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PubMed1993

Social support and cancer screening among older black Americans.

BACKGROUND: Age-adjusted cancer mortality is 27% higher for Black Americans than for the general U.S. population, which may result from inappropriate use of cancer detection tests. Social support has been shown to affect adjustment to breast cancer and survival, but it has not been studied as a predictor of use of preventive health care services in the older population. Our hypothesis is that larger social networks are associated with greater utilization of cancer-screening tests in the older population. PURPOSE: The objective of this study was to examine the relationship between social support and use of cancer-screening tests among older Black Americans. METHODS: Data for this study were obtained from a 1986 baseline survey evaluation of a community intervention program to increase cancer awareness and a 1991 end-point survey of use of cancer detection tests. Our study sample consisted of 617 Black Americans aged 55 years or older who lived in San Francisco (Calif.), the control community, and in Oakland (Calif.), the target community for intervention. The survey included measures of 1) social network characteristics, as determined by a modified version of Berkman and Syme's Social Network Index; 2) demographic characteristics; and 3) use of six cancer-screening tests--mammography, occult blood stool examination, cervical smear, clinical breast examination, digital rectal examination, and sigmoidoscopy. RESULTS: Multiple logistic regression analysis of the Social Network Index results indicated statistically significant positive associations of social support with the use of mammography and occult blood stool examination but not with the other cancer-screening tests. There were statistically significant associations between having HMO (Health Maintenance Organization) insurance and increased use of mammography and occult blood stool examination, compared with having Medi-Cal or other insurance. The interval between the surveys had a statistically significant positive association with use of mammography. These significant associations were not explained by differences in the other variables, which included health status, age, gender, education, type of health insurance, interval between the surveys, and a regular source of care. CONCLUSIONS: Social support seems to be associated with increased use of mammography and occult blood stool examinations among older Black Americans. IMPLICATIONS: Interventions designed to increase utilization of social networks may be an effective way to increase use of cancer screening, which may ultimately lead to reduced mortality from cancer.

Black or African American↗
PubMed2003

Social networks of old people in India: research and policy.

This article presents a comparative analysis of the available research on the social networks of older persons in India. Most of this research has been done in North Indian cities. The research foci of the available studies include network size, core networks and beyond, life course changes in networks, impacts of residency in old-age homes, gender differences, and joint and nuclear family residence. This research is discussed in terms of its policy implications. Because the research demonstrates that social networks are important for the welfare of older Indians, one can conclude that social policy that encourages the maintenance of robust networks throughout the life course may be worth pursuing. One aspect of policy is discussed. The analysis of the relationship between social network and gender suggests that current policies that can be seen as supporting gender inequality in terms of property may have a negative impact on the networks of older women.

Aged↗
PubMed2000

Lay theories of successful aging after the death of a spouse: a network text analysis of bereavement advice.

Social theories of successful aging attempt to explain how individuals adapt to changes characteristically associated with aging and to predict whether older adults' adaptations will lead to successful aging. The death of a spouse and the accompanying bereavement process entail dramatic changes to personal networks and experience to which individuals must adapt to age successfully. Network text analysis (including word frequencies, cluster analysis, and multidimensional scaling) of advice for adjusting to, and coping with, the loss of a spouse given by a sample of 60 bereaved spouses (mean age = 68) at 6 points in time after the death of their marital partner (3-4 weeks to 24 months) reveal respondents' lay theories of successful aging. Thematic clusters address social positioning and qualifiers, activity, communication, time, and spousal characteristics. Results indicate respondents frame their advice as unique to their context of social relationships while providing support for activity theory and negatively addressing disengagement theory.

Aged↗
PubMed1978

Support systems of schizophrenic and nonschizophrenic Puerto Rican migrant women in New York City.

