
of his decisions upon other interest groups. He should only be concerned with these groups to the extent
that they affect the well-being of the stockholder. For example, air pollution is acceptable if there is no
response from the public, and, therefore, no threat to profit-maximization. Something would be done,
however, if it were expected that air pollution might lead to a boycott of the firm’s products.
The relationship of management to the stockholders and to the other interest groups under the
stockholder role is illustrated in Fig. 1. One-way arrows are used between the interest groups and the
stockholder, implying that the group must take the initiative to have its interests recognized by the firm.
Figure 1: Stockholder Theory
Local
Community
Stockholders
Customers
Employees Retailers
Creditors
Suppliers
Competitors
Management
The stockholder role advocates that the manager distributes rewards to maximize the returns to the
stockholder. Since the market is generally imperfect, decisions to maximize the benefits to the
stockho1der can often be accomplished at the expense of the other interest groups. Consider again the
case of air pollution; the local community provides a resource (clean air) to the firm and, in return, it
receives dirty air. The stockholder gains in this transaction, and the local community loses.
As the imperfections of the market increase (e.g., as entry of new competitors is restricted, as
collusion among competitors increases, as free choice by the consumers is restricted, or as the flow of
information is distorted) the relative gain to the stockholder can be increased, while other interest groups
receive less. As a result, the manager following the stockholder role is encouraged to take action that
will reduce the effectiveness of the free market. The stockholder role encourages the manager to create
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situations where one party gains at the expense of another. This argument is discussed further in Nason
and Armstrong [50].
Managers’ Viewpoints on What Role They Should Follow. The stockholder role is advocated by
the legal system. This role is also supported by schools of management. Furthermore, it is the position
that is publicly adopted by most firms. Do managers feel that they should follow the stockholder role?
In a survey of executives (Lorig [39] ), respondents stated that they owed first allegiance to the
stockholders. Barksdale and Darden [1], in a survey of executives from Fortune’s directory of the 500
largest U.S. corporations, reported over 40% of the respondents agreeing with the statement that, “In
event of a conflict between consumer orientation and profit objectives, profits would be the overriding
consideration.” A survey of subscribers to the Harvard Business Review [20] found about 40% of the
responses were consistent with the stockholder role. A replication of Ewing’s survey [35] yielded a
somewhat stronger orientation toward the stockholder role. Nichols [52], in a survey of British
managers, found that 68% of the respondents believed in some form of profit maximizing.
The surveys indicate that although a substantial proportion of managers believe in the stockholder
role, many managers question this role. For example, in Ewing’s study, only 2% of the respondents
selected the most extreme position that “a corporation’s duty is to its owners and only to its owners.”
Similarly, in Baumhart’s [2] survey of subscribers to the Harvard Business Review, 83% of the
respondents agreed that “for corporation executives to act in the interest of shareholders alone, and not
also in the interest of employees and consumers” is unethical.
Expected Behavior under the Stockholder Role. What type of behavior might be expected from a
manager who believes in the stockholder role? How would he act in an extreme situation in which the
stockholder gains by harming other interest groups and in which the whole system is worse off? A
variety of evidence was examined: laboratory experiments, field experiments, attitude surveys, and
documented case histories.
Laboratory Experiments The most relevant set of studies were the “obedience to authority” studies in
social psychology. The basic design of these studies was for someone in a position of legitimate
authority to command a subject to harm a third party. Most subjects showed a high level of obedience.
There are many variations to the obedience studies, but the most widely known design is Milgram’s
[42]. Here, one accomplice and one naive subject arrived for what was ostensibly a “learning
experiment.” Each subject was paid $4.50 at the start and was told that the payment is theirs no matter
what happens. A rigged random drawing was then held to see who would be the “teacher” and who
would be the “learner.” The naive subject was always the teacher. This subject was instructed to teach
the learner a list of paired associates, to test him on the list, and to administer punishment whenever the
learner erred. Punishment was administered in the form of an electric shock to the learner, who was
strapped in an electric chair. (No shock was actually administered.) According to a specified plan, the
learner provided 30 wrong answers and the teacher was instructed to increase the shock from 15 to the
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maximum of 450 volts. The shock generators bore designations going from “Slight Shock” to “Danger
Severe Shock” to AXXX.” To convince the naive teacher of the authenticity of the experiment, he
himself was given a sample shock of 45 volts.
At first, no feedback from the learner was used. It was expected that the designations on the control
panel would be sufficient to curtail the subject’s obedience. Virtually all subjects, however, followed
instructions and administered the maximum shock.
Various forms of feedback from the learner were then introduced – e.g., the learner would cry out
in pain. While a large percentage of subjects continued to shock on command, many subjects did stop
the punishments; about one-third of the subjects stopped when they could hear the victim, and twothirds
of the subjects broke off the experiment when they were placed in the same room as the victim
(who was a professional actor).
The obedient subjects followed instructions even though they were performing a task that was
distasteful to them [42] . This was apparent from the fact that few subjects would administer severe
shocks when they personally could decide on the level of punishment [41, 42]. Furthermore, the act of
shocking people was shown to lead to a sense of guilt [12]. Finally, subjects shocked on command
even though they thought that the learner was being seriously harmed; in Mantell [41), 28% of the
obedient subjects thought that the learner had probably died.
Milgram’s conclusion from the obedience studies was [42:6]1
“... ordinary people, simply doing their jobs, and without any particular hostility on
their part, can become agents in a terrible destructive process. Moreover, even
when the destructive effects of their work become patently clear, and they are
asked to carry out actions incompatible with fundamental standards of morality,
relatively few people have the resources needed to resist authority.”
Additional studies suggest that subjects pay little attention to the consequences of their actions. Orne
[53] was unsuccessful in devising a task that was so useless that the subject would not obey. In this
experiment, subjects would add up a series of random numbers and then destroy this work as ordered;
then they would move onto the next page to repeat the same process, etc. Subjects apparently assume
that no matter how absurd the task, some higher authority has good reason for demanding that it be
carried out. Similar results had also been reported by Frank [2l] where subjects persisted in an
unpleasant and senseless study on cracker eating.
1 The obedience studies have been subjected to much criticism [70]. Concern has been expressed over
the well-being of the subject (Milgram’s results indicated that there was little danger and this was
supported by Ring et al. [57]), and also to the possibility of a tautology (Orne [53] with reply by
Milgram [42]).
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Field Experiment Hofling et al. [18] studied obedience among nurses. Ninety-five percent of the
nurses (N =22) administered a medicine as ordered by a doctor even though the medicine was
unauthorized, the dosage was twice that listed on the pill box, the doctor who gave the order was
unknown to the nurse, and the ordering of medication by telephone was in violation of hospital policy.
(The medicine was actually a placebo.) A survey of 33 graduate and student nurses supported the
assumption that the act was obviously wrong; 94% of these respondents claimed that they would not
give the medicine under such circumstances.
Attitude Surveys Kelman and Lawrence [33] examined the My Lai incident. A national opinion survey
in the U.S. (N = 989) asked: “What would you do if ordered to shoot all inhabitants of a Vietnamese
village suspected of aiding the enemy, including old men, women and children?” Fifty-one percent of the
respondents said that they would “follow orders and shoot,” and only 33% said they would “refuse to
shoot.”
In a study related to business management, Baumhart [2], in a survey of 1,800 subscribers to the
Harvard Business Review, found that unethical practices were widespread. Only 18% of the
respondents said that there were no “enerally accepted unethical practices in his industry.” The primary
influence in making these unethical decisions was reported to be the behavior of one’s superior. A
survey of managers in the private sector [13] found that 64% of the respondents agreed with the
statement “managers today feel under pressure to compromise personal standards to achieve company
goals.” This study was replicated with managers in the public sector [9].
Krishnan [35] asked subjects what they would do in a case where an engineer was fired for refusing
to “edit” the results of a product liability survey to enable a company to receive an order. The engineer
had also informed the customer on the actual results and this had resulted in the loss of the order.
Almost two-thirds of the respondents said the company should not reinstate the engineer.
Documented Case Histories Assuming that the stockholder role is accepted by many managers and
that blind obedience is a common trait among people, then it should not be difficult to find examples of
socially irresponsible decisions by managers. Indeed, there are many documented cases where
managers have brought serious harm to employees, to the local community, or to the customers. The
conflict between the desires of employees and those of stockholders was strong in the early part of this
century (e.g., see Schultz and Coleman [60] for a description of the Ludlow Massacre where an effort
to unionize was put down by John D. Rockefeller). More recently there has been much conflict between
stockholders and customers. Examples have been documented by Nader [48] in the description of the
Corvair; by Sjoström and Nilsson [64] in their description of the thalidomide case; and by the various
examples presented in Heilbroner et al. [26], in Mintz and Cohen [46], in Nader et al. [49], and in the
First Report by the National Commission on Product Safety [51]. These cases refer primarily to
managers who felt that they were acting as they should act. They were obedient to their roles.
In summary, the stockholder role encourages socially irresponsible acts. People who believe in this
role may be expected to seriously harm others, and “trying harder,” in the sense of following the role
more faithfully, will increase the level of irresponsibility.
