Social Networks and Health Inequalities (Utrecht, 2018)

ses01.07 Social Networks and Health Inequalities

Chair: Andreas Klärner, Thünen Institut of Rural Studies, Germany

Description
Our session discusses social networks as drivers, modifiers and outcomes of health inequalities. Contributions may address functional and structural characteristics of whole social networks as well as personal networks. The analytical unit of interest may include individuals, groups or organizations. We are open to qualitative, quantitative, and theoretical contributions. Precedence will be given to novel and interdisciplinary theoretical or empirical work that combines perspectives from the social sciences within the medical field. We aspire to address these questions: – Which are useful theoretical models that offer explanations for the link between social networks and health? – Does the role of social networks for health change over the life-course? – What is the position of non-kin networks, perhaps also compared to kin-networks? – What do we know about social networks of groups with different social or socioeconomic status. – How can current knowledge be translated into policy implications?

Papers
pap01.07.02 Local Social Network Ties and Prenatal Smoking
Emily Smith, University of California, Irvine, United States

Description
Emily Smith, University of California, Irvine
Jennifer Buher-Kane, University of California, Irvine
Carter Butts, University of California, Irvine
John Hipp, University of California, Irvine
Ehsan Farshchi, University of California, Irvine

It is a core sociological observation that the behaviors shaping health outcomes depend not only on individual characteristics, but also on the social context in which individuals are embedded. Interpersonal relationships that forms the substrate of society act as conduits for social influence, exerting pressures on individuals that depend on the behaviors of the others to whom they are connected. To date, social influence processes have not been widely integrated into population-based studies. This is problematic given social influence effects represent one key mechanism linking behaviors (diet, exercise, smoking) to health outcomes. This study introduces one approach to bridging this gap, exploiting recent innovations in the modeling of social networks to estimate the impact of social influence effects on prenatal smoking – a socially influenced behavior with strong potential for intergenerational transmission of health outcomes. Leveraging the observation that, at the population level, the majority of personal network structure can be accounted for by the distribution of the population in space, we computed the expected number of social ties between all Census blocks in New Jersey. Combining this with administrative birth record data, we developed a weighted average prenatal smoking measure for each woman (answering, „Is a given woman exposed to prenatal smokers in her social network?“). Multilevel logistic regression results including this measure showed that propinquity (or the probability of being socially tied) to other women who smoke during pregnancy was an important risk factor for continued smoking behavior throughout pregnancy (versus spontaneously quitting upon learning of a pregnancy).

pap01.07.03 Refining the Buffer Hypothesis: Which kinds of personal networks reduce stress in late adulthood? [More Info]
Lea Ellwardt, University of Cologne, Germany

Description
Lea Ellwardt, University of Cologne
Rafael Wittek, University of Groningen
Louise Hawkley, University of Chicago
John Cacioppo, University of Chicago

Background: Integration into social networks is commonly believed to benefit older adults’ wellbeing, since it reduces stress during adverse life-events and improves coping with morbidity and disability in late life. We argue, however, that stress buffering is conditional on the degree to that networks are stable and balanced. Stability refers to presence of mutual strong ties (i.e., closure in triads), and balance refers to presence of mutual positive ties (cf. Heider’s concept). Objective: The aim is to investigate which kinds of social networks reduce stress. It is hypothesized that perceived stress is lowest for older adults embedded in stable and balanced networks. Previous research designs have almost exclusively focused on the relationships between an older adult and her direct contacts (ego-alter ties). These designs, however, strictly do not permit assessing stability and balance in networks. To address this shortcoming, the current study additionally includes the indirect relationships between the contacts of an older adult (alter-alter ties). Data/Method: Unique panel data on egocentric networks in an older population stem from the population-based Chicago Health Aging and Social Relations Study (CHASRS). The sample contains five waves collected between 2002 and 2006, with 709 observations from 160 participants aged 50 to 68 years at baseline. Data include information on the participants’ direct and indirect social relationships, i.e. contact frequency and relationship quality for ego-alter ties and alter-alter ties, as well as participants’ perceived stress. Fixed-effects models test whether changes in a person’s network stability and balance relate to changes in the same person’s perceived stress. Results: Older adults reporting highest number of balanced relationships (i.e., positive ties among alters) experience least stress. This effect shows independent of socio-demographic confounders, loneliness and network size. There is no stress-buffering effect for network stability, suggesting that balance matters more than stability.

pap01.07.04 Improved Mental Health Through Involvement in a Diverse Social Network? Social Embeddedness as a Determinant of Refugee Mental Health Over the Course of Resettlement [More Info]
Lea-Maria Löbel, German Institute for Economic Research, Germany

Description
Lea-Maria Löbel, German Institute for Economic Research

Refugees go through a variety of phases in their resettlement process: enduring war and prosecution, taking the decision or being forced to leave home, choosing a route to a different place and settling down in the host community. During this process, refugees are subjected to various stressors that may impact their mental health. The outcome-oriented approach has led research to focus on the prevalence of refugee mental illness, measuring depression rates and incidence of post-traumatic stress disorder among the refugee population. A different but promising approach centers on the process of forced migration and studies the stressors and mediating factors during resettlement. This approach offers a starting point for meaningful intervention in the host community. Especially the social network of a refugee can mediate stressors through social support provided by the various ties between the refugees and community members: family, friends, and various acquaintances. This paper uses cross-sectional survey data from the 2016 IAB-BAMF-SOEP Survey of Refugees in Germany to examine the determining factors of refugee mental health before, during, and after resettlement. Further, the paper investigates the potential of refugee social networks as mediators of refugee mental well-being using structural equation modelling. The primary focus of the analysis is the mediating effect of refugee family structures in the host community. As these close ties are potential sources of emotional support, a positive influence on refugee mental well-being can be expected. With this analysis, the paper contributes to the discussion on the role of community based programs and informal safety nets to facilitate social support for refugees and the debate on family reunification in host countries.

pap01.07.05 The Research Network on „Social Networks and Health Inequalities“ [More Info]
Andreas Klärner, Thünen Institut of Rural Studies, Germany

Description
Andreas Klärner, Thünen Institut of Rural Studies

The presentation introduces the Research Network on „Social Network and Health Inequalities“ which is funded by the German Research Foundation (Deutsche Forschungsgemeinschaft, DFG). The Research Network addresses a central topic of social epidemiology and sociology of health which is the close correlation between social and health inequalities. Social inequalities in the dimensions of education, occupation, and income as well as age, gender, ethnicity etc. are closely connected with many different dimensions and indicators of health, illness, and well-being. Yet, at this point there is no comprehensive theoretical explanation for the causes of these health inequalities. While certain aspects of social relations are part of socio-psychological theories on the (re)production of health inequalities they only rarely do take into account the whole network of personal relation, their structures, and social network mechanisms of influence. Only recently, this perspective of sociological social network research has attracted attention in international health research. In the Research Network there are 15 researchers from different disciplines (sociology, psychology, public health, and others) which have different theoretical and methodological backgrounds, they use quantitative, qualitative, and mixed-methods. Their aim is to communicate theories and methods of sociological social network research into the communites of health researchers and practitioneers and to apply the network perspective for explaining the reproduction of health inequalities. Members of the Research Network will present some of their project in the session on „Social Networks and Health Inequalities“.