Are All Health Outcomes 'Contagious'? Detecting Implausible Social Network Effects in Acne, Height, and Headaches
23 Pages Posted: 28 Jan 2009
Date Written: December 15, 2008
Background Current methods used in medical literatures to estimate social network effects of health outcomes may be biased to find these effects, even if none actually exist.
Objective To investigate whether we detect network effects for health outcomes that are unlikely to be subject to network phenomena.
Design Our methods include statistical analysis now common in network studies such as logistic regression analysis with own and friend's lagged health status controlled. We extend the analysis by controlling for environmental confounders.
Setting Sub-samples of the National Longitudinal Study of Adolescent Health (Add Health).
Participants Between 4,300 and 5,400 male and female adolescents who nominated a friend in the dataset and who were both longitudinally surveyed.
Measurements Health outcomes, including headache severity, acne severity, and height were self-reported by respondents in 1994/5, 1995/6, and 2000/1.
Results We find statistically significant network effects in the acquisition of acne, headaches and height. A friend's acne problems increased an individual's odds of acne problems (OR: 1.47, 95% confidence interval [0.93-2.33]). The likelihood that an individual has headaches also increases with the presence of a friend with headaches (OR: 1.62 [0.91-2.89]). An individual's height increases by 20% of his/her friends' height [0.15-0.26]. Each of these results was estimated using standard methodology found in several publications in leading medical journals such as the New England Journal of Medicine and other outlets. However, once environmental confounders are controlled, the results become uniformly smaller and insignificant.
Conclusions Caution is suggested in attributing correlations in health outcomes of close friends to social network effects, especially when environmental confounders are not adequately controlled in the analysis.
Keywords: Peer Effects, Social Networks, Health
JEL Classification: I12
Suggested Citation: Suggested Citation