Analysis of the social networks and support systems of patients with varying degrees of emotional disturbance reveals models of naturally occurring support systems that can be used by mental health professionals for fostering, redeveloping, or building supports for chronic schizophrenic patients in their natural communities. As a demonstration, analysis is made of the social supports of 55 Puerto Rican migrant women with five degrees of emotional disturbance. Seven patterns of social support with associated family and emotional status variables emerge. These support system patterns range on a continuum from one which reflects the ideals of the culture found primarily among women who are symptom-free, through four variations that appear to be adaptations to deficits in the core support system (e.g., absence of husband, extended kin, or both) found predominantly among the nonschizophrenic but disturbed women, to two culturally deviant forms found almost exclusively among the schizophrenics. The salient finding of this analysis is that there is greater reliance upon neighbors, friends, and other non-kin than upon family among the schizophrenic women who lead their lives relatively successfully within the community. It is suggested that these non-kin supports be used in natural network therapy to reintegrate or maintain chronic schizophrenic patients in the Puerto Rican migrant community and that similar analyses be made of the support systems of patients from other communities.

Adult↗
PubMed1984

Social networks and psychosocial support among disabled people.

Analysis of the network characteristics and nature of social ties among physically disabled people living in an inner London borough showed network size rather than network type was related to the availability of psychosocial support, reflecting the important role of both related and non-related people in the provision of this form of support. The study also questioned three commonly held assumptions. Firstly, in contrast to the image of physically disabled people as lacking social ties, those with a high level of disability, although having a lower level of social contact outside the household than other groups, did not differ significantly in other aspects of their network structures and support. Secondly, in contrast to the characterisation of inner city areas as relatively homogeneous and as lacking locally based ties, the inner London area studied comprised a variety of network types with a large proportion of respondents deriving support from people living in close proximity. Thirdly, whereas the presence of household members, and especially a spouse, tend to be equated with the availability of strong emotional support, considerable numbers of married people lacked such support. This suggests measures to promote psychosocial support need to be fairly broadly based and cautions against using marital status as a proxy measure of support.

Adolescent↗
PubMed1999

Logit models and logistic regressions for social networks: II. Multivariate relations.

The research described here builds on our previous work by generalizing the univariate models described there to models for multivariate relations. This family, labelled p*, generalizes the Markov random graphs of Frank and Strauss, which were further developed by them and others, building on Besag's ideas on estimation. These models were first used to model random variables embedded in lattices by Ising, and have been quite common in the study of spatial data. Here, they are applied to the statistical analysis of multigraphs, in general, and the analysis of multivariate social networks, in particular. In this paper, we show how to formulate models for multivariate social networks by considering a range of theoretical claims about social structure. We illustrate the models by developing structural models for several multivariate networks.

Humans↗
PubMed1982

Social networks, beliefs, and the decision to seek medical care: an analysis of congruent and incongruent patterns.

This article focuses on the impact of congruent and incongruent patterns of symptom specific beliefs and social network advice on the decision to seek medical care for symptoms. Data from 769 individuals who reported symptoms in the Los Angeles Health Survey are used to examine this issue. Further, the role of more general health orientations and social network influences in the decision to seek care is examined under these congruent and incongruent conditions. It is concluded that the more general factors, which have little effect on the aggregate, may play a role in decision making when beliefs and advice are incongruent. Further, it is concluded that reports of beliefs and advice about specific symptoms that have been given after the decision has been made to seek care may be valid and not the result of retrospective reconstruction.

Attitude to Health↗
PubMed2004

Brain anatomy in Turner syndrome: evidence for impaired social and spatial-numerical networks.

Analysis of brain structure in Turner syndrome (TS) provides the opportunity to identify the consequences of the loss of one X chromosome on brain anatomy and to characterize the neural bases underlying the specific cognitive profile of TS subjects which includes deficits in spatial-numerical processing and social cognition. Fourteen subjects with TS and fourteen controls were investigated using voxel-based analysis of high resolution anatomical and diffusion tensor images and using sulcal morphometry. The analysis of anatomical images provided evidence for macroscopical changes in cortical regions involved in social cognition such as the left superior temporal sulcus and orbito-frontal cortex and in a region involved in spatial and numerical cognition such as the right intraparietal sulcus. Diffusion tensor images showed a displacement of the grey-white matter interface of the left and right superior temporal sulcus and revealed bilateral microstructural anomalies in the temporal white matter. The analysis of fiber orientation suggests specific alterations of fiber tracts connecting posterior to anterior temporal regions. Last, sulcal morphometry confirmed the anomalies of the left and right superior temporal sulci and of the right intraparietal sulcus. Our results thus provide converging evidence of regionally specific structural changes in TS that are highly consistent with the hallmark symptoms associated with TS.

