Diabetes and Networks of Support


Garrett Parry, University of Calgary

Diabetes is a chronic medical condition affecting approximately 8.8% of Canadians (LeBlanc, et al. 2019). Diabetes can be divided into several distinct types with Type 1 and Type 2 being the most common. While these types are separate, carrying their own stigmas and self-management requirements, there is also substantial overlap between them, especially in the public perception (Browne et al., 2014). Social support, or the “resources provided by other persons” (Cohen and Syme, 1985, p.4) can be important in improving health outcomes (Cobb, 1976; Berkman et al., 2000). For diabetes specifically, higher social support has been associated with improved self-management behaviours (Song et al., 2017; Tang et al., 2008). However, this support does not exist on its own. Rather it is embedded in our tangible social networks. Networks can be analyzed according to their structural (such as number of relations or density) and functional (such as support and other relational content) aspects (Thoits, 1995; House and Kahn, 1985). A majority of research has focused on how network structure and function impact health, but little attention has been paid to how these chronic conditions can themselves impact networks (House, Umberson, and Landis, 1988). Studies involving stroke victims found that post-stroke individuals had smaller networks and struggled to maintain their pre-stroke friends (Northcott et al., 2016). Similarly, Hass, Shaefer and Kornienko (2010) found that children with general poor health were less central in school networks and were more likely to be isolates than their peers. This study aims to expand that literature by exploring both the structural and functional dimensions of diabetics’ personal networks. To best assess the content flowing through these networks, I use a methodology rooted in network diagrams (Antonucci, 1986) that allows for an analysis of structure alongside a qualitative interview exploring the flow of support through that structure. Special attention is paid to the differences and similarities between Type 1 and Type 2 diabetics. The study first explores the diabetics’ close network by asking them to provide their most important relations. Follow-up questions then explore if and how these relations provide them with support for their diabetes management. Support is conceptualized along five dimensions: emotional, reassuring, guiding, integrational, and emergency support (Weiss, 1969; Weiss, 1974). This allows for a multiplex analysis and indeed multiplex relations feature heavily in these networks. Findings suggest that specific dyadic types such as parent-child relations can create barriers to support. Alternatively, these traditional role relationships are sometimes cleverly manipulated to provide support within a diabetic context, often aided by homophily or reciprocity. Furthermore, the relationship between subgroups and support functions yielded interesting insights. For instance, some subgroups specialize by providing only one type of support function that is not present in the rest of the network. Additionally, attitudes and perspectives on diabetes often coincide with subgroup boundaries, representing a potential source of stress for diabetes who have multiple subgroups within their personal network. This research aims to move away from the common approach of analyzing how networks impact illness and instead see how the opposite operates.

This paper will be presented at the following session: