Impact of Geography and Social Ties on Health and Well-being

Date of Award

Spring 2021

Document Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

Christakis, Nicholas


The health of human beings cannot be understood in a vacuum - there are a myriad of factors that contribute to who is ill and who is well. Perhaps the most interesting factor is the influence human beings have on the health of each other via the social networks in which we are all embedded. This truism has never been more apparent than through the lens of the current COVID-19 pandemic, during which this dissertation is being submitted.Moreover, the geographical location of social networks can affect the formation of social ties [Butts et al., 2012, Daraganova et al., 2012] and whether individuals in those networks experience improvements or detriments to their well-being. For instance, spending time with social ties can be salubrious (e.g., we feel a sense of belonging) [Cohen et al., 1997, House et al., 1988] or insalubrious (we can catch an infectious pathogen from others) [Liljeros et al., 2001, Potterat et al., 2002]. The "where" of social ties can also affect their function in profound ways [Festinger,1950, Gieryn, 2000, Logan, 2012]. Yet, researching the interconnection of social networks and geographic space can be challenging, as data with complete information on both contexts is relatively rare [Papachristos et al., 2013]. Nevertheless, prior work has found that individuals tend to live near their social ties and the underlying geography in which a social network exists can impact the kinds of ties that form and the overall structure of those ties [Butts et al., 2012,Verdery et al., 2012]. In this dissertation, we explore how social networks and aspects of geographic place can jointly and separately impact health. While not directly addressed in this selection of papers, the ideas proposed in this research are particularly relevant today, given the complexities of the COVID-19 pandemic and the ways it has imposed restrictions on our health and social life. Yet this seemingly novel phenomenon is actually an ancient idea hearkening back to the days of Hippocrates and his work On Airs, Waters, and Places [Littré et al., 1881]. While not all of his theories hold today, it remains true that where one lives can profoundly influence the course of one's life, and especially one's health. We explore a related matter: How is place related to social ties and how do those ties affect health? We investigate how several aspects of place (proximity, density, spatial autocorrelation), and kinds of social network ties (friend, family, antagonistic) are associated, and we explore their ramifications for several health outcomes using novel, uncommonly large, and comprehensive data from the rural highlands of Honduras. First, we explore how social ties can influence a globally important health outcome: child mortality. We find that more geographically isolated, but socially connected, villages have fewer child deaths. At the individual level, we found that increasing geographic distance from social ties is associated with reduced risk of experiencing child mortality while moderate levels of social connection are more beneficial than either being socially isolated or very connected. We then examine how the amount of and proximity to social ties, particularly antagonistic ties, can influence mental and physical health. We find that those who live nearer to their antagonistic ties are more likely to report that their mental health is poor. Lastly, we examine how antagonistic network ties are associated with the geography within and between villages in the data. We find that there are significantly trends between the geography of a place and the prevalence of antagonistic ties in that region. In light of these research findings, we close the dissertation by discussing the potential ramifications of these results, for both public health and public policy. These recommendations focus on how to use both social networks and geography to improve lives, and focuses on how exogenous factors - not simply individual agency - can profoundly shape and influence human welfare. We then describe how the results from this work can be expanded into new areas and propose several new potential projects that stem from the work presented in this dissertation. Between these research findings, the guidelines stemming from these results, and the future directions of this work, we believe that these projects can significantly improve health and well-being the world over.

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