Adolescent↗
PubMed1988

Social anchorage and blood pressure in elderly men--a population study.

The present study was designed to test the hypothesis that there is an independent association between the three concepts of psychosocial factors, social network, social support, social influence and blood pressure (see Materials and methods for definition). The study sample chosen (n = 621) comprised a randomly selected group of half the male residents of Malmö born in 1914, 500 (80.5%) of whom participated. A study based on a model with clearly defined criteria was used to measure the different aspects of social network, social support and social influence. In multiple regression analysis, social anchorage (a subconcept of social network) was shown to have an association with both systolic (P = 0.03) and diastolic blood pressure (P less than 0.001), when adjustments for social class, marital status, medication for hypertension, alcohol consumption, smoking habits, body mass index (BMI) and physical activity were made. Social anchorage is a concept on a structural level, that describes to what degree the individual belongs to and is anchored within formal and informal groups in society. As such, it may contribute to a deeper understanding of mechanisms behind high blood pressure and could thus be significant in the field of health promotion.

Aged↗
PubMed1996

The impact of internal and external resources on functional outcomes in chronic illness.

This study's purpose was to determine if internal and/or external resources could deter negative consequences of physiologic stress in chronic illness. Resource theory was used to test relationships over time among stress (physiologic), distress (functional outcome), and resources (internal-well-being; external-social network). A secondary analysis was done on data from 112 persons with end stage renal disease, collected yearly over 3 years. Physiologic stressors were strongly associated with higher levels of physical dysfunction. Resources were generally unable to reduce deleterious effects of physiologic stress on functional outcomes; functional outcomes were largely determined by preexisting levels of function.

Adult↗
PubMed2004

The effect of a communal lifestyle on depressive symptoms in late life.

OBJECTIVES: This study compares depression levels among lifetime kibbutz members (n = 525) and old-age kibbutz residents (n = 366) with a comparable national sample (n = 412) and assesses the relationship between depression and individual differences related to lifetime in a kibbutz (e.g., health) and those related to current living conditions (e.g., social network). METHODS: The analysis is based on data from the Cross-Sectional and Longitudinal Aging Study conducted in Israel between 1989 and 1992 and the follow-up during 1993 and 1994. RESULTS: The findings indicate significantly lower depressive symptomatology among women, but not among men, residing in kibbutz communities. The women's lower level of depressive symptoms appears to be a result of better physical and mental functioning among kibbutz members and of such favorable lifestyle characteristics as frequent contact with their children among old-age kibbutz residents. DISCUSSION: Both lifetime and current living conditions contribute to better mental health of women in the kibbutz at older ages.

Aged↗
PubMedDate not supplied

Depression and risk of sudden cardiac death after acute myocardial infarction: testing for the confounding effects of fatigue.

OBJECTIVES: This study examined the impact of depressive symptoms and social support on 2-year sudden cardiac death (SCD) risk, controlling for fatigue symptoms. METHODS: Myocardial infarction (MI) patients (N = 671) participating in the Canadian Amiodarone Myocardial Infarction Arrhythmia Trial completed measures of depression, hostility, and social support. RESULTS: After controlling for significant biological predictors, psychosocial predictors of increased SCD risk in the survival analysis were greater social network contacts (RR = 1.04; 95% CI = 1.01-1.06; p < .007), lower social participation (RR = 0.98; 95% CI = 0.96-1.00; p < .05), and, in placebo-treated patients, elevated depressive symptoms (RR = 2.45; 95% CI = 1.14-5.35; p < .02). Fatigue was associated with SCD (RR = 1.31; 95% CI = 1.11-1.53; p < .001), and, when included in the model, diminished the influence of depression (RR = 1.73; 95% CI = 0.75-3.98; p = .20). When the cognitive-affective depressive symptoms were examined separately from somatic symptoms, there was a trend for an association between cognitive-affective symptoms and SCD in placebo-treated patients after controlling for fatigue (RR = 1.09; 95% CI = 0.99-1.19, p < .06). CONCLUSIONS: Symptoms of depression and fatigue overlap in patients with MI. The trend for the cognitive-affective symptoms of depression to be associated with SCD risk, even after controlling for dyspnea/fatigue, suggests that the association between depression and mortality after AMI cannot be entirely explained as a confound of cardiac-related fatigue. The independent contribution of social participation suggests a role of both depressive symptomatology and social factors in influencing mortality risk after MI.

