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PubMedDate not supplied

Social networks and coronary artery disease: a comparison of the structure and function of social relations as predictors of disease.

This study provides the first direct comparison of the relative importance of structural versus functional aspects of social network ties as they relate to susceptibility to coronary artery disease. Data from 119 men and 40 women undergoing coronary angiography provide an opportunity to compare these associations in relation to a direct and continuous measure of atherosclerosis while controlling for age, sex, income, hypertension, serum cholesterol, smoking, angina, diabetes, family history of heart disease, Type A behavior pattern, and hostility. Regression analyses indicate that network instrumental support and feelings of being loved are more important in predicting coronary atherosclerosis than is network size, independent of all covariables (relative extent of atherosclerosis, low/high support = 1.74 and 1.5, respectively). More "problem-oriented" emotional support did not show a similarly strong association (relative extent of atherosclerosis = 1.01). These findings suggest that certain functional aspects of social network ties are more strongly associated with host resistance to coronary atherosclerosis than are structural characteristics like network size.

Adult↗
PubMed1997

Relation of social network characteristics to 5-year mortality among young-old versus old-old white women in an urban community.

This study examines age-related differences in the association between social network characteristics and mortality for aged white women. Subjects include a community-dwelling sample of white women aged > or = 65 years (n = 806), who lived in northeast Baltimore, Maryland, in 1984. Three characteristics of social networks were measured: availability of network resources; contact with network resources; and integration into the neighborhood. The association of social network with 5-year mortality was examined with a proportional hazards model adjusting for perceived health status, impairment in physical activities of daily living, number of chronic conditions, and years of education. Analyses were stratified by age (65-74 years, > or = 75 years). Elements of social network contact and neighborhood integration were associated with reduced mortality among women aged > or = 75 years, but not among women aged 65-74 years. In the > or = 75 years group, women who had no contact with children, friends, and group organizations showed hazard ratios (95% confidence intervals (CI)) of 3.1 (1.2-7.5), 2.2 (1.0-4.9), and 2.8 (1.2-6.5), respectively. Women who had lived < or = 10 years in the neighborhood and women who had no interaction with local merchants showed hazard ratios of 2.5 (95% CI 1.3-4.8) and 2.2 (95% CI 1.2-3.9), respectively. Thus, both age and specific aspects of network structure were found to influence the association between social networks and mortality in elderly women.

Aged↗
PubMed1999

Women's alcohol dependence and abuse: the relation to social network and leisure time.

The aim of this study was to analyse the occurrence of alcohol dependence and abuse in relation to variables reflecting social network and leisure time, social class, education, occupation and family conditions. The study was based on the second wave of interviews performed within the longitudinal study of Women and Alcohol in Göteborg. In this present study we analysed 416 face-to-face interviews performed in 1995 96. Women with only one or no friends for support had higher rates of alcohol dependence and abuse than did women with more friends. Women with high rates of alcohol dependence or abuse did not take part in cultural events as much as women with low rates of alcohol dependence and abuse. Women with homemaking skills and gardening as leisure time interests had lower prevalences of alcohol dependence and abuse. In general, women with diagnoses of alcohol dependence and abuse in this population-based sample were not alone and without a social network. However, their pattern of activity differed slightly from those without such diagnoses. The association between women with alcohol dependence and abuse and leisure time activities is probably circular: a poor social network and low participation in social activities increase the risk of alcohol dependence and abuse, and alcohol dependence and abuse lead to low participation in social activities.

Adult↗
PubMed1985

Social networks, stress, and physical health: a longitudinal study of an inner-city elderly population.

Research examining the relationship between social networks, stress, and physical symptoms has been limited by rudimentary network measures and the lack of longitudinal data. Using 19 network variables, the authors followed 133 elderly residents of mid-Manhattan hotels for 1 year. The findings indicated that social networks exert a direct effect on reducing subsequent physical symptoms. Moreover, social networks also act to reduce symptoms by buffering the effect of increased levels of stress. Of clinical relevance was the finding that combining knowledge of patients' social networks with their current health status predicts their future health status with an exceedingly high degree of certainty. Consequently, intervention to reinforce a network can be as clinically significant as implementing a medical procedure.

Aged↗
PubMed2002

Legitimacy aspects of social network relations in a group of women with undefined musculoskeletal disorder.

