[This page is intended to provide a study summary, the sections of which are below. Please complete these sections, as applicable. The headings below are suggested headings. You can remove inapplicable sections, or add new ones relevant to your study]
Investigator Names and Contact Information
Crystal Wiley Cené, MD, MPH [email@example.com ]
Social networks, or ties between individuals, are important to a variety of health outcomes and may explain some disparities in health outcomes.1-12 Yet most health-related research does not conceptualize or measure social network ties in ways that support a deeper and more nuanced understanding of their impact on health. Social network analysis (SNA) is a theoretical perspective and methodology for describing, exploring and understanding structural and relational influences on health that is under-utilized in medicine and public health.13 The strength of social network theory rests on the testable assumption that the social structure of the network itself is largely responsible for determining individual health outcomes by shaping the flow of resources (e.g., information, social support) which determine access to opportunities and constraints on behavior.14
The structure and availability of resources through network ties may differ by age, race and gender.15-18 At the same time, social networks are shaped by larger social forces including culture, socioeconomic status, and place of residence.14 Recent work suggests that the networks of older adults- particularly women- tend to be smaller, more kin-centered, more dense (i.e. have a greater proportion of possible ties between network members represented) but with less frequent contact with network members.18, 19 Studies have also noted racial/ethnic differences in network characteristics among older versus younger adults, but the findings are inconsistent.19-22 Moreover, structural effects of the network on health may affect older minorities and Whites differently.21 The contribution of social network characteristics to health outcomes and racial/ethnic disparities in health among older adults is important, yet understudied; in part because of the lack of studies using nationally representative samples that contains both structural network and health outcome data.19 This knowledge gap is critical since the population is aging and becoming more diverse, networks change with age due to life-course factors (e.g., retirement, illness, bereavement), and the prevalence of chronic illnesses is increasing.
We propose to examine the social networks of a racially diverse sample of older women in the WHI using an egocentric network approach-23 where we assess the structure and functions of the personal networks of individuals. The specific aims of this study are:
Aim 1: To assess the feasibility of collecting social network data via telephone from a sample of WHI participants.
Aim 2: To perform descriptive statistics on social network structural characteristics (size, composition, density, bridging potential, etc.) overall and by race/ethnicity to inform sample size calculations for the ancillary study.
Aim 3: To assemble a multi-disciplinary team of WHI investigators with expertise in minority health and aging, health disparities, social network analysis and cardiovascular epidemiology to plan the ancillary study.
1. Cassel J. The contribution of the social environment to host resistance: The Fourth Wade Hampton Frost Lecture. Am J Epidemiol.
2. Berkman LF, Syme SL. Social networks, host resistance, and mortality: A nine-year follow-up study of Alameda County residents.
Am J Epidemiol. 1979;109:186-204.
3. Blazer DG. Social support and mortality in an elderly community population. Am J Epidemiol. 1982;115:684-694.
4. House JS, Robbins C, Metzner HL. The association of social relationships and activities with mortality: Prospective evidence from
the Tecumseh Community Health Study. Am J Epidemiol. 1982;116:123-140.
5. Seeman TE, Kaplan GA, Knudsen L, Cohen R, Guralnik J. Social network ties and mortality among the elderly in the Alameda
County Study. Am J Epidemiol. 1987;126:714-723.
6. Reed D, McGee D, Yano K, Feinleib M. Social networks and coronary heart disease among Japanese men in Hawaii. Am J
7. Cene CW, Loehr L, Lin FC, et al. Social isolation, vital exhaustion, and incident heart failure: Findings from the Atherosclerosis Risk
in Communities Study. Eur J Heart Fail. 2012;14:748-753.
8. Christakis NA, Fowler JH. The collective dynamics of smoking in a large social network. N Engl J Med. 2008;358:2249-2258.
9. Christakis NA, Fowler JH. The spread of obesity in a large social network over 32 years. N Engl J Med. 2007;357:370-379.
10. Fratiglioni L, Wang HX, Ericsson K, Maytan M, Winblad B. Influence of social network on occurrence of dementia: A communitybased
longitudinal study. Lancet. 2000;355:1315-1319.
11. Barnes LL, Mendes de Leon CF, Wilson RS, Bienias JL, Evans DA. Social resources and cognitive decline in a population of older
African Americans and Whites. Neurology. 2004;63:2322-2326.
12. Mendes de Leon CF, Gold DT, Glass TA, Kaplan L, George LK. Disability as a function of social networks and support in elderly
African Americans and Whites: the Duke EPESE 1986--1992. J Gerontol B Psychol Sci Soc Sci. 2001;56:S179-90.
13. Luke DA, Harris JK. Network analysis in public health: History, methods, and applications. Annu Rev Public Health. 2007;28:69-93.
14. Berkman LF GT. Social integration, social networks, social support, and health. In: Berkman LF KI, ed. Social Epidemiology. New
York: Oxford University Press; 2000:137-173.
15. Moore G. Structural Determinants of Men's and Women's Personal Networks. Am Sociol Rev. 1990;55:726-735.
16. Glass TA, Mendes de Leon CF, Seeman TE, Berkman LF. Beyond single indicators of social networks: A LISREL analysis of social
ties among the elderly. Soc Sci Med. 1997;44:1503-1517.
17. Heller K, Mansbach WE. The multifaceted nature of social support in a community sample of elderly women. J Soc Iss. 1984;40:99-
18. Ajrouch KJ, Blandon AY, Antonucci TC. Social networks among men and women: The effects of age and socioeconomic status. J
Gerontol B Psychol Sci Soc Sci. 2005;60:S311-S317.
19. Cornwell B, Schumm LP, Laumann EO, Graber J. Social Networks in the NSHAP Study: Rationale, measurement, and preliminary
findings. J Gerontol B Psychol Sci Soc Sci. 2009;64 Suppl 1:i47-55.
20. Ajrouch KJ, Antonucci TC, Janevic MR. Social networks among blacks and whites: The interaction between race and age. J
Gerontol B Psychol Sci Soc Sci. 2001;56:S112-8.
21. Peek MK, O'Neill GS. Networks in later life: An examination of race differences in social support networks. Int J Aging Hum Dev.
22. Antonucci A, Akiyama H. An examination of sex differences in social support among older men and women. Sex Roles.