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The Stakeholder Role. Assume that groups a, b, and c were brought together in a common
undertaking. The inputs of each of these groups are necessary for satisfactory performance. Now for
whom does the system really exist – a? for b? or for c? One cannot answer this. But when we put
labels on a, b, and c – such as stockholder, employee, and customer – the situation becomes clearer.
Tradition has taught us to perceive this system from the viewpoint of the stockholder.2 We “maximize
profits” rather than “wages” or “consumer satisfaction.” What is done becomes a value. A change from
this value is resisted on the basis that economics does not deal with values.
2 According to the survey by Dent [16], the shift from owner-manager to professional-manager has not
led to any shift in the reported profit orientation of the managers.
The problem is that the manager is asked to place the welfare of one of the groups in this system
above the welfare of the other groups. In a perfectly competitive market, the manager’s perception of
his role (e.g., to maximize wages or to maximize profits) is of no importance. But the perception is
important where imperfections exist. Here, attempts to place the welfare of one group above another
may lead to irresponsible actions. This is expected no matter which group is given priority. For example,
the Yugoslavian solution to maximize wages rather than profits [6, 67] is not expected to remove
incentives to harm others. It only leads to changes in who is injured.
There are many ways in which one might try to reduce the likelihood of socially irresponsible actions
by managers. One of the most effective ways would be to increase competition. Other approaches
would be class action suits, greater publicity about actions by firms, and strict product liability laws. This
article considers one of the many possible approaches – how one might change the managers’
perception from the stockholder role to one where he views himself as being responsible to those
groups that are affected by the firm’s actions. This is referred to as the “stakeholder role.”
This attempt to change managers’ perceptions of their role is consistent with one of the conclusions
from the obedience studies: “Control the manner in which a man interprets his world, and you have gone
a long way toward controlling his behavior” [42, p. 145] .
In contrast to the stockholder role, or any other “sub-optimization” approach, the stakeholder role
suggests that the manager serves many masters. He is responsible to a and b and c. A distinction is
drawn, however, between primary and secondary interest groups. A primary stakeholder is affected by
the decisions of the firm and also makes some contribution to the firm. A secondary stakeholder is
affected by the firm’s decisions, but makes no direct contribution to the firm. An illustration of
management’s relationship to the primary and secondary stakeholders for a typical firm is presented in
Fig. 2. (The secondary stakeholders are designated by a dotted line.)
Management, under the stakeholder role, should try to ensure that the marginal rate of return on
contributions is equal for each of the primary interest groups. He should also avoid bringing unnecessary
harm to competitors. Two-way arrows are used in Fig. 2 to indicate that management should take the
initiative in keeping the interest groups informed and in providing adequate rewards.
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Figure 2: Stakeholder Theory
Local
Community
Stockholders
Customers
Employees Retailers
Creditors
Suppliers
Competitors
Management
The stakeholder role advocates responsibility to all of the interest groups and only to these interest
groups. It does not advocate that the manager act in the best interests of society. This is vague and may
lead to arbitrary actions. For example, assume that General Motors donated money to the University of
Pennsylvania. Under the stakeholder role, such a contribution would be regarded as irresponsible since
the university would hardly be considered as one of General Motors’ interest groups. (In this case, the
burden of proof would be on the management of G.M. to show that the donation was a good
“investment” for its primary stakeholders.) Incidentally, although both the stakeholder and the
stockholder roles [23,35] are in agreement that charitable donations are irresponsible, they are legal in
the U.S., having survived a legal challenge [7].
From the previous definitions of social irresponsibility, it seems that managers who follow the
stakeholder role would not act irresponsibly. The question is how to get managers to adopt such a role.
Although the stakeholder role was discussed at least 40 years ago [ 17, 18], there has been little
movement in this direction. For example, “Campaign GM,” an effort to place consumer and community
representatives on the General Motors board of directors, received only about 3% of the stockholders’
votes [61].
The Panalba Role-Playing Experiment
Validity of Role-Playing: Survey research presents a number of difficulties in the study of social
irresponsibility. Respondents describe themselves in a favorable light. Furthermore, they often have
difficulty in deciding how they would respond in various situations. On the other hand, field experiments
on irresponsibility are expensive and difficult to arrange, and subjects can also become upset in field
experiments (e.g., the nurses in the Hofling et al. [28] study were upset when they found that they were
the subjects of an experiment).
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Role-playing offers one approach to studying social responsibility. It avoids some of the difficulties
of survey research, while being substantially cheaper than field experimentation. Role-playing, however,
has been subject to much criticism [22, 43]. For that reason, it is useful to provide a brief review of the
evidence on the validity of role-playing.
Face Validity: Janis and Mann [32] used role-playing to modify smoking habits; subjects who roleplayed
a lung cancer patient were observed by the experimenter to become emotionally involved with
the role. In a follow-up study, Mann [40] provided reports from the role-players that indicated a
significant amount of emotional involvement. Zimbardo [72] created realistic role play of a prison. The
subjects displayed much emotion and were even surprised at their behavior in their roles. Orne et al.
[54] reviewed research showing that subjects can role-play as hypnotics in such a convincing manner
that observers cannot distinguish between role-players and hypnotics. These studies suggest that roleplaying
provides responses that are representative of those by people in an actual situation.
Construct Validity: Numerous studies have compared role-playing to experiments. Greenberg [25]
found similar results for role-playing as for a laboratory experiment on the relationship between anxiety
and the need for affiliation. Willis and Willis [69] used role-playing to successfully replicate the main
effects from a laboratory study on conformity, although the interaction effects were not the same.
Horowitz and Rothschild [30] found that “forewarned role-playing” provided similar results to a
laboratory experiment on conformity. The forewarned role-playing instructions were to “act as you think
subjects would act in this particular situation.” Wexley et al. [68] used role-playing of the appraisal
interview and obtained results similar to those from a field study, Terry [65] used role-playing and
successfully replicated his experiment on expectancy in food tasting. Darroch and Steiner [15] used
role-playing to replicate an experiment on attitude change and found some similarities and some
differences. In the only completely negative study, Yinon et al. [71] found substantial differences
between role-playing and decisions made by students on a grading issue.
A number of the role-playing studies have been done in connection with the obedience experiments.
Holmes and Bennett [29] and Houston and Holmes [31] asked subjects to act as if they would be
receiving an electric shock; subjects gave similar responses on a questionnaire as did subjects who
expected to receive the shocks, but they did not show the same types of physiological changes.
Berscheid et al. [5] used role-playing to replicate the obedience experiment by Ring et al. [57], and
obtained similar results on the effect of debriefing upon subjects. Mixon [47) used role-playing and
replicated the Milgram experiment. Finally, Simons and Piliavin [63] failed to obtain the same results in
studying subject’s reactions to someone who had been punished by electric shocks.
While these results from role-playing are not identical to those from experiments, there were
substantial differences in only 2 of the 13 studies involving construct validity. It is not clear which
approach is closer to truth, but it is clear that they generally produce similar results.
Predictive Validity: Crow and Noel [14] had subjects play the role of the Mexican leader in a
disguised version of the events leading to the annexation of Texas by the U.S. Subjects were asked to
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reach a decision ranging from 1 (a peaceful response) to 11 (a warlike response). According to
historians, the optimal decision would have been a 1 or 2. One percent of the subjects selected a 1 or 2,
and 57% selected a 4 or 5. The actual decision was classed as about a 4 or 5, and it proved disastrous
for Mexico. Thus, role-playing provided a good way to predict how the Mexican leader would act.
Panalba as an Extreme Case: A case was desired that would allow stockholders to gain at the
expense of other interest groups. Furthermore, the gain to the stockholders should be much less than the
loss to the other groups. The Panalba case met these criteria.
The basic model for this case was “what decision would a manager make if he could earn
$1,000,000 for each customer that he was willing to kill?” Of course, the problem was not stated in
such a direct manner; instead, it was cast in a legitimate framework. The subjects acted as members of
the Board of Directors of the Upjohn Company. Upjohn had a very profitable drug named Panalba.
There was much evidence that substitute drugs from Upjohn’s competitors provided the same benefits
at the same price. Panalba, however, had serious side effects such as death, while the substitutes were
virtually free of side effects. The question was whether Upjohn should remove Panalba from the market.
(See Appendix A for a description of the case.)3
To determine whether this case allowed for irresponsible behavior, a self-administered questionnaire
was given to captive audiences of faculty, students, and managers. This described the Panalba case
(from Appendix A) and explained that Upjohn had taken legal and political action to prevent the
removal of Panalba from the market (decision “e”). Almost all respondents viewed Upjohn’s decision as
socially irresponsible (Table 1). Furthermore, only 2% of the respondents selected this decision when
asked, “If you were Chairman of Upjohn, what decision would you have made?”
Table 1: Attitudes Toward Upjohn’s Decision (N = 71)
In Your Opinion, Did Upjohn Act: Percentage of Responses
In a socially responsible manner? 0
In a socially irresponsible manner? 97
No opinion 3
The Sample: The role-playing sample was selected on the basis of convenience. The subjects were
from undergraduate and graduate courses in management (g = 264), and also from executive training
programs (g = 55). Although managerial experience was limited for the undergraduates, most graduate
3 The description was based upon the true case of Panalba as reported by Mintz [45]. Information was
also taken from Upjohn’s Annual Reports. I made up details for this case, such as the accounting
estimates of Table 2, to make the extreme nature of this case obvious. Attempts were made to obtain
further information from the Upjohn Co. to ensure that the facts were accurately presented, but they
refused to answer.
