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Social Networks and Health
This page intentionally left blank
Social Networks
and Health
Models, Methods, and Applications

Thomas W. Valente

1
2010
1
Oxford University Press, Inc., publishes works that further
Oxford University’s objective of excellence
in research, scholarship, and education.

Oxford New York

Auckland Cape Town Dar es Salaam Hong Kong Karachi
Kuala Lumpur Madrid Melbourne Mexico City Nairobi
New Delhi Shanghai Taipei Toronto
With offices in
Argentina Austria Brazil Chile Czech Republic France Greece
Guatemala Hungary Italy Japan Poland Portugal Singapore
South Korea Switzerland Thailand Turkey Ukraine Vietnam

Copyright © 2010 by Oxford University Press, Inc.

Published by Oxford University Press, Inc.

198 Madison Avenue, New York, New York 10016
www.oup.com

Oxford is a registered trademark of Oxford University Press

All rights reserved. No part of this publication may be reproduced,

stored in a retrieval system, or transmitted, in any form or by any means,
electronic, mechanical, photocopying, recording, or otherwise,
without the prior permission of Oxford University Press.

Library of Congress Cataloging-in-Publication Data

CIP data on file

ISBN 978-0-19-530101-4

9 8 7 6 5 4 3 2 1
Printed in the United States of America
on acid-free paper
To
Becca, Kate, and Thomas

for being such a supportive and fun network.

This page intentionally left blank
Preface

This book provides an introduction to the major theories, methods, models,

and findings of social network analysis research and application with atten-
tion to medical and public health topics. It is designed to be accessible to
anyone interested in network analysis but also is designed for use in gradu-
ate introductory courses on social network analysis. The fundamental dis-
tinction of social network analysis research is that relationships—who is
connected to whom—are of paramount importance in explaining behavior.
Relationships and the pattern of relationships have a large and varied influ-
ence on individual and group action. Research on social network analysis has
been conducted within the scientific community for over 70 years, although
recent advances in computing and communication technology have dramati-
cally altered the science.
This book is divided into three sections. Chapters 1 through 4 comprise
Part I, “Models.” Chapter 1 introduces the major areas of study and research
questions with which social network analysis is concerned. Chapter 2 pro-
vides a historical review of the field and an introduction to how social net-
work analysis complements existing behavior change theories. Chapter 3
presents a typology of the five different methods of network data collec-
tion, each of which has a general and a specific form, yielding 10 different
research methodologies that constitute network data collection. Chapter 4
vii
viii PREFACE

describes personal and ego-centric network effects and the many hypotheses
tested using personal network data. Part II, “Methods,” provides informa-
tion on methods used to calculate concepts and metrics from network data.
Centrality measures provide a means to locate the most important nodes
in the network, and this is covered in Chapter 5. Chapter 6 presents meth-
ods used to define groups within a network, Chapter 7 presents methods
used to identify positions within a network, and Chapter 8 presents network-
level measures such as density, average path length, and clustering. Part III,
“Applications,” discusses the applications of social network analysis to behav-
ior change in Chapters 9 through 11. In this section, individual behavior
within the context of social network connections becomes important. Three
application areas are reviewed and developed: stochastic network estimation
or exponential random graph models, diffusion of innovations, and network
interventions. Part III ends with a book summary in Chapter 12.
Every attempt has been made to make the text clear, concise, and com-
prehensible to a lay audience. Occasionally some chapters and sections will
contain short mathematical formulas for some key indicators or concepts.
Readers less mathematically inclined should be able to skip these equations
with no loss of comprehension or flow. Readers more mathematically inclined
may be a bit disappointed in the superficial treatment of these concepts. My
apologies to both mathematically and non–mathematically inclined readers
with this attempt to balance these sometimes competing needs.
My hope is that this book will enable researchers interested in understand-
ing social network analysis to adopt this method in their research and/or prac-
tice. The field of network analysis offers many exciting tools and techniques
useful in research and practice that can be applied to any situation ranging
from organizational improvements, understanding risk behaviors, coordinat-
ing coalitions, or the delivery of health care services. The only barrier to
widespread use of social network analysis has been people’s understanding
and training of how network analysis works. This book aims to make some
progress in removing that barrier and helping us all become better network-
ers and network analysts.