This study was conducted to investigate legitimacy aspects of social network relations in a group of women with undefined musculoskeletal disorder. The aim was to study, from the viewpoint of the patient, the extent to which the symptoms of musculoskeletal disorder have legitimacy within the social network and how this legitimacy affects the patient's social network relations. A structural equation model was used to find the model best fitting the data arising between social support, legitimacy aspects and negative outcomes in the social network relations. The results can be summarised as indicating that illness legitimacy does affect availability of social relations and social support from friends, relatives and family. Of particular importance to this process is the patient's own perception of the legitimacy of her disorder. These results also confirmed previous findings indicating that greater attention should be paid to the impact of negative aspects of social support and its affect on patient health.

Adult↗
PubMed2003

Social networks and coronary heart disease risk factors in South Asians and Europeans in the UK.

OBJECTIVES: To compare the social networks of South Asian (Indians, Pakistanis and Bangladeshis) and European-origin participants in the Newcastle Heart Project, and to examine the relationships between social network sizes and coronary heart disease (CHD) risk factors in both groups, testing the hypothesis that part of the reason for high rates of CHD in the South Asian UK population may be social isolation. DESIGN: Participants were 684 South Asian (259 Indians, 305 Pakistanis, 120 Bangladeshis) and 825 European men and women aged 25-74 years, who completed a questionnaire and were screened for CHD risk factors in a cross-sectional study. RESULTS: South Asians were more likely to be married than Europeans, had bigger households and were more likely to attend a place of worship regularly. Europeans saw more friends and relatives on a regular basis than did South Asians. There was also some heterogeneity between the South Asian groups. Europeans who reported bigger social networks were less likely to smoke than those with smaller networks, but there was little evidence of an association between social network size and waist circumference, blood pressure or TC:HDL ratio in either Europeans or South Asians. CONCLUSION: The results provided only partial support for the hypothesis that South Asians in the UK are socially isolated, and suggest that South Asians and Europeans in the UK utilise different sources of social support. Future work should acknowledge variation in sources of social support between ethnic groups, and should explore the possibility that different mechanisms link social support and health in different ethnic groups.

Adult↗
PubMed1988

Methodological issues in social support and social network research.

With the plethora of articles describing a relationship between social support and/or social network and health status, it was considered useful to take stock of the current status of research in this area, focusing on two critical methodological issues: clarity of definition, and validity and reliability of the measurement instruments. Of the 33 instruments reviewed only modest agreement was found in conceptual definition, and frequently the concepts were not defined or ill-defined. Of particular concern is the definitional confusion between social support and social network. Variables used to operationalize these concepts confirm this lack of specificity and ambiguity in definition. As for validity and reliability, many of the investigators reported no data on these issues; others provided information that only modestly supported the validity or reliability of their instrument. The conclusion of this assessment suggests the need to clarify the essential elements of social support and social networks in order to better distinguish between the behavioral (support) and structural (network) variables that may be affecting health status. A question is also raised as to the likelihood of a single questionnaire being designed that would accurately measure the perceptions of support or supportive behaviors in the variety of supportive research that will continue to be studied. Finally, more rigorous standards need to be used by investigators in establishing the validity and reliability of the instruments in order to improve their predictive utility.

Data Collection↗
PubMedDate not supplied

Size and complexity of social networks among substance abusers: childhood and current correlates.

The objective of this study was to identify parental, childhood, demographic, and social function factors associated with social network size and complexity among substance abusers using retrospective data regarding family and childhood history and current data regarding demographic characteristics and psychosocial function. The authors interviewed 505 voluntary patients with substance abuse at two university medical centers in Minnesota and Oklahoma with alcohol-drug programs located within departments of psychiatry. Data collection instruments included a childhood questionnaire, a demographic checklist, and two psychiatric rating scales of psychosocial function. The authors found that years of education, current residence with others, being actively occupied at work or school, and higher psychosocial function on two psychiatrist-rated scales were associated with increased social network size and complexity. Loss of mother, out-of-home placement, and runaway before age 18 were associated with smaller social networks in adulthood. Age, gender, and current marital status were not associated with social network. Regression analysis indicated that network size (i.e., the number of individuals in the network) was associated with higher psychosocial function over the last year but not over the last two weeks, whereas network complexity (ie, the number of subgroups in the network) was related to psychosocial function over both the last year and the last two weeks. These data indicate that in addicted persons, both childhood factors and current social factors affect network size and complexity. Network complexity may be amenable to short-term change, whereas network size may be more related to longer-term coping.

