"Social capital" has been critiqued as distracting attention from inequalities and
policies that produce ill health. We support this critique insofar as social capital
refers to the degree of trust and consensus in a locality, but find value in another
dimension often included in the concept of social capital--social network ties and
their associated communication patterns. We present a case study of Bushwick, a community
of 100,000 people in Brooklyn NY, to suggest that the network aspect of "social capital"
is useful to understand the active, on-the-ground processes by which residents of
some neighborhoods beset by poverty, racial/ethnic subordination, and internal divisions
(that themselves arise from inequalities and state policies) work out ways to defend
their own and others' safety and health. We use a combination of population-representative
survey data for young adults; sexual network survey data; and ethnography to show
that Bushwick residents (including drug users and dealers) have used social network
ties, communication, and normative pressures to reduce the extent to which they are
put at risk by the drug trade and by drug-use-related HIV/AIDS in spite of conflicting
interests, disparate values, and widespread distrust both of other community members
and of dominant social institutions. This was done by "intravention" health communications,
development of protective norms, informal negotiations, and other forms of adjustments
within and among various groups--but it occurred in the absence of trust or consensus
in this community. We conclude both (1) that social network interpretations of "social
capital" might be better conceptualized in dialectic terms as collective action to
survive in a harsh social order, and (2) that the social capital theory emphasis on
trust and consensus as important causal factors for lowering drug-related risks at
the community level may be a romanticized and erroneous perspective.