Enabling Social Networks a Response to Constrained Individual Agency Approaches to Long Term Condition Management Under Neo-Liberalism

Constrained individual agency forms the backdrop to contemporary approaches to managing illness. This is demonstrated in the increasing adoption of systems of self-care support for long term conditions which focus on enhancing individual, competencies, skills, behaviour and lifestyle changes to the exclusions of networked and structural and socio-economic aspects implicated in the population’s ability to self- manage. A potential counter to this is a re-focus in theory policy and practice on the collective power of networks to connect to and mobilise resources. Social networks and capital are key constituents permitting individuals to make choices and relevant for understanding flows of trust, reciprocity, altruism, social participation that underpin collective action and mutual support. They are also associated with improved health and well-being through the mechanism of contagion, collective efficacy navigation and negotiation.

In this paper we argue that the construct of social network type offers a way of capturing the inter-personal environment (Shiovitz-Ezra and Litwin 2012) that counters the constraints of individualised actions and agency. Drawing on a study conducted in six EU countries, UK, Netherlands, Spain, Bulgaria, Greece, and Norway, with 1,800 respondents, we identified five network types: family-centred, family supported, isolated, diverse-weak ties, diverse-friends. We show how diverse networks are likely to promote high levels of informational and emotional support and self-management capacity, while family-centred networks report higher levels of happiness and well-being. We use the findings from this study to analyse how network types are important constructs in understanding the capacity and constraints of individuals to manage chronic illness and  the  how engagement with a wide range of links including to community group memberships, friends, and acquaintances are  facilitators of managing  illness and to accessing high levels of network support.