Acknowledgments

This book has emerged from a desire to create a text useful for introduc-
ing public health researchers to the field of social network analysis. It has
benefited greatly from the support of my colleagues at the University of
Southern California including studies conducted with Chih-Ping Chou,
Michael Cousineau, Kayo Fujimoto, Marientina Gotsis, Andy Johnson, Mary
Ann Pentz, Alan Stacey, Donna Spruijt-Metz, Anamara Ritt-Olson, Steve
 Preface ix

Sussman, and Jennifer Unger, among others. I would also like to thank the
many students who have taken my social network analysis course over the
years at Johns Hopkins University and the University of Southern California.
I also want to thank the students who have worked with me conducting
social network studies. In particular, my thanks to Kate Coronges, Heather
Hether, Patty Kwan, Janet Okamoto, Lisa Prosser, and Beth Hoffman. I am
also indebted to Marc Boulay (Johns Hopkins University), Jenine Harris
(St. Louis University), and Charles Kadushin (Brandeis University) who read
and commented on a penultimate draft. My wife, Rebecca Davis, has pro-
vided invaluable insight and counsel on almost every aspect of this volume.
Most of the network graphs in this book were drawn with NetDraw and much
of the analysis conducted with UCINET.
I have also received support from several funding agencies, including
National Institute on Drug Abuse (NIDA) support for the USC Transdis-
ciplinary Drug Abuse Prevention Research Center (TPRC), particularly
Project 2: TND Network (DA16094); National Cancer Institute support
for the Transdisciplinary Tobacco Use Research Centers (P50-CA84735);
National Institute on Drug Abuse support for Steps Toward Effective
Prevention (STEP) (CA-012524, Pentz, PI); National Cancer Institute–funded
Transdisciplinary Research on Energetics and Cancer (U54 CA 116848);
California Endowment’s support of our network studies of coalitions
(HS-CG-06-000006); and Robert Wood Johnson Foundation support of our
Wellness Partners study (U-64448).
This page intentionally left blank
Contents

Part I Models
1 Introduction 3
Relationships Matter 3
Random Sampling Is Not Enough 6
Literature Overview 7
Major Research Advances 9
Individual- and Network-Level Measures 21
Summary 25
2 History 26
History Reconsidered 28
Behavioral Science 30
Life Span Approaches 35
Public Health and Medical Applications 36
Summary 39
3 Methods 41
Data Collection Techniques 43
Data Management 50
Data Characteristics 55
Network Variables 55
Summary 60

xi
xii CONTENTS

4 Ego- and Personal-Network Effects 61

Measures 65
Statistical Analysis 70
Personal Network versus Sociometric Variables 72
Snowball/Sequenced Data 74
Summary 77

Part II Measures
5 Centrality 81
Degree 82
Closeness 83
Distances for Unconnected Nodes 85
Betweenness 87
Correlation among Centrality Measures 91
Other Centrality Measures 93
Link or Edge Centrality 93
Centrality versus Centralization 94
Centrality and Behavior 95
Characteristics of Opinion Leaders 98
Summary 99
6 Groups 100
Components and K-Cores 101
Girvan-Newman Technique 105
Groups and Behavior 108
Group Membership and Disease 109
Groups, Density, and Bridges 110
Summary 113
7 Positions 114
Network-Level Positions 115
CONCOR 121
Individual Positional Measures 122
Individual Measures as Positions 123
Positions and Behavior 124
Network Weights 125
Summary 126
8 Network-Level Measures 128
Size 129
Density 129
Mutuality/Reciprocity 130
Triads/Transitivity 132
Diameter/Average Path Length 134
Density and Cohesion 135
Clustering 137
 Contents xiii

Centralization 138
Core-Periphery 140
Two-Mode Data 144
Individual Network-Level Interactions 146
Summary 147

Part III Applications

9 Exponential Random Graph Models, P* and Actor
Oriented Models 151
Estimating the Link 153
Vectorizing the Matrix 153
Exponential Random Graph Models (ERGM) 156
Simulation 157
New Specifications 160
Obesity Example 161
Actor-Oriented Model 163
WINCART 166
Summary 170
10 Diffusion of Innovations 172
Homogeneous Mixing 175
Integration and Opinion Leadership 179
Structural Models 181
Dynamic Models 184
Empirical Estimates Using Diffusion Network Data 187
Infection and Susceptibility 190
Thresholds 191
Limitations to Diffusion Theory 194
Summary 194
11 Network Interventions 196
Opinion Leaders 197
Key Players 201
Groups 202
Identifying Leaders and Groups 203
Snowball Sampling or Network Recruitment 205
Rewiring Networks 207
Bridges and Potential Bridges 208
Links versus Nodes 209
Networks and Attributes 212
Iatrogenic Effects 214
A Pharmaceutical Marketing Example 216
Summary 218
xiv CONTENTS

12 Summary 219
Agent-Based Modeling 224
Increasing the Threshold 231
Statistical Analysis 232
Network Scale 232
Future Research Questions 233
How to Get Started 237
Limitations 237
Conclusion 238
Appendix A: Glossary 239
Appendix B: Sample Sociometric Survey 241
Appendix C: Sample Egocentric Survey 243
Appendix D: Centrality Scores for Network in Figure 1–1 245
Appendix E: Input Files (Network and Attribute) for the
Network in Figure 1–1 247
References 251
Author Index 269
Subject Index 273
PART I

MODELS
This page intentionally left blank
1

Introduction

This book presents social network models for understanding human

behavior—particularly health behaviors. It provides a general introduction
to the many theories, methods, and models of social networks and how
researchers use social networks to understand and change human behav-
iors. The models show that social networks and the communication among,
within, and between people and groups exert their influence and constrain
behavior in myriad and complex ways. The network paradigm focuses on
relationships, or connections, among people. Social networks are measured
and defined as connections among people, organizations, political entities
(states or nations), and/or other units. Social network analysis is a theoretical
perspective and a set of techniques used to understand these relationships
and how they affect behaviors.