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students had previous experience. Results were obtained from groups in 10 countries: U.S. (166),
Sweden (109), Belgium (11), France (8), Canada (6), Norway (4), England (8), Denmark (3), Finland
(2), and Mexico (2). No one in the sample had heard of Panalba.
All groups were from captive audiences. This seemed advantageous since studies of volunteers have
shown that they are less authoritarian and they have a higher need for social approval [58]. Both of
these factors would be expected to affect decision-making in the Panalba case.
Role Descriptions. The role descriptions were simple and realistic, and they allowed flexibility for each
member. The instructions (Appendix B) emphasized that the subject should “act as you would act if
you were in the role of the person described. “Of the seven roles in the control group, the chairman
was asked to help the group reach consensus; he had no prior position on the subject, and he had no
information other than the background information. The president of the company had no prior position,
but some possible courses of action had been suggested to him by others in the company. Two other
board members had no predisposition and no additional information. The remaining three members
were favorably disposed toward Panalba prior to the meeting, but there was nothing in the role that
would prevent them from changing their opinion during the meeting. (The roles are shown in Appendix
C. All subjects received the background information, Appendix A.)
The roles were altered in two respects when trying to emphasize the stockholder role. The first
change was to add the following passage to each subject’s role:
It is important to note that the members of the Upjohn Board had a number of
discussions in the past as to the proper role that a Board member should take. A
resolution had been passed in 1950 which stated that the board’s duty was to
represent the stockholders. It was felt that society’s needs would be served best if
the board acted in such a way as to maximize the return to the stockholder – i.e.,
to maximize profits. (All of the current board members are well aware of this policy
statement.)
The second change was to provide subjects with accounting information to show how the various
decisions would affect the stockholders (column 1 in Table 2). There were two different approaches to
implementing the stakeholder role. One was to say that the board believed in the stakeholder role by
adding the following statement to each subject’s role:
Finally, it is important to note that the members of the Upjohn Board had a number
of discussions in the past as to the proper role that a Board member should take. A
resolution had been passed in 1950, which stated that the Board’s duty was to
recognize the interests of each and every one of its “interest groups” or
“stakeholders.” The stakeholders are those groups which make specific
contributions to the firm. Thus, the board is to consider the effects of decisions
upon employees, creditors, stockholders, customers, suppliers, distributors and the
local community. Furthermore, the board should consider only its own
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stakeholders in making decisions. It shall not attempt to serve the common good or
society in general. (All of the current board members are well aware of this policy
statement.)
These instructions did not command the subject to follow the stakeholder role; they state that the
board advocated such a role. Beyond this the roles were identical to those described for the traditional
board. The other approach to the stakeholder role was to provide representation to the various interest
groups. No single group would dominate the board in this democratic version. The Chairman, the
President, and a stockholder representative were the same as described in the traditional board. In
addition, there was one representative each for employees, customers, suppliers, and the local
community. (These roles are presented in Appendix D.) Again, it may be seen that the roles allow
flexibility in decision making.
Table 2: Accounting Provided in Panalba Case. Estimated Losses
(in Millions of Dollars)a
Alternatives Stockholders Customers Employees Total Losses
a. Recall immediately 20.0 0.0 2.0 22.0
b. Stop production 13.0 13.6 1.8 28.4
c. Stop promotion 12.0 16.8 1.2 30.0
d. Continue until banned 11.0 19.6 1.0 31.6
e. Prevent ban 4.0 33.8 0.2 38.0
a These estimates represent present value losses to each group affected by this decision. The losses to
customers represent deaths and illnesses caused by Panalba for which no compensation is received;
losses to employees represent lost wages and moving expenses beyond those covered by severance
pay and unemployment benefits.
The stakeholder role was reinforced by providing explicit measures on how each of the interest
groups would be affected (all information from Table 2). This is referred to as Asocial accounting.” It is
not a new concept, having been suggested at least as early as 1953 (e.g., see Bowen [8] ). Referring
again to the obedience studies, social accounting would be analogous to the feedback from victims; this
feedback led to substantial reductions in blind obedience [10, 42, 66]. One might also infer from Tilker
[66] that feedback is most effective when it is perceived as being legitimate to the person’s role; in his
experiment, the feedback had the greatest impact when the subject felt responsible for the safety of the
victim. The assumption used in the Panalba case was that social accounting will be most effective if the
subject perceives himself as being responsible to all interest groups.
Administration of the Experiment: The case was not introduced to the subjects as an experiment;
instead, it was used as a teaching vehicle. Furthermore, it was not introduced as a case on social
irresponsibility, but as a decision-making exercise in a crisis situation. In no instance was it implied that
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performance in this situation would be related to a subject’s grade in a course; in fact, the case was
generally administered in nongraded courses.
Administrative instructions were standardized (Appendix B). To date, the administration has been
conducted by 33 different people, although about 40% of the groups were run by the author. It was
administered on 91 different occasions over a period of over 5 years (February 1972 to March 1977).
The administration by different people in different settings at different times should help to compensate
for biases.
Table 3: Decisions in Panalba Case: Control Condition
Level of Social Irresponsibility Percentage of Groups (g = 57)
High (decision e: block FDA) 79
Moderate (decisions b, c, d) 21
None (decision a: remove drug) 0
Results: The results address the following three questions: First, can managers be expected to act in
an irresponsible manner? Second, do differences among backgrounds of managers lend to differences in
socially irresponsible behavior? Finally, can the role perceptions of managers be modified so that they
affect decision-making?
Social Irresponsibility under the Current System: The control version of the Panalba case provided
evidence on the likelihood that managers will make socially irresponsible decisions. It should be noted
that subjects were not instructed to maximize profits. However, as noted by Larsen et al. [36] in their
study of obedience, it seems sufficient merely to put people in a mildly compelling situation. That is,
subjects in the Panalba case were expected to fee1 some pressure toward that stockholder role
because of their background. The fact that they were working in a group was expected to increase this
pressure because the stockholder role was expected to be the dominant viewpoint in the group.
The results are presented in Table 3. None of the groups removed the drug from the market. In fact,
79% of them selected the highly irresponsible decision. This was the decision that had been made by
Upjohn. According to Mintz [45], Upjohn had a judge serve an injunction on the FDA, and they also
used political pressure. Although Upjohn was eventually forced to remove Panalba from the U.S.
market in March 1970, it continued to sell Panalba in foreign markets [46].
The possibility of biases in the control version was examined. Although many researchers have
suggested that subjects help the researcher prove his hypotheses, Sigall et al. [62] reviewed the
evidence and found little empirical evidence to support such a viewpoint. Furthermore, Carlsmith et al.
[11] found no differences in their role-playing study when comparing results from two experimenters
who held contradictory hypotheses. A follow-up survey of 32 subjects in the contro1 version of the
14
Panalba role-playing case (after the role-playing, but prior to any discussion), found that 90% were
unable to guess that the hypotheses being tested related to social irresponsibility. Finally, there were no
differences in the decisions for groups administered by the author (g = 26) and those for all other
administrators (g = 31).
Subjects in the Panalba case often seemed to be bothered by their decision. As in Milgram’s [42]
and Larsen’s [36] studies on obedience, subjects seemed to feel that they were being asked to do
something wrong. Some subjects dealt with this by misinterpreting the information in order to minimize
the bad effects of the decision. Others tried to justify their decision to keep Panalba on the market; they
would suggest, for example, that they were merely following their role. This argument was suspect in
view of the difficulty in getting many of the subjects to follow the stakeholder role.
The results from the control condition were in agreement, then, with the previously cited evidence
that the typical manager may be expected to seriously harm others in carrying out his duties. (From a
methodological viewpoint, these results add support for the use of role-playing as a predictive device.)
Differences among Managers: An examination was made of differences among managers. Two
possible factors were examined: nationality and age.
The popular press has suggested that managers in various countries differ in their social
responsibility. For example, the Financial Times (March 29, 1974) suggested that Norwegian
managers have objectives that differ from those of American managers; they are more interested in A...
the effectiveness of the social system.” Furthermore, previous research on the obedience studies
suggested that there were differences according to nationality [34, 41].
Differences due to nationality were examined by analyzing the results from the 57 groups in the
control condition. For Sweden (g = 18), 72% of the decisions were classed as highly irresponsible. The
corresponding figure for the U.S. (g = 29) was 79%. Results from the other six countries (g = 10)
showed 90% highly irresponsible. There were no statistically significant differences among these groups.
Observers have suggested that younger people are more concerned with social irresponsibility, and
that they are less profit oriented [55]. Empirical evidence on this issue is limited. Baumhart’s [2] survey
of subscribers to the Harvard Business Review suggested that younger managers are more
irresponsible. Krishnan [35] found younger managers to be more oriented toward profit maximizing.
