Social Network Theory

Social Network Theory (SNT) is another broad theoretical approach that is used to understand a variety of social phenomena beyond health behaviors, such as communications, political opinions, organizational behavior, and economic behaviors. At its core, SNT emphasizes the significance of the web of social relationships that surround each individual. While individual-level theories emphasize the importance of individual s characteristics, SNT points out the significance of the characteristics of the relationships between people. As we spent a good deal of time speaking about social network theory in week 4, this section will serve mainly as a review.

The concept of a social network can be understood simply. No man is an island. Each one of us has family members, friends, neighbors, co-workers, acquaintances. These individuals – the people whom we know with who we interact on an at least semi-regular basis – are parts of our social network. Social networks are linkages between people.

With regard to health, social networks can play a profound role in shaping whether people behave in ways that will promote or undermine health. One s social network can influence whether you smoke, drink, or exercise; it shapes what sort of information you have access to, and what sorts of help you can receive. Social networks can provide emotional support, instrumental support, informational support, and appraisal support. Let us take, as an example, the issue of mammography. How might social networks matter for whether or not a given woman receives a mammogram? If her network is made of women who fear cancer and value mammography, she will receive encouragement to receive one. Her network may offer her emotional support and informational support - telling her why it is important, where to go to receive one, what to expect, and allaying any fears she may have about the process. The network may offer her instrumental support - she may need help with transportation to receive a mammogram, or may need childcare while she is at the doctor s office receiving one. She may receive appraisal support, as her friends and family members affirm her decision to receive a mammogram.

In order to use SNT for health intervention programs, we need to take into account various characteristics of the network associated with the individuals or group we are hoping to affect. This sort of information can help us to determine where channels of communication and influence exist. Within a contained network, a researcher may make use of individuals central to the network in an attempt to influence the behavior of the group as a whole. Imagine you were trying to encourage a class of seventh graders to not experiment with tobacco. If students who hold central locations in this class network were identified, these students could be enlisted as leaders in the intervention to discourage tobacco experimentation. Presuming you were able to influence those centrally-positioned students to truly reject tobacco experimentation, these students may help to influence the entire group.


Evidence and Critiques of SNT

The evidence about the significance of social networks on health is reasonably profound - social networks do have an impact on health. The social support available through social networks - be it informational, emotional, appraisal or instrumental - makes a difference for health. Studies consistently find a relationship between a lack of social relationships and all-cause mortality. Low levels of social integration are damning for health. People without strong social networks miss out on the health-beneficial aspects of social support that are available to people with stronger social networks.

Critiques of SNT deal less with the usefulness of the theory for explaining health behaviors than with its usefulness from an intervention perspective. We can use SNT easily to understand existing patterns of behavior and belief. But if our goal is to promote health behavior change for a large group, the understandings we gain from SNT may not be the most helpful for planning an intervention. In order to understand how to manipulate networks to beneficial health ends, we first must plot out and characterize the appropriate social network. The data collection necessary to plot and characterize a social network is labor-intensive, requiring hours upon hours of interviewing. Even if a project has the resources to do such data collection, the ability to use SNT for interventions is limited to contained, smaller social networks. For example, SNT may help us to plan an intervention if the population of interest is the workforce at a single company, or a seventh grade class. But what if our population is all Hispanic women in LA, or all teens? Large populations do not lend themselves well to social network analysis.