Relationships Matter

Relationships influence a person’s behavior above and beyond the influence

of his or her individual attributes. Attributes such as sex, age, educational
level, income, occupation, and ethnicity are very important and influence a
person’s attitudes, beliefs, and behaviors. These attributes also influence who
3
4 MODELS

people know and spend time with: Their social networks. Although individual
attributes are important and can in part determine a person’s social network,
network analysis focuses on the types of relations people have and how these
relationships influence behavior. As Borgatti (2009) notes, “One of the most
potent ideas in the social sciences is the notion that individuals are embed-
ded in thick webs of social relations and interactions” (p. 892).
Social networks are most often composed of who knows whom or who
talks to whom within a community or an organization. Network models
are constructed to show how these relations influence attitudes, beliefs, and
behaviors. There are also networks that connect organizations and networks
of computers, organic cells, streets, power stations, and just about anything
one can think of. Networks are ubiquitous and varied. Networks describe
relationships between people and between people and things. By studying
relationships, network researchers add another dimension or set of factors
that can explain human behavior. Throughout this book, many new terms
will be used, and a glossary of relevant network definitions is provided in
Appendix A.
Figure 1–1 shows a network based on friendships in one sixth-grade class
in a California middle school. We asked students to name their closest friends

3
32 Bridges 15
Girls 16 Boys
30
2 37
14
25 24
35
17 Central 31
Members 25
22
27
15 29
12
23 10 36

6 13 25 5
11

Isolates Group
Members
9

Figure 1–1. The network of friendship choices among six-grade students who named
their five closest friends in the class. Girls are depicted as circles and boys as squares.
The data can be used to identify positions in the network such as isolates, central mem-
bers, group members, bridges, and so on. In addition, the network can be characterized
as dense or sparse, centralized or decentralized, and so on. Grey shaded students are
susceptible to smoking. (This graph and others were generated with Netdraw, 2006.)
 Introduction 5

by selecting them from a class roster. There was a unique identification (ID)
number (1 to 34) for each student that they wrote on a form (a copy of the
survey is given in Appendix B) and the form included a space for their own
ID number. The list of ID numbers was entered into a spreadsheet, and the
friendships then were mapped using widely available social network analysis
software. Each circle or square represents a student; boys are depicted as
squares and girls as circles. The ID number for each student is shown next to
his or her circle or square, and lines connecting them indicate who nominated
whom. In this example, the boundary of the network is the classroom, whereas
in other cases it might be a grade in school or even the entire school.
The lines have arrows indicating the direction of the nomination. For
example, 27 named 3 as a friend, but 3 did not name 27. The length or width
of the arrows in this graph does not have meaning, although it is possible to
make graphs that vary line properties (width or style) to represent strength
of relation or type of relation. The graphs are usually drawn with the peo-
ple who are most central in the center and then their connections are placed
near them. There are many different ways to place people in the graph and
many different techniques to arrange everyone in the graphing space. Colors
or shapes can be used to represent different properties of the people. There
are up to four attributes of the nodes that can be included in a network graph
by using color (or shading), shape, labels, and size, and two attributes of the
relations can be indicated using line size and style.
There are specific positions in a network and most people instinctively look
to see who is at the center of a network. There are, however, deceptively
numerous ways to define and hence identify central members (see Chapter 5).
It might also be useful to determine isolates (people with no connections)
or peripheral members (people with one or few links on the outside of the
network). It should be emphasized that while many people equate being on
the periphery or isolated in a network as a negative quality, often peripheral
members have connections to other people and other networks in which they
may occupy important positions. It is also true that peripheral members may
act as bridges connecting different networks. In Figure 1–1, we can iden-
tify people (numbers 3 and 27) who occupy bridging positions within the
network.
In this network, there are also two groups defined by sex (boys and girls).
It is possible to categorize people as being members of specific groups, and
here again there are numerous ways to define a group and hence partition
a network into groups (see Chapter 6). Network analysts have also devised
ways to partition a network into distinct positions. People occupy similar
positions in a network to the extent they have similar relations to others in
the network (see Chapter 7). Consequently, people may be in the same group
but in different positions and vice versa.
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