Activities of Daily Living↗
PubMed2003

Propagation and immunization of infection on general networks with both homogeneous and heterogeneous components.

We consider the entire spectrum of architectures of general networks, ranging from being heterogeneous (scale-free) to homogeneous (random), and investigate the infection dynamics by using a three-state epidemiological model that does not involve the mechanism of self-recovery. This model is relevant to realistic situations such as the propagation of a flu virus or information over a social network. Our heuristic analysis and computations indicate that (1) regardless of the network architecture, there exists a substantial fraction of nodes that can never be infected and (2) heterogeneous networks are relatively more robust against spreads of infection as compared with homogeneous networks. We have also considered the problem of immunization for preventing wide spread of infection, with the result that targeted immunization is effective for heterogeneous networks.

Animals↗
PubMed2000

Influences of socioeconomic status, social network, and competence on subjective well-being in later life: a meta-analysis.

Meta-analysis is used to synthesize findings from 286 empirical studies on the association of socioeconomic status (SES), social network, and competence with subjective well-being (SWB) in the elderly. All three aspects of life circumstances are positively associated with SWB. Income is correlated more strongly with well-being than is education. The quality of social contacts shows stronger associations with SWB than does the quantity of social contacts. Whereas having contact with friends is more strongly related to SWB than having contact with adult children, there are higher associations between life satisfaction and quality of contact with adult children when compared with quality of friendships. Moderating influences of gender and age on the effects of SES, social network, and competence on SWB are also investigated.

Aged↗
PubMedDate not supplied

Cross-cultural analysis of longevity among Swedish and American elders: the role of social networks in the Gothenburg and Missouri longitudinal studies compared.

This paper reports the results of a cross-national comparison of the 'H70' longitudinal study of elders in Gothenburg, Sweden, with the 'Rural Missouri Elders' longitudinal study in Missouri, USA. Analysis of the combined data sets focused on the question of how longevity was affected by culturally divergent forms of social network participation. The H70 study was a representative, systematic 3/10 sample of 70-year-old (in 1971) men and women living in Gothenburg. Follow-up data was gathered when the respondents were 75, 79, 81, 82, 83, 85, 88, 90 and 95 years of age. Face-to-face interviews and physical medical examinations were the major source of data. The Missouri study involved a representative cluster proportional-to-size sample of all rural Missourians 65 years of age and older. Face-to-face interviews were conducted in 1966, 1974 and 1987. Logistic regression and cross-tabular analyses revealed that social networks were important predictors of longevity for both samples. However, marital status and participation in formal organizations predicted longevity for the Americans, whereas contact with children emerged as the predictor variable for the Swedes. Specific functions of the different network patterns in the two countries are discussed.

Journal Article↗
PubMed1988

Social networks and the functional health status of the poor: a secondary analysis of data from the National Survey of Personal Health Practices and Consequences.

This study uses data from the Wave I of the National Survey of Personal Health Practices and Consequences (N = 3025) to examine the relationship between social networks and the health status of the poor. No single category of networks was found to be consistently predictive of health status among the poor. The number of close friends, satisfaction with number of close ties, frequency of contact with network ties and church attendance were all significantly related to health status, but in no case were sufficient to bring health status levels of the poor up to the level of the nonpoor.

Adult↗
PubMed2005

Support network transformations in the first stages of the caregiver's career.

The purpose of this article is to propose a method to facilitate analysis of the processes involved in the transformation of support networks for caregivers of persons with dementia. The authors are particularly interested in the preliminary phases of the caregiver's career: the initial period ranging from the first manifestations of dementia to the confirmation of a diagnosis. This method combines the social network approach with narrative analysis. The authors discuss two cases to illustrate the concepts of density and clique to explain the maintenance and dissolution of the caregiver's supportive relationships. This method shows significant potential, in that it will help researchers explore social mechanisms related to the development of supportive relationships.

Aged↗