Longevity and Quality of Life of the Aging Chronically Ill: The Development of the Concentric Model of Health-bound Networks

Michele Battle-Fisher, MPH, MA
Joann Mawasha, Psy.D.
Wright State Boonshoft School of Medicine
2012 International Aging and Society Conference
University of British Columbia, Vancouver
November 2012

Making Quality of Life “Social”: CMHN
Individuals “live” their illnesses in a social environment.
Quality of life is related to the quality of social support.
The new proposed model, Concentric Model of Health- Bound Networks, redefines this support as connected & dynamic.

CMHN Assumptions
Individuals exist in relationships that are overlapping.
Social networks can influence social support and analyzing networks should be a part of the solution.
Understanding a social network of a patient is vitally important to supporting positive patient outcomes.

Key assumptions of Social Networks (Valente, 2010)
The aggregate influence of the group is more important than individual attributes.
The Analysis is done at the level of the “network”.
Relationships exists in dyads as well as across the whole network.

Some basic SNA terms (Hanneman & Riddle, 2005)
Terms
Ego
Actors
Alters
Ties
Density
Homophily
Isolate
Sample Ego network

Why QOL and networks?
Isolation (sparse networks) has been associated with low self-reported health (Cornwell & Waite, 2009).
Strong ties for aged patients counters stressors (Cacioppo & Hawkley, 2003)
Adverse health effects “flow” within networks (Smith & Christakis, 2008)

Complexity?
Complexity is nonlinear change for social adaptation (Strogatz, 1994; Newman, 2003).
“Deep” complexity= changing in parts of system affect “health” of system (Miller & Page, 2007).
Loss of support has an acceptable level before “chaos” and a less robust system (Miller & Page, 2007).
Kilduff & Tsai (2003) are critical of viewing networks as stable.

The proposed model

Components of the model
“Nucleus” ego
The Kidney (Health) Network
The General Well Being Network
The Social Network
The Polis
Migration (direct/ intermediary)
Structural Folds

Why is this model needed?
Realities of caregiving and stress of illness could leave to loss of support at many levels.
Chronic disease is best navigated with dependable assistance.
Micro-Macro linkages between larger social structure and individuals (Kilduff & Tsai, 2003)
Conventional discussions of social support and QOL (as something you have or as High/Low) do not allow dynamic exploration that SNA provides.

Testing the model…Next steps
Testing network resilence and community structure
Using ABM (computer simulation), the model will be tested using social network responses of ESRD patients .
An algorithm based on these responses will be run to “test” the appropriate of the components of the proposed model.
Co-investigator: Dr. David Shoham of Loyola-Chicago

References
Cacioppo, J., & Hawkley, L. (Summer 2003). Social isolation and health, with an emphasis on underlying mechanisms. Perspectives of Biology in Medicine. 46(3 Suppl), S39-52.
Cornwell, E. & Waite, L. (March 2009). Social disconnectedness, perceived isolation and health among older adults. Journal of Health and Social Behavior. 50(1), 31-48.
Hanneman, R., & Riddle, M. (2005). Introduction to Social Network Methods. Retrieved on Dec. 29, 2009 from http://www.faculty.ucr.edu/~hanneman/nettext/.
Kilduff,M. & Tsai , W. (2003) Social Networks and Organizations. London: Sage.
Miller, J. & Page, S. (2007) Complex Adaptive Systems: an Introduction to Computational Models of Social Life (Princeton Studies in Complexity). Princeton, NJ: Princeton University Press.
Newman, N. (2003) The structure and function of complex networks. SIAM Review. 45:167–256.
Strogatz, S. (1994). Nonlinear dynamics and chaos: with applications to physics, biology, chemistry, and engineering. Cambridge, MA: Perseus Books Publishing LLC.
Valente, T. (2010). Social Networks and Health. New York: Oxford University Press.
Smith, K. & Christakis , N. (2008) Social Networks and Health.
Annual Review of Sociology. 34, 405-29.

Contact Information
Michele Battle-Fisher, MPH, MA
Wright State Boonshoft School of Medicine
Assistant Program Director and Instructor of Community Health
3123 Research Blvd. #200
Kettering, OH 45420-4006
Tele: 937-258-5557
Fax: 937-258-5544
michele.battle-fisher@wright.edu

Website: http://www.med.wright.edu/mph/index.html

THANK YOU FOR YOUR ATTENTION!