Goodman and Crawford [24] found no differences by age in a survey that asked respondents what
decisions they would make in various situations, many of which allowed for socially irresponsible
decisions.
Differences due to age were examined in the Panalba study by comparing results from advanced
management courses (where average ages were generally above 30) against those from undergraduate
and graduate programs (where the average ages generally ranged from 20 to 25). Older managers (g =
15) selected the highly irresponsible decision in 73% of the groups, while younger managers (g = 42)
selected this decision in 81% of the groups. Although this difference is not statistically significant, the
15
direction is in agreement with the previously cited evidence; younger managers tend to be more
irresponsible.
The Stakeholder Role: Consideration was given to ways in which the role perceptions of the subject
might be modified. The first step was to ask subjects about these perceptions. A “managerial orientation
questionnaire” (MOQ) was administered to a subset of the subjects both before and after the roleplaying
exercise. The MOQ described the stockholder and stakeholder roles as they were presented in
the role-playing instructions. Before the role-playing, the subjects were asked. “Which of these
descriptions best represents the role which you feel that you would use as a manager?” The results
(summarized in Table 4) were inconsistent with the assumption that subjects would normally adopt the
stockholder role. Only 21% of the respondents said that they would use the stockholder role, while
76% said they would use the stakeholder role.
Table 4: “A Role That I Would Use”: Before Role-Playing of Panalba
(N = 268)
Stockholder Undecided Stakeholder
(-2) (-1) (0) (1) (2)
5% 16% 3% 62% 14%
After the role-playing, but before any discussion, the same subjects were given the same scale and
asked to “Mark the category that best represents how you feel that you acted in this role-playing
case.” The responses are summarized in Table 5. All group’s averages moved toward the stockholder
end of the continuum, indicating that the respondents felt that their behavior in this case was more
oriented toward the stockholder role than were their attitudes. Note, however, that the change in the
stockholder version of the case was greater than that in the control group, which, in turn, was greater
than that in the two stakeholder versions. Although the role manipulations did have the intended effect,
the magnitude of the effect was not large. Subjects bring a perception of their role into the case that is
not easily changed.
Table 5: Perceived Behavior vs. Prior Attitude
Role Emphasis
Number of
Groups
Perceived Behavior
Minus Initial Rating Final Rating
Stockholder (board agrees) 10 - 1.7 - 1.0
Control group 9 - 0.9 - 0.4
Stakeholder (board agrees) 13 - 0.1 +0.5
16
Stakeholder (democratic board) 11 - 0.3 +0.6
Primary interest lay in the extent to which decision-making was influenced. The results, summarized
in Table 6, indicate that the attempts to change the role orientation did have an effect upon decisionmaking.
Decisions under the stakeholder version were less irresponsible: 76% of the decisions in the
stockholder version were classed as highly irresponsible, compared with 22% of the stakeholder
decisions (taking the last two columns together). None of the stockholder decisions were free of
irresponsibility vs. 21% of the stakeholder decisions. These results were statistically significant at the
0.05 level (calculated level of significance was less than 0.001 using the test).
Although the democratic board was more effective than was a prior agreement by the board to
represent all interest groups, the difference was not statistically significant.
The stakeholder version changed the role and the method of accounting. An analysis was conducted
to assess the relative contribution of each aspect. The hypotheses in this report suggested an interaction:
social accounting should be of greater value where it is part of the legitimate framework. Also, the
stakeholder role becomes stronger when the accounting system is designed along the same framework.
Still, some effect was expected if either of these components was used by itself.
The impact of social accounting was tested by varying the information in the control condition
(where no statement was made on roles.) Financial accounting was used for 30 groups and 24 groups
received social accounting. The results were surprising: instead of a reduction in irresponsibility, there
was a tendency (not significant) for irresponsibility to be greater with social accounting.
Neither a reorientation of the role nor social accounting, by themselves, proved effective. It was
only when used to reinforce one another that significant reductions in irresponsibility were obtained.
These results are relevant to those advocates of social accounting who are concerned with changing the
method of accounting alone.
The results would seem to be subject to serious biases because different versions were run during
each administration of the role-playing case and the biases would be expected to be constant across the
different versions.
Table 6: Decisions in Panalba Case: Stockholder and Stakeholder Conditions
Role: Percentage of Groups Selecting Each Decision
Stakeholder Versions
Level of social irresponsibility
Stockholder
(Board Agrees) Board Agrees
Democratic
Board
High 76 23 22
Moderate 24 65 49
17
None 0 12 29
(g =) (41) (57) (59)
The results from Table 6 also indicate that the stockholder results, with 76% of the groups selecting
the highly irresponsible decision, were no different than those from the control group where the
corresponding figure was 79%. This supports the hypothesis that managers tend to act in accordance
with the stockholder role.
Conclusions
A review of previous evidence suggested that a substantial proportion of managers may be
expected to bring serious harm to others in situations where they feel it is proper behavior for their role.
Further evidence was provided by the Panalba role-playing study, where 79% of the groups selected a
highly irresponsible decision and none chose the decision that was free of irresponsibility. These results
were due to the pressure of the role rather than to differences among individuals; differences in
irresponsibility were not related to nationality or to age.
The stakeholder role led to a reduction in irresponsibility. Instructions that a board member should
represent all interest groups, along with the evidence on how these groups were affected, led to a
reduction in irresponsibility as only 23% chose the highly irresponsible decision. Reductions also
occurred when the interest groups were represented on the board of directors; 22% of these groups
selected the highly irresponsible decision.
18
Appendix A: Background Information for the Panalba Case
Assume that it is August, 1969, and that Upjohn Corporation has called a Special Board Meeting to
discuss what should be done with the product known as “Panalba.”
Panalba is a “fixed-ratio” antibiotic sold by prescription. That is, it contains a combination of drugs.
It has been on the market for over 13 years and has been highly successful. It now accounts for about
18 million dollars per year, which is 12% of Upjohn Company’s gross income in the U.S. (and a greater
percentage of net profits). Profits from foreign markets, where Panalba is marketed under a different
name, are roughly comparable to those in the U.S.
Over the past 20 years there have been numerous medical scientists (e.g., the AMA’s Council on
Drugs) objecting to the sale of most fixed-ratio drugs. The argument has been that (1) there is no
evidence that these fixed-ration drugs have improved benefits over single drugs, and (2) that the
possibility of detrimental side effects, including death, is at least doubled. For example, these scientists
have estimated that Panalba is causing about 14 to 22 unnecessary deaths per yearBi.e., deaths which
could be prevented if the patients had used a substitute made by a competitor of Upjohn. Despite these
recommendations to remove fixed-ratio drugs from the market, doctors have continued to use them.
They offer a shotgun approach for the doctor who is unsure of his diagnosis.
Recently a National Academy of Science - National Research Council panel, a group of impartial
scientists, carried out extensive research studies and recommended unanimously that the Food and Drug
Administration (FDA) ban the sale of Panalba. One of the members of the panel, Dr. Eichewald of the
University of Texas, was quoted by the press as saying, AThere are few instances in medicine when so
many experts have agreed unanimously and without reservation” (about banning Panalba). This view
was typical of comments made by other members of the panel. In fact, it was typical of comments which
had been made about fixed-ratio drugs over the past 20 years. These impartial experts then believe that
while all drugs have the possibility of side effects, the costs associated with Panalba far exceed the
possible benefits.
The Special Board Meeting has arisen out of an emergency situation. The FDA had told Upjohn
that it plans to ban Panalba in the U.S. and wants to give Upjohn time for a final appeal to them. Should
the ban become effective, Upjohn would have to stop all sales of Panalba and attempt to remove
inventories from the market. Upjohn has no close substitute to Panalba, so consumers will be switched
to close substitutes which are easily available from other firms. Some of these substitutes offer benefits
which are equivalent to those from Panalba, and yet they have no serious side effects. The selling price
of the substitutes is approximately the same as the price for Panalba.
It is extremely unlikely that bad publicity from this case would have any significant effect upon the
long term profits of other products made by Upjohn.
The following possible solutions were considered by the Board:
19
1. Recall Panalba immediately and destroy.
2. Stop production of Panalba immediately but allow what’s been made to be sold.
3. Stop all advertising and promotion of Panalba but provide it for those doctors that request
it.
4. Continue efforts to most effectively market Panalba until sale is actually banned.
5. Continue efforts to most effectively market Panalba and take legal, political, and other
necessary actions to prevent the authorities from banning Panalba.
You, as a member of the Board, must help to reach a decision at today’s meeting. The Chairman of
the Board, Ed Upjohn, has provided this background information to each of the Board members. He is
especially concerned about selecting the most appropriate alternative for the U.S. market. (You must
decide which if the possible alternatives is closest to your preferred solution.)
A similar decision must also be made for the foreign market under the assumption that the sale of
Panalba was banned in the U.S. This decision will be used as a contingency plan.
20
Appendix B
Instructions The major instructions given to the subjects are provided below. The underlined
statements were also written on the blackboard.
“I am providing one envelope to each group. Please do not write on these materials
unless you are the Chairman. The Chairman will complete a group decision form.
When you receive the envelope, please remove the contents, take the “role” on top and
pass the roles to the person on your right, etc., until everyone has a role.
