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Research continues to demonstrate that the characteristics of one's social network could have an impact on the development of Alzheimer's disease. Given the predisposition of people with Down syndrome to develop Alzheimer's disease, analysis of their social networks has become an emerging focus. Previous pilot research demonstrated that the personal networks of people with DS could be quantitatively analyzed, with no difference between self-report and parent-proxy report. This manuscript focuses on a 12-month follow-up period with the same original participants (24 adults with Down syndrome). Their social networks demonstrated sustainability, but not improvement, as reported by people with DS (mean network size: 8.88; mean density: 0.73; mean constraint: 0.44; mean effective size: 3.58; mean max degree: 6.04; mean degree: 4.78) and their proxies (mean network size: 7.90; mean density: 0.82; mean constraint: 53.13; mean effective size: 2.87; mean max degree: 5.19; mean degree: 4.30). Intentional and continued efforts are likely needed in order to improve the social network measures of people with Down syndrome.
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Doença de Alzheimer , Síndrome de Down , Adulto , HumanosRESUMO
BACKGROUND: Previous studies show that the personal support networks of people with intellectual disability are smaller and less diverse than those of people without intellectual disability. This article aims to compare the characteristics of the personal networks of young people with and without intellectual disability. METHOD: The Personal Network Analysis (McCarty, Revista Hispana Para El Análisis de Redes Sociales, 2010, 19, 242-271) was applied. The participants comprised 51 young people aged between 13 and 19, of whom 27 had an intellectual disability. The Egonet programme was used to compile information, and SPSS v.27 for the statistical analysis. RESULTS: Young people with intellectual disabilities have smaller personal networks than people without disability, while they also comprise more people with disability and fewer 'friends' and support people. CONCLUSIONS: The full social inclusion of people with intellectual disability requires schools, families, the community and the individual to work together to develop activities that help them initiate and maintain relationships, prioritising mainstream contexts.
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Pessoas com Deficiência , Deficiência Intelectual , Humanos , Adolescente , Adulto Jovem , Adulto , Apoio Social , Projetos de Pesquisa , Instituições AcadêmicasRESUMO
Studies in the neurotypical population have demonstrated that personal social networks can mitigate cognitive decline and the development of Alzheimer disease. To assess whether these benefits can also be extended to people with Down syndrome (DS), we studied whether and how personal networks can be measured in this population. We adapted a personal networks instrument previously created, validated, and implemented for the neurotypical population. We created two versions of the survey: one for participants with DS, ages 25 and older, and another for their study partners, who spent a minimum of 10 h/wk in a caregiver role. Participants with DS gave concordant data to those of study partners. Their personal networks included a median network size of 7.50, density 0.80, constraint 46.00, and effective size 3.07. Personal networks were composed of 50% kin, 80% who live within 15 miles, and 80% who eat a healthy diet. In this proof-of-principle study, we demonstrated that the personal networks of people with DS can be quantitatively analyzed, with no statistical difference between self-report and parent-proxy report. Future research efforts can now evaluate interventions to enhance personal networks for preventing Alzheimer disease in this population.
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Doença de Alzheimer , Disfunção Cognitiva , Síndrome de Down , Humanos , Adulto , Síndrome de Down/epidemiologia , Síndrome de Down/psicologia , Doença de Alzheimer/epidemiologia , Cuidadores , Rede SocialRESUMO
Increasing research highlights heterogeneity in patterns of social network change, with growing evidence that these patterns are shaped in part by social structure. The role of social and structural neighborhood conditions in the addition and loss of kin and non-kin network members, however, has not been fully considered. In this paper, we argue that the residential neighborhood context can either facilitate or prevent the turnover of core network relationships in later life - a period of the life course characterized by heightened reliance on network ties and vulnerability to neighborhood conditions. Using longitudinal data from the National Social Life, Health, and Aging Project linked with data from the American Community Survey, we find that higher levels of neighborhood concentrated disadvantage are associated with the loss of older adults' kin and non-kin network members over time. Higher levels of perceived neighborhood social interaction, however, are associated with higher rates of adding non-kin network members and lower rates of adding kin network members over time. We suggest that neighborhood conditions, including older adults' perceptions of neighborhood social life, represent an underexplored influence on kin and non-kin social network dynamics, which could have implications for access to social resources later in the life course.
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Adult children are key confidants for their aging parents, often providing emotional and advisory supports. Still, adult children are not a guaranteed presence in older people's core discussion networks. Geographical distance is a leading explanation for why some children are excluded from the confidant network, but we hypothesize that certain parent- and dyadic-level factors make these intergenerational ties more or less resilient to distance. Using wave six of the Survey of Health, Ageing, and Retirement in Europe, we identified whether a living adult child was also a member of the parent's egocentric confidant network. We found that fifty-eight percent of children were excluded from a parent's network and that such network exclusion was more common the greater the distance between parent and child. Random slope logit models indicate that parents with higher education were less sensitive to longer distances when listing a child as a confidant, whereas poor parental health exacerbated distance consequences. We also observed regional differences, with Northern Europeans being more impervious to geographical distance than older adults living in areas of the continent considered most familistic. Together, results point to the contingency of distance, as a number of demographic factors and personal and social resources contribute to the elasticity of parent-child ties across geographic space.