Adaptation, Psychological↗
PubMed2005

[Relationship between social network and hypertension in older people in Spain].

INTRODUCTION AND OBJECTIVES: To investigate the association between a patient's social network and hypertension risk in older adults in Spain and to determine whether the nature of the social network is related to a patient's awareness of hypertension, to disease treatment and control, or to adherence to hypertension drug therapy. PATIENTS AND METHOD: Cross-sectional study of 3483 subjects representative of the non-institutionalized Spanish population aged 60 years or more. Logistic regression analysis, adjusted for sex, age, educational level, lifestyle and frequency of medical consultation, was used to derive odds ratios (ORs) for associations between characteristics of the social network (e.g., marital status, cohabitation status, frequency of contact with family members, and frequency of contact with friends and neighbors) and aspects of hypertension. RESULTS: The hypertension risk in married individuals and those living with others was less than in those who were unmarried (OR=0.79; 95% confidence interval [CI] 0.67-0.94) or who lived alone (OR=0,75; 95% CI, 0.61-0.93). Men who saw their friends frequently were more likely to be aware of hypertension (OR=1.57; 95% CI, 1.19-2.07). Women who saw their friends or neighbors frequently were less likely to be aware (OR=0.70; 95% CI, 0.51-0.97). No clear relationship between social network characteristics and other hypertension-related variables was observed. CONCLUSIONS: In older adults, hypertension was associated with aspects of social integration, such as marital and cohabitation status. Among hypertensives, awareness of hypertension was partly related to the frequency of contact with family and friends or neighbors.

Aged↗
PubMed1998

Social network dynamics and HIV transmission.

OBJECTIVE: To prospectively study changes in the social networks of persons at presumably high risk for HIV in a community with low prevalence and little endogenous transmission. METHODS: From a cohort of 595 persons at high risk (prostitutes, injecting drug users, and sexual partners of these persons) and nearly 6000 identified contacts, we examined the social networks of a subset of 96 persons who were interviewed once per year for 3 years. We assessed their network configuration, network stability, and changes in risk configuration and risk behavior using epidemiologic and social network analysis, and visualization techniques. RESULTS: Some significant decrease in personal risk-taking was documented during the course of the study, particularly with regard to needle-sharing. The size and number of connected components (groups that are completely connected) declined. Microstructures (small subgroups of persons that interact intensely) were either not present, or declined appreciably during the period of observation. CONCLUSIONS: In this area of low prevalence, the lack of endogenous transmission of HIV may be related in part to the lack of a network structure that fosters active propagation, despite the continued presence of risky behaviors. Although the relative contribution of network structure and personal behavior cannot be ascertained from these data, the study suggests an important role for network configuration in the transmission dynamics of HIV.

Cohort Studies↗
PubMed2006

Prevention of HIV and sexually transmitted diseases in high risk social networks of young Roma (Gypsy) men in Bulgaria: randomised controlled trial.

OBJECTIVE: To determine the effects of a behavioural intervention for prevention of HIV and sexually transmitted diseases that identified, trained, and engaged leaders of Roma (Gypsy) men's social networks to counsel their own network members. DESIGN: A two arm randomised controlled trial. SETTING: A disadvantaged, impoverished Roma settlement in Bulgaria. PARTICIPANTS: 286 Roma men from 52 social networks recruited in the community. INTERVENTION: At baseline all participants were assessed for HIV risk behaviour, tested and treated for sexually transmitted diseases, counselled in risk reduction, and randomised to intervention or control groups. Network leaders learnt how to counsel their social network members on risk prevention. Networks were followed up three and 12 months after the intervention to determine evidence of risk reduction. MAIN OUTCOME MEASURE: Occurrence of unprotected intercourse during the three months before each assessment. RESULTS: Reported prevalence of unprotected intercourse in the intervention group fell more than in control group (from 81% and 80%, respectively, at baseline to 65% and 75% at three months and 71% and 86% at 12 months). Changes were more pronounced among men with casual partners. Effects remained strong at long term follow-up, consistent with changes in risk reduction norms in the social network. Other measures of risk reduction corroborated the intervention's effects. CONCLUSIONS: Endorsement and advice on HIV prevention from the leader of a social network produces well maintained change in the reported sexual practices in members of that network. This model has particular relevance for health interventions in populations such as Roma who may be distrustful of outsiders. TRIAL REGISTRATION: Clinical Trials NCT00310973.