“When you receive your role, remove the 3 x 5 card and place it on you or in front of
you so that the others in your group can tell who you are. Then read your role and act
as you would act if you were in the role which is described. (Repeat this.)
Improvise as necessary but do not step out of your role. The roles all differ so do
not discuss your role with others in your group.
“This meeting has been called by E. G. Upjohn, the Chairman of the Board at Upjohn.
Due to time pressures, your group must reach a decision in 45 minutes. Dr. Upjohn will
start the meeting as soon as you have read your roles.”
21
Appendix C: Roles for “Traditional Board”
Chairman of the Board As Chairman of the Board, it is your job to have the Board reach a decision
on the two issues within the time allowed. Unfortunately, you have only 45 minutes to reach a decision
since some of the Board members can stay no longer than that.
Your general philosophy about meetings is to try to allow for various sides of the issue to be
discussed before a decision is reached.
Legally speaking, a majority vote is required in order to reach a decision. You prefer that a
consensus be reached, but a formal ballot may be used at the end of the meeting if necessary. (Please
record the group decision on the form which has been given to you and give it to the administrator of
this case.)
Vice Chairman of the Board You were the President of Upjohn when Panalba was introduced into
the market. Naturally, you feel that Panalba was, and still is, a good product both for Upjohn and for
the people who have used it. If you didn’t feel this way, you would have never put Panalba on the
market in the first place.
President You’ve been President for about two years. Since you have taken over, the economy has
been slacking off and, as a result, company profits have been off somewhat. The Panalba problem
seems to have come at an especially bad time, then.
You have been checking out various ways of handling the Panalba problem. One suggestion has
been sent to you by an Upjohn lawyer. He had seen the Panalba issue develop over the past few years.
He thinks that it would be possible to delay any action by the FDA. He suggests that Judge Kent of
Kalamazoo (a man whom you know personally) would be willing to serve an injunction on the FDA.
The injunction would prohibit the FDA from banning Panalba until such time as a formal hearing can be
held. The results of the hearing, if unfavorable, could then be appealed. In effect, the case could be tied
up in the courts for years. And, if the court action was successful, it would help to prevent the FDA
from moving against other drug products in the future.
Another suggestion was sent to you by the Upjohn lobbyist in Washington. He suggests that it might
be possible to bring political pressure to bear and to attempt to have Robert Finch, head of HEW (and
therefore having jurisdiction over the FDA), overrule the proposed action by the FDA.
Vice President and Director You have, of course, been aware of the bad publicity on Panalba. One
idea has been suggested to you, however. This is that an appeal should be sent to all doctors to protest
to the FDA on the grounds that the FDA would be violating the physician’s right to prescribe if they
removed Panalba. You feel that the fact that the doctors have been using Panalba for the past 13 years
indicates that it must have some value.
22
You’ve been a member of the Board of Directors for 8 years and you own 20,000 shares of
Upjohn stock.
Executive V.P. - Upjohn You have been on the Board of Directors since 1955 and you own about
25,000 shares of Upjohn.
President: William John Upjohn, Assoc., Inc., Marketing and Advertising Consultants You are
part of the Upjohn family and you own a considerable amount of stock. Your consulting firm does most
of its work for the Upjohn Co.
Stockholder You are a practicing M.D. You’ve been prescribing Panalba for years and you have seen
nothing wrong with it.
23
Appendix D: Description of the Roles for the Democratic Board
The roles for the Chairman, President, and Stockholder are exactly the same as in Appendix C. The
four new roles are as follows.
Public Representative You have been selected by the Mayor to represent the community interests.
The Mayor had to find someone who would represent all groups in the local community and your
decisions are reported in the local papers. Prior to the meeting, you had not been able to think of any
major impact which the ban on Panalba might have. True, there will be some impact upon the
employment level but the community is so large that this would be very minor. You hold no shares of
Upjohn stock.
Suppliers’ Representative You represent the organizations that sell goods and services to Upjohn.
Upjohn, of course, represents only a small part of each supplier’s sales. And if the purchase were
instead made by a competitor of Upjohn, the firm would also obtain its supplies from the firms which
you represent. Your job is to try to make sure that the suppliers receive fair treatment. Whether or not
Panalba will stay on the market is of little importance to the suppliers. You hold no shares of Upjohn
stock.
Consumer Representative You are elected by a consumer’s group. Your job is to ensure that the
interests of the consumer are protected. Your decisions are widely reported by the press and by such
groups as Consumer’s Union. You have reviewed the evidence behind the Panalba case and you feel
that the background information which was sent to the members provides a fair picture of the effect of
Panalba upon consumers. You hold no shares of Upjohn stock.
Employee Representative You have been elected by the employees and they expect you to
represent their interests. You have been a director since 1969. You’ve given some thought as to what
would happen if Panalba were to be banned from the market. Approximately 200 jobs would be
eliminated (out of the roughly 5,000 jobs at Upjohn). Naturally, your constituents won’t be too happy
about this. You hold no shares of Upjohn stock.
24
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69. Willis, Richard H. and Willis, Y. A., “Role Playing versus Deception: An Experimental
Comparison,” J. Pers. Soc, Psychol. 16 (July, 1970): 472-477.
70. Wrightsman, Lawrence S., “The Most Important Social Psychological Research of this Generation?
Review of Stanley Milgram’s Obedience to Authority,” Comtemporary Psychol. 19 (December,
1974): 803-805.
71. Yinon, Yoel, Shoham, Varda and Lewis, Tirza, “Risky-shift in a Real vs. Role-played Situation,” J.
Soc. Psychol. 93 (1974): 137-138.
72. Zimbardo, Phillip, “Pathology of Imprisonment,” Society (April 9, 1972); 4-8.
Sumber : http://mktg-sun.wharton.upenn.edu/ideas/pdf/social.pdf

KOMPAS/TOTOK WIJAYANTO
Pegawai di kantor Kelurahan Bendungan Hilir, Kecamatan Tanah Abang, Jakarta, menunjukkan Daftar Pemilih Sementara (DPS) Pemilihan Umum 2009, yang terpasang di depan kantor, Selasa (12/8). Warga yang namanya belum masuk DPS dapat segera mendaftar ke Panitia Pemungutan Suara di kelurahan masing-masing agar bisa menggunakan hak memilih dalam Pemilu 2009.
TERKAIT:
Sebagian Besar DPS di Jakarta Baru Terpasang
JAKARTA, RABU - Berdasar audit independen Lembaga Penelitian, Pendidikan dan Penerangan Ekonomi dan Sosial (LP3ES), sekitar 20,8 persen calon pemilih belum terdaftar dalam Daftar Pemilih Sementara (DPS) dari total responden sekitar 7 ribu orang. Kurangnya sosialisasi tenggat waktu daftar pemilih oleh Komisi Pemilihan Umum (KPU) diduga menjadi penyebabnya.
Hal itu dikatakan Kepala Divisi Penelitian LP3ES Fajar Nursahid dalam "Presentasi Hasil Audit Daftar Pemilih (ADP) 2008" di Hotel Nikko, Jakarta, Rabu (20/8). Fajar menuturkan audit kali ini mencatat sebanyak 79,2 persen calon pemilih Pemilu 2009 telah terdaftar dalam Daftar Pemilih Sementara (DPS). Sedangkan audit serupa Pemilu 2004 terhadap daftar pemilih tetap menunjukkan tingkat pendaftaran 91 persen.
"Proses penyusunan DPS tahun ini lebih rumit sehingga butuh waktu lebih panjang. Proses pencocokan dan penelitian tidak dilakukan, kualitas data juga buruk. Hal itulah yang menyumbang tingkat pendaftaran tahun ini lebih rendah dari tahun lalu," katanya seraya menegaskan ada 35 juta orang atau 20 persen yang kehilangan hak suara karena tidak terdaftar dalam daftar pemilih Pemilu 2009.
Selain itu menurut Wakil Direktur LP3ES Sudar Dwiatmono, KPU harus memperpanjang masa pengumuman DPS. "Jadwal yang baru harus mempertimbangkan hari-hari kerja efektif untuk memproses penyusunan daftar pemilih," ujarnya.
Sudar menyatakan ADP 2008 melibatkan 520 relawan LP3ES dilakukan pada 7-11 Agustus 2008 dan didanai olah the United States Agency for International Developement (USAID) dengan tingkat kepercayaan 95 persen.
Sumber: http://nasional.kompas.com/read/2008/08/20/12102073/kpu.kurang.sosialisasi.sekitar.20.persen.calon.pemilih.tak.terdaftar

Javier Mignone, PhD and
John O’Neil, PhD
Centre for Aboriginal Health Research
Department of Community Health Sciences
University of Manitoba


Abstract
The study examined the concept of social capital in First Nations communities. Its two main goals
were to clearly define social capital and to create culturally-appropriate methods for measuring it
in First Nations communities. The research was conducted with the participation of three First
Nations communities in Manitoba. After offering a brief summary of the findings of the study, the
paper discusses social capital as a determinant of health in First Nations communities and possible
research and policy implications.
