Poverty, community and health: social networks as mediators between poverty and well-being

This thesis argues that social networks are key mediators between the harsh circumstances of people's lives and their lived experience and perceptions of health and well being. The thesis offers a critical review of the literature on health inequalities and social networks and health and from this identifies key concepts which serve as analytical/heuristic tools in approaching a study of the dynamics between poverty, community and health in the Lea Valley area of London. The complexities of the relationship between these various aspects of life are currently under researched in the literature. Both quantitative and qualitative methods are utilised. A statistical overview of the Lea Valley was undertaken and confirmed relationships between lower social class, poverty and deprivation (on a comprehensive range of measures) and poor health for the region. The evidence is considered in relation to current conceptual approaches to poverty. Two deprived areas are chosen as exemplary case studies and through detailed analysis of interview data the relationship between neighbourhood, social networks and the experience of health and well being is illustrated. Different social network formations were found to mediate poverty and health in different ways. Local patterns of social networks were influenced by local structural and historical features, by facilities and opportunities, including opportunities for positive neighbouring, for forming friendship networks, and for participation in local life as well as for casual interaction. Individuals' social networks were influenced by characteristics of their neighbourhood, by their perceptions of their community as well as by their experience of work, their values, and attitudes to others. It is suggested that the range of membership groups in an individual's network has implications for the mechanisms involved in the relationship between networks and health. Health promoting functions of networks and health protecting or damaging attributes and attitudes were found to be closely related to the type of network identified. Different network models also helped people to cope with poverty and life’s problems in different ways. It is concluded that social networks, attitudes and values, coping resources and health and well being are closely linked. A conception of social cohesion at the neighbourhood level is offered, based on interaction, strong community perceptions, solidarity, trust, inclusion and tolerance, with adequate distribution of resources and availability of work as preconditions