Social Networks and Chronic Illness Management among Low-Income Tenants in Publicly Subsidized Housing: Findings from a Pilot Study

Abstract

ABSTRACT Low-income tenants in publicly subsidized housing (PSH) have higher rates of chronic illnesses than non-PSH-based residents, making the implementation of chronic illness management (CIM) essential. Based on the person-in-environment framework used in social work practice, which emphasizes the importance of interactions between clients and their social environment, this pilot study used personal network analysis (PNA), a variant of social network analysis, to explore what attributes of social networks are relevant to CIM among 26 low-income tenants independently living in a PSH in the Southwest United States. Tenants with a smaller network size and effective size presented better self-efficacy to manage chronic disease (SEMCD) and lower levels of depressive symptoms. Being connected to a higher proportion of alters (i.e., network members) with whom they discussed health matters was also associated with high SEMCD. As for CIM implementation, being connected to a doctor and a lower proportion of alters who have chronic illnesses were associated with doing aerobic exercise. Tenants with a larger proportion of alters serving multiple functions reported more frequent vegetable and fruit consumption, while those with a higher share of kin alters and lower share of alters living in the same PSH reported less frequent high-fat food consumption. Our findings help social workers discover relevant social networks and dynamics that low-income tenants at PSH capitalize to locate resources for CIM. Further studies are recommended to adopt PNA to expand practice-related knowledge that social workers can use for health promotion among low-income tenants with chronic illness.