Key Words
First Nations, health determinants, social capital
• captures social elements that are relevant from a
First Nations community perspective; and
• offers a meaningful structure from which to theorize
and empirically study potential pathways between
social environmental factors and health.
In response to a request from the HIR Committee
of the Assembly of Manitoba Chiefs, a study proposal
was produced to develop a conceptual framework of
social capital and to create culturally-appropriate
methods for measuring it in First Nations communities.
With funding from the Canadian Population
Health Initiative of the Canadian Institute for Health
Information, the study was conducted between January
2001 and December 2002.
Three First Nations communities from Manitoba
were chosen to be part of the study by the HIR Committee
from seven that had volunteered. (See Table 1
for information on these communities.5) The study
hired a co-ordinator (Janet Longclaws) and 10 research
assistants from the three communities to conduct
the fieldwork and provide ongoing consultation.
The study consisted of two phases. The first phase
of the study had two aims: to contribute to the development
of the conceptual framework and to generate
a list of survey questions. Over a period of about three
weeks in each community, researchers collected primary
data through a combination of in-depth interviews,
informal focus groups, participant observation,
archival research, and unobtrusive observations. A total
of 89 people were interviewed.
Following the interview process, researchers identified
dimensions of social capital to measure and developed
a questionnaire. During the second phase of
the study, after extensive feedback and seven drafts,
the questionnaire was pilot-tested. Community research
assistants surveyed 462 randomly selected
adults from the three communities. The large size of
the sample allowed researchers to conduct a series of
analyses to determine the reliability and validity of
the questionnaire. The results of the study were
shared with representatives from the communities
that participated in the study and with the HIR Committee.
The authors combined an extensive analysis of the
conceptual development of social capital in the scientific
literature with a thematic analysis of the qualitative
data collected in community fieldwork. Details of
this analysis are presented elsewhere.6 In this paper,
the author’s summarize the broad dimensions of the
concept and provide examples of various dimensions
drawn from the fieldwork.
Social capital has been defined in different ways by
numerous writers.7 The common notion is that social
capital of a community is composed of the following
elements: social relationships, networks, social norms
and values, trust, and resources. As well, some authors8
formulated three dimensions of social capital:
bonding, bridging, and linkage. When this conceptual
model was tested against the field data collected in
First Nations communities, the authors concluded that
social capital in a First Nation community is based on
the degree to which:
• the community’s resources are socially invested;
• there is the existence of a culture of trust, norms of
reciprocity, collective action, and participation; and
• the community possesses inclusive, flexible, and
diverse networks.
The following definition summarizes the conceptual
findings of the study. Social capital characterizes
a First Nation community based on the degree that its
resources are socially invested; that it presents a culture
of trust, norms of reciprocity, collective action,
and participation; and that it possesses inclusive, flexible,
and diverse networks. Social capital of a community
is assessed through a combination of its bonding
(relations within the community), bridging (relations
with other communities), and linkage (relations with
formal institutions) dimensions.
The level of social capital of a community is assessed
through a combination of its three dimensions
(see Table 2 for overall framework).
• Bonding: relations within each First Nation community
• Bridging: horizontal links with other communities,
whether they are First Nations communities or
other communities (e.g., urban centres)
Journal of Aboriginal Health • March 2005 27
Table 1: First Nations Communities Involved in the Study
N
1 Ojibway/Dakota Close to small city 1,602
2 Cree Isolated–500km to closest city 1,891
rail access some distance from community
3 Cree Semi-isolated–road access 4,065
• Linkage: connections between a particular First
Nation community and institutions like
federal/provincial government departments and
public/private corporations (e.g., Manitoba Hydro,
banks).
Each of the three dimensions has three components:
• Socially Invested Resources: the resources used for
the benefit of the community as a whole
• Culture:9 the relations within the community and
between communities and institutions that are characterized
by trust, norms of reciprocity, collective
action, and participation
• Networks: within the community and between
communities and institutions that are inclusive,
flexible, and diverse
For the component socially invested resources, the
social capital framework includes five descriptors:
physical, symbolic, financial, human, and natural.
For example, physical resources would be building a
recreation centre or paving community roads. Symbolic
would be resources that strengthen cultural
identity like cultural camps or Aboriginal language
programs. An example of financial resources would
be access to credit to help people start small businesses.
Human resources would be those that help increase
the abilities of people through formal or informal
education. Natural resources would be land or
water that has been protected from pollutants or
degradation.
Resources can be consumed, stored, or invested.
Capital is a resource that is invested to create new resources.
Socially invested resources are considered
aspects of social capital in this framework because
they are resources that are invested for the good of the
entire community, not just for some privileged few individuals.
Thus, socially invested resources should be
assessed by a combination of the amount of resources
invested and the degree to which they are invested to
the benefit of the whole community. The following
are a few examples that illustrate these ideas.
Examples of the Socially Invested
Resources Component
Symbolic
Cultural camps for children and youth are held in
one of the communities.
[T]hey’d show the kids how to snare [and]
trap beaver; skin beaver, rats, muskrats,
moose–anything that tracks. They would always
talk Cree. They would make bannock
over the fire, you know, what the people used
to do a long time ago. That’s what they did
with the kids.”
Financial
The following observation was made on the relationship
with banks. It points to difficulties in this
area.
With the majority of Native people, I think
it’s either you have poor credit, no credit or
bankrupt . . . and because of that, a lot of band
members have limited access or no access to
funding to start their own businesses.
The culture component has four descriptors: trust,
norms of reciprocity, collective action, and participation.
First Nations communities with higher levels of
trust between community members as well as with
community authorities; with stronger positive norms
of reciprocity between individuals and groups; with
more potential for collective action; and with a higher
willingness to participate in community activities
would be considered as possessing higher stocks of
Mignone and O’Neil
28 Journal of Aboriginal Health • March 2005
Table 2: Social Capital Framework
Physical Trust Inclusive
Symbolic Norms of reciprocity Flexibility
Financial Collective action Diverse
Human Participation
Natural
Physical Trust Inclusive
Symbolic Norms of reciprocity Flexibility
Financial Collective action Diverse
Human Participation
Natural
Physical Trust Inclusive
Symbolic Norms of reciprocity Flexibility
Financial Collective action Diverse
Human Participation
Natural
SIR = Socially Invested Resources
social capital. An example of positive culture would
be a community where people trust chief and council
or in general think well of other families; community
members are willing to get together to work for common
causes; people are willing to volunteer in community
activities; and individuals tend to return
favours. The following are a few examples that illustrate
these ideas.
Examples of the Culture Component
Norms of Reciprocity
There are norms in our community where
people do things for other people. It’s not
written down in stone anywhere. It’s just part
of the culture. If someone is building a house
and says, I need a screw-gun, yeah I have a
box, go to my shed and get it. And that person
later, the one who loaned the thing may say, I
need to borrow an axe of him, and goes back
to the guy that borrowed from him.
Participation
The loss of participation at a linkage level was
made graphic by one person’s statement.
Yes, I guess part of our practice, part of our
culture, is doing a lot of community consultation
. . . and the federal government slashed
that piece of it . . . We used to have community
co-ordinators who would do the consultation,
set up workshops to inform the people
about the changes. The federal government
argued that we were doing too much consultation.
Networks can be characterized by how inclusive,
diverse, and flexible they are. Higher degrees of these
three characteristics would imply higher levels of social
capital. Inclusive networks are those that are relatively
welcoming of newcomers and to the exchange
of information with newcomers. Diversity implies the
co-existence of a number of different networks that
are capable of interacting in a meaningful way. Flexibility
means that the networks can adapt to new, different,
or changing needs. Inclusiveness, diversity,
and flexibility are actually interrelated qualities. They
are different aspects of the same phenomenon. In general,
a correlation among these three descriptors of
networks should be expected. The following are a few
examples that illustrate these ideas.
Examples of the Networks Component
Flexible
The following comment illustrates a lack of flexibility.
You hear a lot of animosities that are carried
forward from years back. I’ve also heard so
and so and his family did so and so to this
family and so we are not talking to so and so.
There is a lot that is carried on for quite a few
years.
Diverse
Another individual from one of the communities
expressed concern over the lack of diverse bridging
networks.
We have to learn how to network with one another
. . . even network with our First Nations,
even the ones that are the most successful,
that have all those facilities in their First Nations.
How did you do it? Can you lend us a
hand over here?
SOCIAL CAPITAL AS A
DETERMINANT OF HEALTH
Other authors have recognized that although
. . . the health maintenance and illness care of
individuals are known to be major determinants
of health . . . they are still often investigated
as discrete behaviours separated from
the interplay of social and psychosocial forces
that shape them.10
According to them,
. . . this approach limits knowledge regarding
their role in shaping health, the forces that
maintain behavioural practices and the potential
of approaches to changing them.
Health is the product of multiple levels of influence.
These include genetic and biologic processes,
individual behaviours, and the context within which
people live–the social environment. A multi-level approach
to community health requires society to take
into consideration, and act upon, social determinants.
Social capital has been put forward as a characteristic
of the social environment and thus as a potential de-
Social Capital as a Health Determinant in First Nations
Journal of Aboriginal Health • March 2005 29
terminant of health. However, for social capital to be
identified as a health determinant, three steps are required.
