Networks and Neighborhoods

描述（由申请人提供）：本项目涉及一套综合的、创新的调查，研究社会网络和居住社区在个人健康行为、卫生保健和健康结果中的作用。我们有两个总体目标：(1)提出关于社会网络和当地社会环境在健康中的作用的新问题；(2)利用新的统计技术和利用遗传信息的社会科学因果推理的新方法来开发回答这些问题的方法。我们将重点关注美国健康和医疗保健方面的紧迫问题，包括心血管疾病、癌症、肥胖、暴力和药物使用。有八个组成项目：(1)“弗雷明汉心脏研究（FHS）社会网络中健康行为的传播”在一个独特的，紧密相连的12,630人的网络中检查吸烟，饮酒，体育活动，健康饮食和体重增加的人际传播程度，从1971年到现在（“FHS网络”数据）；(2)“基因作为健康行为同伴效应在FHS-Net中的工具变量”研究了肥胖和吸烟中的同伴效应，并利用详细的遗传信息作为工具变量；(3)“弗雷明汉社区对健康的影响和社会网络的作用”利用FHS-Net数据及其详细地址信息，评估了一个人的社会网络和居住社区对健康的相对贡献；(4)“社区对老年人癌症病程的影响”评估了地理对美国55万名老年患者癌症全病程的影响；(5)“非正式医生网络和医疗保险受益人的护理模式”研究了多达150,000名共享患者或信息的初级和专科医生的非正式网络，以及这些网络如何影响患者护理；(6) “邻里网络和幸福轨迹的社会机制”利用PHDCN关于6 000多名儿童的数据集，研究不断变化的网络和社区如何影响健康结果；(7)“公民参与和社会网络的遗传基础及其对健康的影响”使用AddHealth数据集及其2030名受试者，调查社会网络和合作的遗传决定因素及其在肥胖、吸烟和饮酒中的作用；(8)“纵向社会网络数据分析方法”开发了新的统计方法来解释网络数据的复杂相关结构。这些项目由三个核心提供支持：行政核心、数据和统计核心以及初级教师发展核心。这些项目相互建立，阐明了临床护理、基础社会科学和卫生政策的重要方面。

DESCRIPTION (provided by applicant): This Program Project involves an integrated and innovative set of investigations into the role of social networks and residential neighborhoods in the health behaviors, health care, and health outcomes of individuals. We have two overarching goals: (1) to ask new questions about the roles of social networks and local social environments in health; and (2) to develop methods for answering such questions using new statistical techniques and using new approaches to causal inference in the social sciences that exploit genetic information. We will focus on pressing problems in health and health care in the U.S., including cardiovascular disease, cancer, obesity, violence, and substance use. There are eight constituent Projects: (1) "The Spread of Health Behaviors in the Framingham Heart Study (FHS) Social Network" examines the extent of person-to-person spread in smoking, drinking, physical activity, healthy eating, and weight gain in a unique, densely inter-connected network of 12,630 people followed from 1971 to the present (the "FHS-Net" data); (2) "Genes as Instrumental Variables for Health Behavior Peer Effects in the FHS-Net" examines peer effects in obesity and smoking and exploits detailed genetic information as instrumental variables; (3) "Neighborhood Effects on Health in Framingham and the Role of Social Networks" uses the FHS-Net data, and its detailed address information, to evaluate the relative contribution of a person's social network and residential neighborhood to health; (4) "Neighborhood Effects on Cancer Course in the Aged" evaluates the influence of geography across the full course of cancer in 550,000 elderly patients from around the U.S.; (5) "Informal Physician Networks and Patterns of Care for Medicare Beneficiaries" examines the informal networks of up to 150,000 primary and specialist physicians that share patients or information and how these networks affect patient care; (6) "Neighborhood Networks and Social Mechanisms of Trajectories in Well Being" uses the PHDCN data set regarding over 6,000 children to examine how changing networks and neighborhoods affect health outcomes; (7) "The Genetic Basis of Civic Engagement and Social Networks and their Effect on Health" uses the AddHealth dataset, and 2,030 of its subjects, to investigate the genetic determinants of social networks and cooperation, and their role in obesity, smoking, and drinking; and (8) "Methods for the Analysis of Longitudinal Social Network Data" develops novel statistical methods to account for the complex correlational structure of network data. These projects are supported by three Cores: an Administrative Core, a Data and Statistics Core, and a Junior Faculty Development Core. The projects build on one another and shed light on important aspects of clinical care, basic social science, and health policy.