Social networks : the future for health care delivery

With the rapid growth of online social networking for health, health care systems are experiencing an inescapable increase in complexity. This is not necessarily a drawback; self-organising, adaptive networks could become central to future health care delivery. This paper considers whether social networks composed of patients and their social circles can compete with, or complement, professional networks in assembling health-related information of value for improving health and health care. Using the framework of analysis of a two-sided network – patients and providers – with multiple platforms for interaction, we argue that the structure and dynamics of such a network has implications for future health care. Patients are using social networking to access and contribute health information. Among those living with chronic illness and disability and engaging with social networks, there is considerable expertise in assessing, combining and exploiting information. Social networking is providing a new landscape for patients to assemble health information, relatively free from the constraints of traditional health care. However, health information from social networks currently complements traditional sources rather than substituting for them. Networking among health care provider organisations is enabling greater exploitation of health information for health care planning. The platforms of interaction are also changing. Patient-doctor encounters are now more permeable to influence from social networks and professional networks. Diffuse and temporary platforms of interaction enable discourse between patients and professionals, and include platforms controlled by patients. We argue that social networking has the potential to change patterns of health inequalities and access to health care, alter the stability of health care provision and lead to a reformulation of the role of health professionals. Further research is needed to understand how network structure combined with its dynamics will affect the flow of information and potentially the allocation of health care resources

Social capital and health: the problematic roles of social networks and social surveys

Social capital, social networks, social support and health have all been linked, both theoretically and empirically. However, the relationships between them are far from clear. Surveys of social capital and health often use measures of social networks and social support in order to measure social capital, and this is problematic for two reasons. First, theoretical assumptions about social networks and social support being part of social capital are contestable. Second, the measures used inadequately reflect the complexity and ambivalence of social relationships, often assuming that all social ties and contacts are of similarly value, are mutually reinforcing, and, in some studies, are based on neighbourhoods. All these assumptions should be questioned. Progress in our understanding requires more qualitative research and improved choice of indicators in surveys; social network analysis may be a useful source of methodological and empirical insight

The general health, social networks and lifestyle behaviours of young people looked after by local authorities in Scotland

The survey of the mental health of young people looked after by local authorities in Scotland was the second major national survey focusing on the development and well-being of young people to be carried out by ONS. The first survey, carried out in 1999, obtained information about the mental health of nearly 900 young people living in private households in Scotland. (Meltzer, Gatward, Goodman & Ford, 2000). Both surveys were commissioned by the Scottish Executive Education Department and the Scottish Executive Health Department

Ethnic differences in women's use of mental health services: do social networks play a role? Findings from a national survey

Objectives: The reasons for ethnic differences in women’s mental health service use in England remain unclear. The aims of this study were to ascertain: ethnic differences in women’s usage of mental health services, if social networks are independently associated with service use, and if the association between women’s social networks and service use varies between ethnic groups. Design: Logistic regression modelling of nationally representative data from the Ethnic Minority Psychiatric Illness Rates in the Community (EMPIRIC) survey conducted in England. The analytic sample (2260 women, aged 16–74 years) was drawn from the representative subsample of 2340 women in EMPIRIC for whom data on mental health services, and social networks were available. Results: Pakistani and Bangladeshi women were less likely than White women to have used mental health services (Pakistani OR = 0.23, CI = 0.08–0.65, p = .005; Bangladeshi OR = 0.25, CI = 0.07–0.86, p = .027). Frequent contact with relatives reduced mental health service use (OR = 0.45, CI = 0.23–0.89, p = .023). An increase in perceived inadequate support in women’s close networks was associated with increased odds of using mental health services (OR = 1.91, CI = 1.11–3.27, p = .019). The influence of social networks on mental health service use did not differ between ethnic groups. Conclusions: The differential treatment of women from Pakistani and Bangladeshi ethnic groups in primary care settings could be a possible reason for the observed differences in mental health service use

Social medicine and international expert networks in Latin America, 1930–1945

This paper examines the international networks that influenced ideas and policy in social medicine in the 1930s and 1940s in Latin America, focusing on institutional networks organised by the League of Nations Health Organization, the International Labour Organization, and the Pan-American Sanitary Bureau. After examining the architecture of these networks, this paper traces their influence on social and health policy in two policy domains: social security and nutrition. Closer scrutiny of a series of international conferences and local media accounts of them reveals that international networks were not just ‘conveyor belts’ for policy ideas from the industrialised countries of the US and Europe into Latin America; rather, there was often contentious debate over the relevance and appropriateness of health and social policy models in the Latin American context. Recognition of difference between Latin America and the global economic core regions was a key impetus for seeking ‘national solutions to national problems’ in countries like Argentina and Chile, even as integration into these networks provided progressive doctors, scientists, and other intellectuals important international support for local political reforms

Leveraging Social Networks in Direct Services: Are Foundations Doing All They Can?

· Social networks are critical to physical and mental health, and they shape how people see themselves and their possible futures. · Social networks represent an under-leveraged resource in social services’ efforts to alleviate poverty and other social challenges. · Foundations may be unintentionally creating barriers to practice that leverages social networks by incentivizing individually-focused, highly specific services delivered in standardized, replicable ways. · “Network-oriented” practice can help craft a new way forward that threads the needle between everything-is-different-for-everyone and everything- is-the-same-for-everyone. · By focusing funding on efforts that build and support social networks, foundations can deepen and sustain the impact of their funding

Social networks, work and network-based resources for the management of long-term conditions: a framework and study protocol for developing self-care support

Background: increasing the effective targeting and promotion of self-care support for long-term conditions requires more of a focus on patient contexts and networks. The aim of this paper is to describe how within a programme of research and implementation, social networks are viewed as being centrally involved in the mobilisation and deployment of resources in the management of a chronic condition. This forms the basis of a novel approach to understanding, designing, and implementing new forms of self-management support.Methods: drawing on evidence syntheses about social networks and capital and the role of information in self-management, we build on four conceptual approaches to inform the design of our research on the implementation of self-care support for people with long-term conditions. Our approach takes into consideration the form and content of social networks, notions of chronic illness work, normalisation process theory (NPT), and the whole systems informing self-management engagement (WISE) approach to self-care support.Discussion: the translation and implementation of a self-care agenda in contemporary health and social context needs to acknowledge and incorporate the resources and networks operating in patients' domestic and social environments and everyday lives. The latter compliments the focus on healthcare settings for developing and delivering self-care support by viewing communities and networks, as well as people suffering from long-term conditions, as a key means of support for managing long-term conditions. By focusing on patient work and social-network provision, our aim is to open up a second frontier in implementation research, to translate knowledge into better chronic illness management, and to shift the emphasis towards support that takes place outside formal health services.<br/

Hospital Choice: Survey Evidence From Istanbul

This paper analyzes the patient characteristics that affect the choice between public and private health care providers in Istanbul, Turkey. In addition to socioeconomic variables, such as insurance status or income, which have often been considered in the previous literature, we also focus on another factor, the availability of social networks, which might determine ease of access to hospital services in developing countries. The analysis is based on data from a household survey conducted in Istanbul. The econometric results indicate that potential social ties play an important role in choosing public health care centers over private ones for minor health problems. As public facilities have long been characterized by long waiting lines even for appointments for medical exams, this finding indicates that households who possess higher levels of social networks might be using those in easing access to public facilities.Public vs. Private Health Care Providers; Hospital Choice; Social Networks; Household Survey; Turkey