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Social Networks and Environmental Context in Health-Related Behaviors
Gina S. Lovasi, PhD, MPHColumbia University
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Yates, L. B. et al. Arch Intern Med 2008;168:284-290.
Probability of an additional 20-year survival for a 70-year-old man, according to the presence of modifiable adverse factors at baseline
Behavior patterns predict longevity
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Individual-focused interventions are limited
Many effective individual focused interventions are expensive
Maintenance of behavior change is difficult to achieve
Social networks and environments may present barriers to behavior change and maintenance of new behaviors
Network-based or multi-level interventions may reach a broader audience and be effective over a longer time
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The Built Environment
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Bod
y m
ass
inde
x
0 20000 40000 60000Population density (residents per square km)
≤ high school ≤ $30,000/year
Black race Hispanic ethnicity
College educated, higher income, non-Hispanic whites
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2830
Bod
y m
ass
inde
x
0 20000 40000 60000Population density (residents per square km)
≤ high school ≤ $30,000/year
Black race Hispanic ethnicity
College educated, higher income, non-Hispanic whites
≤ high school ≤ $30,000/year
Black race Hispanic ethnicity
College educated, higher income, non-Hispanic whites
Hypothetical stronger association for disadvantaged groups ???????
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2426
2830
Bod
y m
ass
inde
x
0 20000 40000 60000Population density (residents per square km)
≤ high school ≤ $30,000/year
Black race Hispanic ethnicity
College educated, higher income, non-Hispanic whites
p < 0.001
Static environment(e.g., current park access)
Behavior(e.g., physical activity)
Health outcome(e.g., blood pressure)
a.
Simplifying assumption that causal relationships are automatic and uniform has facilitated interpretation of cross-sectional studies
Complexity and social context are recognized, requiring awareness of the role of human agencyBlacksher, E., Lovasi, G.S., 2011. Place-focused physical activity research, human agency, and social justice in public health: Taking agency seriously in studies of the built environment. Health & Place.
Static environment(e.g., current park access)
Dynamic environment to meet local needs
Selection of activity spaces and behavior patterns
Residents’ health and wellbeing
Behavior(e.g., physical activity)
Health outcome(e.g., blood pressure)
Social connections and local capacity
a.
b.
Simplifying assumption that causal relationships are automatic and uniform has facilitated interpretation of cross-sectional studies
Engagement can activate local social networks
Depending on process, environmental change can
enhance local capacity
Perceptions, barriers, and goals determine resource utilization
Consequences of behavior extend beyond `health’
The environment to fit local needs will depend on behavior of residents
Prior health status and achievement of other goals
will affect behavior
Complexity and social context are recognized, requiring awareness of the role of human agencyBlacksher, E., Lovasi, G.S., 2011. Place-focused physical activity research, human agency, and social justice in public health: Taking agency seriously in studies of the built environment. Health & Place.
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Social Networks
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SSCI abstracts Medline abstracts
Social network studies are increasing
Lovasi, G.S., adams, j., Bearman, P., In Handbook of Medical Sociology, Sixth Edition, Edited by Chloe E. Bird, et. al.Vanderbilt University
Press, New York. 2010.
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a. Isolation vs connection
b. Group identity, norms, or common constraints may characterize the network
c. Transmission through a network of a pathogen or idea
Connections can enable or transmit
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1975
Christakis NA, Fowler JH. Connected: The Surprising Power of Social Networks and How They Shape Our Lives.
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Christakis NA, Fowler JH. Connected: The Surprising Power of Social Networks and How They Shape Our Lives.
1990
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Juxtaposition of social and spatial distance
Christakis, N.A., Fowler, J.H., 2008. The collective dynamics of smoking in a large social network. N Engl J Med 358, 2249-2258.
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Homophily and influence are challenging to disentangle
People tend to be connected to similar people (homophily)
Over time connected people may become similar (influence)
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Using social networks to support healthy behaviors
Target dyads, families, groups, workplaces, neighborhoods
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Using social networks to support healthy behaviors
Target dyads, families, groups, workplaces, neighborhoods
Develop strategic partners within network
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Valente, T. W., & Davis, R. L. (1999). Accelerating the diffusion of innovations using opinion leaders. The Annals of the American Academy of the Political and Social Sciences, 566, 55-67.
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Sociogram based on ties Optimal leader/learner matching
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Using Social Network Structure to Deploy an Intervention
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Using social networks to support healthy behaviors
Target dyads, families, groups, workplaces, neighborhoods
Develop strategic partners within network
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Using social networks to support healthy behaviors
Target dyads, families, groups, workplaces, neighborhoods
Develop strategic partners within network
Foster local social connections and physical activity through built environment design
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Intersection Between Social and Built Environment
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Bringing together Social Networks and Built Environments
Complementary types of resource supporting healthy behaviorsSocial Networks special issue on the intersection of social networks and spatial
analysis
Identification of influence vs homophily or selectionadults with high BMI are move to “sprawl”, and also to where they have connections
As an outcome that matters to a broader sense of wellbeingSocial network protection/cultivation may compete with or complement health promotion
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Acknowledgements
Funding from the National Institutes of Health (NIEHS, NIDDK, NHLBI), Environmental Protection Agency US Forest Service Robert Wood Johnson Foundation Active Living Research program Robert Wood Johnson Foundation Health & Society Scholars program
Key collaborators in this work: Andrew Rundle, Kathryn Neckerman, Chris Weiss, Michael Bader, Julien Teitler, James Quinn, Malo Hutson, John Beard, Erika Blacksher, jimi adams and Peter Bearman