First, a clear understanding of how social capital
can characterize a community is needed. The previous
section provided an overview of the formulation
created from the author’s study. Second, a model presenting
the plausibility of social capital as a factor in
health is required. This section will provide ideas for
this model. Third, studies that may produce evidence
that confirms or contradicts the theory that social capital
is a determinant of health are also needed. Studies
like the 2002 wave of the Manitoba portion of the
First Nations Regional Longitudinal Health Survey
are gathering data on social capital that will enable
these analyses. The last section of this paper will address
further research requirements of this type.
Community social capital as discussed in this study
was based on the concept that this capital pertains to
the entire community. All components of the conceptual
framework emphasize this. A key difference between
this formulation of social capital and that of
other authors is the multidimensional notion of the
concept. Based on initial ideas by Michael Woolcock
and Deepa Narayan,11 the authors further developed
these ideas in a comprehensive framework pertinent
to First Nations communities. The differences between
bonding, bridging, and linkage social capital
means a community can have higher levels of bonding
social capital while at the same time lower levels
of linkage social capital when compared to another
community, for example. This implies that there can
be relative independence among the three dimensions.
As Woolcock has indicated:
. . . a multidimensional approach allows us to
argue that it is different combinations of
bonding, bridging and linking social capital
that are responsible for the range of outcomes
we observe, and to incorporate a dynamic
component in which optimal combinations
change over time.12
The importance of separating the three dimensions is
that it captures the reality that communities do not exist
in isolation, but in relationship with other communities
and with institutions.
The decision of a community to invest in cultural
camps and/or First Nations language programs for
their children has the potential of increasing the cultural
identity of its youth, thus strengthening the community.
One of the central effects of colonization was
the disruption of the cultural continuity of First Nations
and the destruction of the sense of pride as a
people. This resulted in serious effects on the health
and well-being of generations. The resurgence of First
Nations ceremonies, practices, and values has already
shown to have powerful healing qualities. Researchers
investigating the relations of social to biological
processes in disease argue that:
. . . the enormous complexity of human society
and man’s capacity through his symbol
system to identify with more powerful beings–
gods, or chosen leaders or institutions–
give him certain invulnerability to limbic system
arousal as long as he perceives himself to
be socially supported here or in the hereafter.
But, if as the result of early or late experience
or a combination of both, he comes to perceive
himself as helpless and lacking power
to control his fate, he may well become more
vulnerable . . . (to illness).13
This is why symbolic socially invested resources are
so important, whether they be within the community
(bonding), jointly with other communities (bridging),
or in interaction with institutions (linkage).
A community with higher levels of social capital
would be expected to have a culture of trust, participation,
collective action, and norms of reciprocity.
There has been increasing evidence in population
health studies that communities where people tend to
trust each other live under less stressful conditions.
Stress has been recognized as an important pathway to
health or illness.14 However, trust among community
members is only one aspect of social capital (bonding).
Trust among members of different communities
(bridging) can also have significant impacts. The possibility
of learning from what others are doing, the
willingness to share resources or information, and the
enjoyment of positive relations with other communities
impact the well-being of community members.
Organizations like the Assembly of Manitoba Chiefs
have created spaces of trust, participation, and collective
action among communities. This increase in
bridging social capital has already had a positive impact
in addressing health needs of First Nations.
Studies have shown that the quality of social networks
impacts on health. Rigid social networks that
exclude others from information or even meaningful
social contact are harmful to health. For example, the
feeling of exclusion or social isolation has a powerful
impact on self-esteem while the lack of information
about resources or opportunities limits the access to
Mignone and O’Neil
30 Journal of Aboriginal Health • March 2005
those resources and thus to well-being. Studies have
related social isolation to an array of adverse health
outcomes.15 Communities with flexible, inclusive,
and diverse networks tend to develop a social environment
that is more conducive to health because
fewer people will be left out of opportunities, dialogue,
information, and resources. The same can be
said of relations with other communities (bridging)
and with institutions (linkage). A community that has
a series of well established networks with institutions
will have a better possibility of obtaining resources or
opportunities, thus increasing its well-being.
In summary, and paraphrasing other authors,16 decreased
social capital may cause or indicate unjust,
exclusive social policies; unequal patterns of participation;
and decreased trust, any of which may affect
health. Lower social capital might impact the society’s
influence over an individual’s health behaviours,
cause or indicate increased uncertainty about the future,
or affect access to health services and information.
Decreased social capital might weaken informal
social support systems, lead to social policies that do
not emphasize preventive services, or impact economic
structures resulting in fewer educational or occupational
opportunities.
Diagram 1, adapted from Shelley Taylor, Rena
Repetti, and Teresa Seeman,17 provides an outline of
partial pathways between social capital and health that
may link to form more complex pathways. It is a preliminary
model that requires further adjustments, development,
and testing. Nonetheless, together with a
clear conceptual framework of social capital, it provides
a basis for guiding future research and policy.
POLICY DISCUSSION
As other authors have indicated, “social determinants
of health are societal conditions that affect
health and can potentially be altered by social and
health policies and programs.”18 The arguments suggest
that health is impacted to a large extent by policies
defined outside of traditional health policy areas.
More so, they highlight how policies that affect the
life of communities should be a source of consideration
because of their role in ultimately reducing health
risks and improving resistance.
Several levels of policy require examination–federal,
provincial, regional, and community levels. In
relation to areas of policy, these cover a wide range. A
central argument of this paper is that health is affected
by community-level factors and, consequently, communities
need to be identified as objects of policy.
Policy decisions, at whatever level, need to take into
account how they impact communities’ social capital.
Take as an example a situation where the chief and
council of a community are debating whether to allow
video lottery terminals to be introduced. From a
strictly financial point of view, this could be
favourable for band administration funds. However,
potential negative impacts in the community’s social
capital would have to be considered in the decision. If
the video lottery terminals were to negatively impact
families or norms of reciprocity within the community,
these considerations could outweigh potential
benefits.
On the other hand, investment in organizing powwows
could have a positive impact both within the
community and among communities, despite funding
requirements. The understanding that these factors ultimately
have an impact on health and well-being of
community members would provide a more accurate
information basis for policy decisions.
As a study on Amish communities demonstrated:
. . . their success is primarily due to the sophisticated
organizational structures and prac-
Social Capital as a Health Determinant in First Nations
Journal of Aboriginal Health • March 2005 31
Diagram 1i
C
S
H
R
S
H
o S
O
D
i S.E. Taylor, R.L. Repetti, and T. Seeman, “Health Psychology:
What is an Unhealthy Environment and How Does it
Get Under the Skin?” Annual Review of Psychology , Vol. 48
(1997) p. 411-447.
tices that promote and preserve social capital
in their community . . . with keen social capital
consciousness their leaders and members
have adopted and fine-tuned efficient and culturally
appropriate practices to preserve their
sociability and solidarity.19
Communities need deliberate policies and co-ordinated
efforts to sustain social capital in the face of ongoing
political and economic conditions as well as
evolving technological and social forces.
The three-dimensional understanding of social capital
provides an initial framework from where to develop
policies at the different levels. A northern Manitoba
First Nations community has experienced a
cluster of youth suicides. One of the needs identified
by community members and leadership was the development
of recreational facilities and programs for
children and youth. The expectation was that these
initiatives would reduce youth suicide risk factors to
some extent. A large recreational facility was constructed.
However, it has not opened because of contractual
disagreements between the chief and council
and the construction company, and with Indian and
Northern Affairs Canada. From a social capital perspective,
this can be understood as contributing significantly
to low linkage social capital. Given the
severity of the situation among youth, federal department
policy should take social capital as a critically
important factor relevant to health and should focus
on resolving the dispute to open the recreation centre
for community use.
Recently, the City of Winnipeg unveiled a strategy
aimed at reducing poverty, improving housing, and
creating jobs for the Aboriginal community. Among
the initiatives, a transition service was proposed to
help First Nations people who move to Winnipeg
from rural reserves. This could be viewed both as a
socially invested resource of linkage social capital and
as increased diversity and inclusiveness of bridging
networks. If this initiative is implemented in full, it
would be expected to improve the health and well-being,
among other benefits, of First Nations individuals
affected by the transition to the city.
The concept of social capital offers a lens that
takes into account historical factors as they are embedded
in current community characteristics, consequently
having the potential to offer a richer understanding
of these factors as health determinants. For
example, the devastatingly deadly diseases in the
early years of colonization, the loss of traditional
lands, the policies of assimilation and residential
schooling, and the loss of self-government20 can be
interpreted as having had a potentially negative impact
on the stocks of social capital. However, this interpretation
should not be simplistic because the ongoing
struggles to counter these forces may also have
had the potential of generating stocks of social capital,
even if only in one or two dimensions.
The three-dimensional understanding of social
capital implies that policies may at times require the
sacrifice of one dimension over another. For example,
communities with high levels of resistance to external
relationships (linkage) may do so to generate
high levels of bonding and bridging social capital.
