It is related to but distinct from analyses of the mechanisms through which social support affects health. Social network analysis measures relationships among social actors, assesses factors that shape their structure, and ascertains the extent to which they affect health-related outcomes. Social network models of how individuals influence one another offer one approach toward measuring the presence and magnitude of such collateral health effects, and a path toward assessing the total effects of interventions. Such direct and indirect (or multiplier) health effects of interventions could be of interest to both doctors and patients in the selection of treatments, and merit attention from policy makers and public health practitioners when assessing the value of interventions. Networks are also channels through which certain communicable diseases, notably sexually transmitted ones, spread ( Klovdahl 1985), and some contend that certain network structures reduce exposure to stressors ( Haines and Hurlbert 1992).Ĭhristakis (2004) has recently suggested that health interventions may have “collateral” effects, including not only the individual targeted by an intervention, but others in the target’s social network. They can also convey social influence by defining norms about such health-related behaviors as smoking or diet, or via social controls promoting (for example) adherence to medication regimes ( Marsden 2006). Beyond social support, networks may also offer access to tangible resources such as financial assistance or transportation.
Prominent among these is social support, which has emotional, instrumental, appraisal (assistance in decision making), and informational aspects ( House and Kahn 1985).
#COMPUTE GEODIST FOR EACH ROW STATA PROFESSIONAL#
1997) familial and friendship networks that may influence dietary practices, exercise habits, and other behaviors affecting the risk of obesity ( Christakis and Fowler 2007) or of smoking ( Christakis and Fowler 2008) sexual partnership networks that may raise or reduce the risk of contracting sexually transmitted diseases ( Laumann and Youm 1999) and discussion networks among professional colleagues that may influence treatment protocols or decisions to prescribe novel drug regimens ( Coleman, Katz, and Menzel 1966).įive principal mediating pathways through which social relationships may influence the health of individuals have been posited ( Berkman and Glass 2000). Among many other examples are social support networks that may serve to improve individual well-being by providing psychosocial or tangible resources ( Berkman and Syme 1979) peer group influence networks that may heighten-or protect against-the risk of substance abuse ( Unger and Chen 1999) or shape decisions about contraceptive use ( Valente et al. patients, nurses, physicians, and hospitals), networks are of increasing interest to health services researchers. Since many medical and health-related phenomena involve interdependent actors (e.g. Social network analysis studies structures of relationships linking individuals (or other social units, such as organizations) and interdependencies in behavior or attitudes related to configurations of social relations. Complexities in estimating both types of models arise due to the complex correlation structures among outcome measures. After introducing forms of network data, basic network statistics, and common descriptive measures, it describes two distinct types of statistical models for network data: individual-outcome models in which networks enter the construction of explanatory variables, and relational models in which the network itself is a multivariate dependent variable.
This article reviews fundamentals of, and recent innovations in, social network analysis using a physician influence network as an example. More recently, interest in the analysis of social network data has grown among statisticians, who have developed more elaborate models and methods for fitting them to network data. Social network studies have been pursued for some time in social science disciplines, where numerous descriptive methods for analyzing them have been proposed. Many questions about the social organization of medicine and health services involve interdependencies among social actors that may be depicted by networks of relationships.
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