Social inequality, social networks, and health: a scoping review of research on health inequalities from a social network perspective.

BACKGROUND: This review summarises the present state of research on health inequalities using a social network perspective, and it explores the available studies examining the interrelations of social inequality, social networks, and health. METHODS: Using the strategy of a scoping review, as outlined by Arksey and O'Malley (Int J Sci Res Methodol 8:19-32, 2005), our team performed two searches across eight scientific, bibliographic databases including papers published until October 2021. Studies meeting pre-defined eligibility criteria were selected. The data were charted in a table, and then collated, summarised, and reported in this paper. RESULTS: Our search provided a total of 15,237 initial hits. After deduplication (n = 6,168 studies) and the removal of hits that did not meet our baseline criteria (n = 8,767 studies), the remaining 302 full text articles were examined. This resulted in 25 articles being included in the present review, many of which focused on moderating or mediating network effects. Such effects were found in the majority of these studies, but not in all. Social networks were found to buffer the harsher effects of poverty on health, while specific network characteristics were shown to intensify or attenuate the health effects of social inequalities. CONCLUSIONS: Our review showed that the variables used for measuring health and social networks differed considerably across the selected studies. Thus, our attempt to establish a consensus of opinion across the included studies was not successful. Nevertheless, the usefulness of social network analysis in researching health inequalities and the employment of health-promoting interventions focusing on social relations was generally acknowledged in the studies. We close by suggesting ways to advance the research methodology, and argue for a greater orientation on theoretical models. We also call for the increased use of structural measures; the inclusion of measures on negative ties and interactions; and the use of more complex study designs, such as mixed-methods and longitudinal studies.

[Coping in families with members suffering from a mental disorder]. / Coping in Familien mit psychisch erkrankten Mitgliedern.

BACKGROUND: Stress and coping during the lockdown in families with mentally ill members have not yet been described. AIM OF THE STUDY: First findings on this issue are to be gained in order to derive questions for further research. MATERIAL AND METHODS: Narrative interviews were carried out on a convenient sample of healthy families (n = 4), families with mentally ill children (n = 12) and families with mentally ill parents (n = 3). The quantifying evaluation of the in vivo codes assigned by two raters for the categories "problems" and "coping" was carried out with the help of numerical ratios and detailed analyses of the codes that differentiate between the families. RESULTS: The lockdown resulted in a large number of problems in all families. While in families with mentally ill children the restrictions were the biggest problem, families with mentally ill parents reported mainly about a lack of support. Families with sick members more often reported about risky coping patterns, in particular rumination and denial, and less often about protective coping, especially the mobilization of social support. CONCLUSION: Both risk groups require targeted interventions that focus in particular on adaptive parenting behavior and mobilization strategies.

[Consequences of the corona pandemic on social networks in families at risk]. / Auswirkungen der Coronapandemie auf soziale Netzwerke in Risikofamilien.

Background: The measures taken to reduce the incidence of infections during the corona pandemic brought about considerable restrictions, especially for families with school-age children. Particularly affected are families at risk, who were already confronted with mental disorders, poverty and cramped housing before the pandemic. Research question: How does the lockdown affect the composition and dynamics of the social networks of risk families? Material and method: Mixed methods analysis based on 19 problem-centered interviews and 18 standardized egocentered networks with 224 persons (alter) named by the interviewees (ego). Results: Networks are weakened by the crisis. At the same time, they are the most important resource for coping. Support is lacking, especially in the care of mentally ill children. The most important sources of support are the extended family and institutional facilities. The latter proved to be particularly unreliable during the crisis. In the best case the remaining relationships are strong enough to survive the situation. In the worst case the children are not only discharged from institutional structures (day care, school, medical and therapeutic assistance) but disappear completely from institutional and social custody. Their well-being then depends solely on the competence of their parents. Conclusion: In times of contact restrictions, families at risk need special attention. It is not enough to wait for them to ask for help or emergency care for their children. Institutions should proactively offer practical and informal support.