Adult↗
PubMed2002

Family interaction and a supportive social network as salutogenic factors in childhood atopic illness.

The role of psycho-social factors in the development of allergy was studied prospectively in 82 infants with a family history of atopy. The family participated in a standardized family test when the children were 18 months old. The ability to adjust to demands of the situation ('adaptability'), and the balance between emotional closeness and distance ('cohesion'), were assessed from videotapes by independent raters. Families rated as functional in both of these aspects were classified as 'functional', otherwise as 'dysfunctional'. The social network, life events, atopic symptoms (based on postal inquiries regarding symptoms answered by the parents, and on physical examinations), psychiatric symptoms, and socio-economic circumstances of the families were evaluated when the children were 18 months and 3 years of age. The children were classified as atopic (asthmatic symptoms or eczema) or as non-atopic. All but two children with atopic disease at 3 years of age had atopic disease before 18 months of age, while 32 of 60 children with atopic disease at 18 months of age had no problems by 3 years of age. An unbalanced family interplay at 18 months was associated with a relative risk (RR) of 1.99 for continuing atopic illness at 3 years of age (1.18 < RR < 3.37, p = 0.01). There was a weak positive confounding effect for smoking (RR reduced by 7%), eczema on three or more localizations (RR reduced by 4.5%), and the amount of cat allergen in household dust (RR reduced by 3%). Recovery from atopic illness between 18 months and 3 years of age was four times as probable in families with functional interaction and a good social supportive network when children were 18 months of age, than in dysfunctional families with a poor social network (74% versus 20% p < 0.01). Children with asthmatic symptoms showed more signs of emotional distress than did healthy children (p = 0.02). Dysfunctional family interaction patterns were more commonly observed in families of children who at 3 years of age still had atopic symptoms, than in children who had recovered. The patterns included expression of emotion and reaction to the needs of others, alternating between total disinterest and over-involvement (p = 0.02), lack of support and rejection of offered support (p = 0.01), a greater number of individual decisions without regard to the other family members (p = 0.04), and indistinct 'generational boundaries' (p = 0.04). We conclude that psychosocial factors, such as family interaction and a supportive social network, play a significant role in the course of atopic illness in early childhood and that measures which enhance family interaction and the social network could influence the course of the disease favorably.

Asthma↗
PubMed2001

Illicit drug use in one's social network and in one's neighborhood predicts individual heroin and cocaine use.

PURPOSE: The nature of competing social environmental factors' influence on substance abuse is unclear. A longitudinal study was undertaken to determine the relative power of social network and neighborhood characteristics to predict continuing illicit drug use. METHODS: Three hundred forty-two inner-city adults with a history of injection drug use were followed for 1 year; their heroin and cocaine use were assessed semiannually. Multiple logistic regression models were fit to determine the degree to which social network and neighborhood characteristics, assessed at baseline, predicted continuing heroin and/or cocaine use throughout the study period. RESULTS: Two hundred thirty-six (69%) participants reported continuing heroin and/or cocaine use. Drug use by members of the social network was a stronger predictor of participants' continuing drug use (OR = 4.31, 95% CI 2.51 to 7.40) than was a high level of drug-related arrests in the participant's neighborhood (OR = 2.41, 95% CI 1.24 to 4.71), after adjusting for drug treatment and demographic variables. Both seemed to have independent effects on study participants' drug use. CONCLUSIONS: These findings reiterate the importance of breaking ties with drug-using associates, even for those who reside in high-risk environments. Further work is needed to develop interventions that increase drug users' success in altering social network composition or also treat drug-using network members.

Adult↗
PubMed2004

The interaction of social network size and stressful life events predict delayed-type hypersensitivity among women with metastatic breast cancer.

This study examined relationships between social support, stressful life events and antigen-specific cell-mediated immunity. Participants were 72 women with documented metastatic breast carcinoma, who completed self-report measures of social support and life stress. Immune response was assessed using the delayed type hypersensitivity (DTH) skin test. Number of positive antigens was significantly related to the interaction of social network size and stressful life events (p<0.05). Number of positive antigens was greater for women who had experienced a high frequency of stressful life events but who reported a larger network of support. However, social network size was inversely related to DTH response among women who had experienced fewer stressful life events. Average induration size was not significantly related to the quality of social support, life stress per se, or their interactions. The relationship between social network size and immune response in women with metastatic breast cancer depends on prior stressful life experience.

Antibody Formation↗
PubMed2006

The effect of social networks on the relation between Alzheimer's disease pathology and level of cognitive function in old people: a longitudinal cohort study.

BACKGROUND: Few data are available about how social networks reduce the risk of cognitive impairment in old age. We aimed to measure this effect using data from a large, longitudinal, epidemiological clinicopathological study. METHODS: 89 elderly people without known dementia participating in the Rush Memory and Aging Project underwent annual clinical evaluation. Brain autopsy was done at the time of death. Social network data were obtained by structured interview. Cognitive function tests were Z scored and averaged to yield a global and specific measure of cognitive function. Alzheimer's disease pathology was quantified as a global measure based on modified Bielschowsky silver stain. Amyloid load and the density of paired helical filament tau tangles were also quantified with antibody-specific immunostains. We used linear regression to examine the relation of disease pathology scores and social networks to level of cognitive function. FINDINGS: Cognitive function was inversely related to all measures of disease pathology, indicating lower function at more severe levels of pathology. Social network size modified the association between pathology and cognitive function (parameter estimate 0.097, SE 0.039, p=0.016, R(2)=0.295). Even at more severe levels of global disease pathology, cognitive function remained higher for participants with larger network sizes. A similar modifying association was observed with tangles (parameter estimate 0.011, SE 0.003, p=0.001, R(2)=0.454). These modifying effects were most pronounced for semantic memory and working memory. Amyloid load did not modify the relation between pathology and network size. The results were unchanged after controlling for cognitive, physical, and social activities, depressive symptoms, or number of chronic diseases. INTERPRETATION: These findings suggest that social networks modify the relation of some measures of Alzheimer's disease pathology to level of cognitive function.

Aged↗
PubMed2005

Social network normative influence and sexual risk-taking among women seeking a new partner.

This paper examines the relative influence of social network norms on sexual risk-taking among women seeking a new partner in Quebec (Canada). A survey was conducted among 430 women, 30 to 54 years of age, and living without a partner. Condom use is significantly influenced by the norms of women's different social networks: confidants, social circles through which they meet partners (e.g., family, friends, internet or newspapers virtual communities), with a minority following prescribed condom use habits. Further the results indicate that among the study participants the search for love and well being, social proximity, feelings of trust and intimacy that appear to evolve almost instantly in new encounters, are in conflict with the prescribed condom-use norms. These results suggest that there is a need to build new norms for starting relationships, for improved dialogue among women and between women and men on affective solitude. The findings also underscore the need for public health interventions that seek to influence social networks as well as the behavior of individuals.

Adaptation, Psychological↗
PubMed2006

Relational correlates of interpersonal citizenship behavior: a social network perspective.

This study examines the role of social network ties in the performance and receipt of interpersonal citizenship behavior (ICB), one form of organizational citizenship behavior (OCB). A field study involving 141 employees of a manufacturing firm provided evidence that social network ties are related to the performance and receipt of ICB. Results support hypothesized relationships, which are based on social exchange theory, suggesting strength of friendship is related to performance and receipt of ICB. Support was also found for impression management-based hypotheses suggesting that asymmetric influence and 3rd-party influence are related to the performance and receipt of ICB. These relationships were significant when controlling for job satisfaction, commitment, procedural justice, hierarchical level, demographic similarity, and job similarity. Implications and directions for future research are addressed.

Friends↗
PubMed1997

Social network in relation to plasma fibrinogen.

Consistent findings about the inverse association of social network level with coronary heart disease mortality and morbidity suggest the importance of investigating biological pathways of association. Differences in plasma fibrinogen level were investigated among middle-aged men with weak and strong structural and functional social network ties. Men with low scores in the adequacy of social participation variable (structural) had higher mean values of plasma fibrinogen than those with high scores. The difference remained after adjustment for age, smoking and cardiovascular health status and after possible modifying factors were taken into account, but did not remain significant after allowing for physical fitness. Men with high scores in overall support (functional) had higher plasma fibrinogen levels compared to the men with low scores. This difference persisted after age and cardiovascular health status were taken into account but was explained by smoking. The data suggest that smoking and cardiorespiratory fitness are important mediating or modifying factors between structural and functional aspects of social network ties and plasma fibrinogen.

Cardiovascular Diseases↗