The community that resists Manitoba Hydro and
funding for flooding of traditional territory may be
creating stronger bonds of trust and collective action
within the community. On the other hand, a higher
degree of internal collective action may provide the
leverage necessary for higher levels of linkage social
capital. That was the case of a northern Manitoba
community that marched in protest to Winnipeg and
camped at a public place in the city for weeks, until
the funding for housing was obtained.
Approaches to developing policy also have an impact
on social capital. The implementation of programs
or initiatives without consultation may negatively
impact trust, participation, and collective
action. Many times, under the rationale of efficiency
or cost-effectiveness, programs are put in place while
community consultation is curtailed. An accurate costing
would have to take into account the potential for a
reduction of social capital and ultimately a reduced
return on the investment.
Most of these illustrations do not directly address
health policy, although these policies ultimately may
impact health. The principle is that policy should consider
social capital as an intervening variable in
health. Policy, and ways of developing and implementing
policy that are in the hands of several parties,
can have a profound impact on First Nations communities
and, consequently, on the health and well-being
of their populations.
CONCLUSION
This paper presents ideas that emerged from a
study that examined the concept of social capital in
First Nations communities and explores the possibility
of it being a community-level determinant of
health. These are the initial stages in a broader research
agenda. Further steps are required to assess if
social capital is an adequate descriptor of the social
environment of First Nations communities and plays a
Mignone and O’Neil
32 Journal of Aboriginal Health • March 2005
role as a health determinant. First, a new round of
measurement refinement and validation is necessary.
Second, based on findings from the current study and
from findings of future studies using the revised tools,
further adjustments to the conceptual framework need
to be made. Third, formulation of more refined theoretical
models of social capital as a determinant of
population health are needed. Fourth, studies to test
the theories of social capital as determinant of health
in First Nations communities need to be conducted.
Fifth, further work is needed to empirically establish
the pathways between social capital and health. This
research agenda requires an effective partnership between
First Nations communities, First Nations organizations,
and academic centres in a research process
that combines conceptual analyses, grounded theory
development, and quantitative evidence on an ongoing
basis.
ACKNOWLEDGEMENTS
The authors acknowledge the three First Nations
communities that participated in the study, Janet
Longclaws, Dr. Cam Mustard, Dr. Sid Frankel, and
the Health Information and Research Committee of
the Assembly of Manitoba Chiefs. The Canadian Population
Health Initiative and the Social Sciences and
Humanities Research Council provided the funding
for the study.
ENDNOTES
1. Royal Commission on Aboriginal Peoples, Report of the
Royal Commission on Aboriginal Peoples: Gathering
Strength, Vol. 3 (Ottawa: Minister of Supply and Services
Canada, 1996).
2. The Health Information and Research (HIR) Committee is
mandated by the Chiefs of Manitoba to represent the health
research and information interests of all 62 First Nations
communities in Manitoba. The members of the HIR Committee
are all health directors (or designates) representing all
tribal councils, independent First Nations, and other First Nations’
political organizations in Manitoba.
3. John D. O’Neil et al., Why are Some First Nations Communities
Healthy and Others are Not?: Constituting Evidence in
First Nations Health Policy (Winnipeg: Northern Health
Medical Unit and Assembly of Manitoba Chiefs, 1999).
4. Javier Mignone, Social Capital in First Nations Communities:
Conceptual Development and Instrument Validation, doctoral
dissertation (Winnipeg: University of Manitoba, 2003). A
complete report of the study can be obtained from the website
of the Centre of Aboriginal Health Research at the University
of Manitoba at http://www.umanitoba.ca/centres/cahr/.
5. Given the developmental nature of the study, it was decided
to keep the communities anonymous.
6. Mignone, Social Capital, 2003.
7. These include: James S. Coleman, Foundations of Social
Theory (Cambridge: The Belknap Press of Harvard University
Press, 1990); Pierre Bourdieu, “The Forms of Capital,”
Handbook of Theory and Research for the Sociology of Education,
J. Richardson (Ed.) (New York: Greenwood Press,
1983) p. 241-258; Robert D. Putnam, Bowling Alone: The
Collapse and Revival of American Community (New York:
Touchstone, 2000); and M. Woolcock and D. Narayan, “Social
Capital: Implications for Development Theory, Research,
and Policy,” The World Bank Research Observer, Vol. 15
(2000) p. 225-249.
8. Woolcock and Narayan, “Social Capital,” 2000.
9. The use of the term “culture” in this study has generated considerable
discussion among the First Nations partners. They
have expressed concern that the term has a particular meaning
in the context of First Nations traditions and world views.
In the social sciences, there is a long history of using the culture
concept to refer to shared values, norms, and beliefs. It is
this more general understanding that has informed this analysis
of social capital. Culture, as a component of social capital,
refers to values and norms of trust, reciprocity, and collective
action. Values related to aspects of First Nations culture such
as spirituality are not included in this definition. Similarly, in
this paper, the term does not refer to the idea that there are
many First Nations cultures that have unique traditions and
practices.
10. K. Dean, “Social Support and Health: Pathways of Influence,”
Health Promotion, Vol. 1 (1986) p. 133-149.
11. Woolcock and Narayan, “Social Capital,” 2000.
12. M. Woolcock, “The Place of Social Capital in Understanding
Social and Economic Outcomes,” Isuma, Vol. 2 (2001) p. 11-
17.
13. J.P. Henry, “The Relation of Social to Biological Processes in
Disease,” Social Science and Medicine, Vol. 16 (1982) p.
369-380.
14. B.S. McEwen, “Protective and Damaging Effects of Stress
Mediators,” The New England Journal of Medicine, Vol. 338
(1998) p 171-179.
15. J.S., House, K.R. Landis, and D. Umberson, “Social Relationships
and Health,” The Society and Population Health
Reader: Income Inequality and Health, I. Kawachi, B.P.
Kennedy, and R.G. Wilkinson (Eds.) (New York: The New
Press 1999) p. 161-170.
16. D. Briggs and P. Elliott, “The Use of Geographical Information
Systems in Studies on Environment and Health,” World
Health Statistics Quarterly, Vol. 48, No. 85. (1995).
17. S.E. Taylor, R.L. Repetti, and T. Seeman, “Health Psychology:
What is an Unhealthy Environment and How Does it
Get Under the Skin?” Annual Review of Psychology, Vol. 48
(1997) p. 411-447.
18. L. Anderson et al., “The Community Guide’s Model for
Linking the Social Environment to Health,” American Journal
of Preventative Medicine, Vol. 24, No.3S, (2003) p 12-
20.
19. T.K. Tan, Silence, Sacrifice, and Shoo-Fly Pies: An Inquiry
into the Social Capital and Organizational Strategies of the
Amish Community in Lancaster County, Pennsylvania (Cambridge:
Harvard University, 1998).
20. Royal Commission on Aboriginal Peoples, Report of the
Royal Commission on Aboriginal Peoples: Gathering
Strength, Vol. 5. (Ottawa: Minister of Supply and Services
Canada 1996); O.P. Dickason, Canada’s First Nations: A
History of Founding Peoples from Earliest Times, second
edition (Oxford: Oxford University Press, 1997); and R.M.
Gralewicz, Federal Policies and Their Effects on Indian
Health: A Southern Alberta Plains Case Study (Pullman,
Washington: Washington State University, 1997).
Social Capital as a Health Determinant in First Nations
Journal of Aboriginal Health • March 2005 33
MEDICINE THAT WALKS
Disease, Medicine, and Canadian
Plains Native People, 1880-1940
By Maureen K. Lux
University of Toronto Press, 2001
ISBN 0-80204-728-9
288 pages
In this seminal work, author Maureen Lux takes issue
with the biological invasion theory of the impact
of disease on plains Aboriginal Peoples. She challenges
the view that Aboriginal medicine was helpless
to deal with the diseases brought by European newcomers
and that Aboriginal Peoples therefore surrendered
their spirituality to Christianity. Lux argues that
biological invasion was accompanied by military, cultural,
and economic invasions–which, combined with
both the loss of the bison herds and forced settlements
on reserves–led to population decline. The diseases
killing the plains Native Peoples were not contagious
epidemics, but the grinding diseases of poverty, malnutrition,
and overcrowding.
Medicine That Walks provides a grim social history
of medicine from the end of the 19th to the middle of
the 20th century. It traces the relationship between the
ill and the well, from the 1880s when Aboriginal Peoples
were perceived as a vanishing race doomed to extinction
to the 1940s when they came to be seen as a
disease menace to the Canadian public. The Aboriginal
Peoples lived and coped with a cruel set of circumstances.
However, they survived, in large part because
they consistently demanded a role in their own
health and recovery.
Painstakingly researched and convincingly argued,
this work will change society’s understanding of a
significant era in western Canadian history.
Lux is a post-doctoral fellow at the Hannah Institute
for the History of Medicine.
34 Journal of Aboriginal Health • March 2005
R
EDITOR’S NOTE
Book abstracts are printed with permission from
the publishing company that produced each
book. Abstracts provide further information on
some of the resources referenced in the preceding
research paper or are generally related to the
theme of this issue.
Journal of Aboriginal Health • March 2005

Sumber: http://www.umanitoba.ca/faculties/human_ecology/media/Social_Capital_Journal_of_Aboriginal_Health.pdf