Social network inequalities and health impacts: socioeconomic, geographic, and migration-related dimensions (NetHealth)

Project description

Networks of social relationships are often seen as the glue that keeps societies together and are typically associated with positive outcomes such as social cohesion, support, trust, social capital, and civic participation. However, social networks can also form powerful structures of inequality, both reflecting and amplifying disparities of opportunities and outcomes along other dimensions, such as socioeconomic status. Inequalities in social networks matter for two reasons: because social relationships are a valued good in themselves for individuals in human societies; and because they are means to achieving other valued ends, such as jobs, housing, or health care.

Evidence from previous research on these topics indicates three important facts:

  1. People’s social networks are often profoundly different between population groups (e.g., socioeconomic or ethnic groups), for example in terms of network size, compositional diversity, and structure of connectivity.
  2. The composition and structure of social networks can strongly influence individual beliefs, behaviors, and outcomes in terms of health and well-being.
  3. Contemporary societies are characterized by significant health inequalities between social groups.

NetHealth departs from this knowledge and takes a step further by asking: (1) how and to what extent different characteristics of local and global social networks vary systematically between social groups, defined on the basis of socioeconomic status, geography of residential location, and migration status; (2) whether and to what degree group differences in social networks explain inequalities in health-related beliefs, behaviors, and outcomes between socioeconomic, geographic, and migration-status groups.

We focus on the context of Lombardy, one of the largest and socio-demographically most diverse areas of Italy and Europe. This region has been for years at the forefront of macro-level social and demographic trends of growing importance in the whole Western world, such as population aging, immigration from the Global South, and the health challenges posed by COVID-19.

In a sequential mixed-methods design, the project will collect quantitative and qualitative data in population groups with different socioeconomic status, living in areas with different degrees of urbanization, and including first-generation migrants, migrant descendants (second generations), and the non-migrant ethnic majority. Research steps will include:

  1. A population-representative survey on health beliefs, behaviors, and outcomes, and (offline and online) social networks, using recent data collection methods to obtain information about six different aspects of respondents’ personal networks (i.e., size, support function, resources, diversity, connectivity structure, negative ties).
  2. In-depth interviews to elucidate mechanisms of association between the three inequality dimensions of interest (socioeconomic, geographic, migration-related), social network characteristics, and health.
  3. Statistical modeling of network data and agent-based modeling to simulate global networks, study processes of influence and diffusion of health beliefs and behaviors, and elucidate potential mechanisms underpinning inequalities in health outcomes.

Data analysis will rely on various methods, including statistical modeling of survey data; traditional content analysis of interview data; computational methods such as natural language processing and network science techniques; and empirically calibrated agent-based modeling.

Conducted by a multidisciplinary team combining expertise from sociology, statistics, and public health, this will be the first project in Italy to systematically collect comprehensive, population-representative data on the composition and structure of social networks and on health beliefs, behaviors, and outcomes – purposefully stratified by socioeconomic, geographic, and migration status.

Project team: Raffaele Vacca (PI), Viviana Amati (co-PI, University of Milano-Bicocca), Federico Bianchi (University of Milan), Flaminio Squazzoni (University of Milan), Ilaria Capua (Johns Hopkins School of Advanced International Studies).

Funding agency: Fondazione Cariplo (Inequalities Research)