Chronic health conditions and adolescent friendship: perspectives from social network analysis

The current study uses methods from social network analysis to examine the relationship between chronic health conditions (CHCs) and adolescent friendships. Particular attention is given to the processes of peer marginalization, peer withdrawal and homophily related to CHCs.

Exponential random graph models were used to investigate the extent to which a CHC is associated with patterns in adolescent friendship connections, while controlling for important social network properties and covariates. The study uses cross-sectional data from six small US high schools (n = 461) within the National Longitudinal Study of Adolescent to Adult Health.

Findings demonstrate no significant differences between adolescents with CHCs and adolescents without CHCs in the number of incoming friendship nominations (peer marginalization) or outgoing friendship nominations (peer withdrawal). In addition, similarity in CHCs (homophily) was not significantly related to friendship between two individuals.

In sum, the presence of an adolescent CHC was not significantly associated with adolescent social network structure, including peer marginalization, peer withdrawal, and homophily related to CHCs, after controlling for alternative social network processes. Although previous literature suggests that adolescents with CHCs experience negative social consequences, the current findings demonstrate that the social network structure of adolescents with CHCs did not differ significantly from that of their peers without CHCs. Thus, findings from the current study suggest that CHCs are not related to objective reductions in social connections.