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Filhos Adultos , Apoio Social , Filhos Adultos/psicologia , Idoso , Humanos , Pais , Rede Social , População BrancaRESUMO
BACKGROUND: Sleep is an important, restorative behavior for health, yet many adults report troubled sleep. The existence of a support network may be beneficial for sleep quality, including as a buffer for stressful events, yet few studies have examined these relationships longitudinally. PURPOSE: To examine the causal effect of changes in personal network support on sleep quality both directly and as a buffer of negative life events among young and older adults. METHODS: The UC Berkeley Social Network survey collected data from young (21-30 year old, n = 475) and late middle-age (50-70 year old, n = 637) adults across three waves between 2015 and 2018. Participants reported on personal network characteristics, negative life events, and number of nights with trouble falling and staying asleep. Fixed effects models are used to examine causal relationships among each age cohort. RESULTS: Direct effects of network support on sleep quality were observed among older adults. Insufficient practical support predicted higher rates of trouble falling asleep (incident rate ratio [IRR] = 1.40, p < .01), while a desire for more social companions predicted lower rates of trouble staying asleep (IRR = 0.81, p < .01). Buffering effects of network support on sleep quality were observed among young adults. Changes in partnership status buffer the negative effects of the death of a close tie on trouble falling asleep (IRR = 0.75, p < .01) and persistent difficulties paying bills on trouble staying asleep (IRR = 0.45, p < 0.001) among young adults. CONCLUSIONS: This study provides evidence for the direct and buffering role of network support on sleep quality. Our results indicate that efforts to improve sleep quality should address personal networks and the support they provide, perhaps especially during times of stress for younger adults.
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Relações Interpessoais , Sono , Rede Social , Adulto , Idoso , Causalidade , Feminino , Humanos , Modelos Logísticos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Distribuição de Poisson , Adulto JovemRESUMO
Although it is widely accepted that personal networks influence health and illness, network recall remains a major concern. This concern is heightened when studying a population that is vulnerable to cognitive decline. Given these issues, we use data from the Social Network in Alzheimer Disease project to explore similarities and discrepancies between the network perceptions of focal participants and study partners. By leveraging data on a sample of older adults with normal cognition, mild cognitive impairment, and early stage dementia, we explore how cognitive impairment influences older adults' perceptions of their personal networks. We find that the average individual is more likely to omit weaker, peripheral ties from their self-reported networks than stronger, central ties. Despite observing only moderate levels of focal-partner corroboration across our sample, we find minimal evidence of perceptual differences across diagnostic groups. We offer two broad conclusions. First, self-reported network data, though imperfect, offer a reasonable account of the core people in one's life. Second, our findings assuage concerns that cognitively impaired older adults have skewed perceptions of their personal networks.
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The typical human personal social network contains about 150 relationships including kin, friends, and acquaintances, organized into a set of hierarchically inclusive layers of increasing size but decreasing emotional intensity. Data from a number of different sources reveal that these inclusive layers exhibit a constant scaling ratio of [Formula: see text] While the overall size of the networks has been connected to our cognitive capacity, no mechanism explaining why the networks present a layered structure with a consistent scaling has been proposed. Here we show that the existence of a heterogeneous cost to relationships (in terms of time or cognitive investment), together with a limitation in the total capacity an individual has to invest in them, can naturally explain the existence of layers and, when the cost function is linear, explain the scaling between them. We develop a one-parameter Bayesian model that fits the empirical data remarkably well. In addition, the model predicts the existence of a contrasting regime in the case of small communities, such that the layers have an inverted structure (increasing size with increasing emotional intensity). We test the model with five communities and provide clear evidence of the existence of the two predicted regimes. Our model explains, based on first principles, the emergence of structure in the organization of personal networks and allows us to predict a rare phenomenon whose existence we confirm empirically.
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Cognição , Alocação de Recursos , Apoio Social , Teorema de Bayes , Feminino , Humanos , Relações Interpessoais , MasculinoRESUMO
Capturing dynamics in high-risk personal networks is essential for preventing HIV transmission. Online social networking data offer incentive to augment traditional selfreported approaches for network enumeration. To explore what online networks reveal about dynamics among high-risk associates, we examine the relationship between egocentric confidant and sex networks and personal Facebook friendship networks of a cohort of young Black men who have sex with men. Although overlap exists between self-reported and Facebook associates, the stabilities of each were unrelated. Confidants who were also Facebook friends with a respondent were, however, more likely to be retained. Thus, Facebook networks contain stable confidants.
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BACKGROUND: Studies have shown that social networks influence health behaviors, including the adoption of health innovations. This study explored the potential for early adopters of community health worker-delivered injectable contraceptives (CHWDIC) to influence the uptake of this innovation by women in their social networks. METHODS: This Social Network Analysis (SNA) study was conducted in Gombe, Nigeria. Twenty women who were early adopters of the CHWDIC were recruited. Each participant (ego) listed ten women of reproductive age (alters) with whom they related. An interviewer-administered questionnaire was used to collect from each ego, data about the nature of her relationship with each alter (ego-alter relationship), whether she talked about CHWDIC with each alter, and whether her listed alters talked to each other about CHWDIC (alter-alter relationship). Data were also collected on age, marital status and education level for each ego and alter. Data were analyzed with UCINET social network analysis software. Variables of interest include homophilia (similarity), density (number of ties as a proportion of possible ties), degree (popularity) and betweeness (frequency of connecting actor pairs who otherwise might not communicate). RESULTS: There were 20 egos and 200 alters. Between two thirds (alters) and three quarters (egos) of the women were 30 years or older. All of the egos and 196 (98%) of alters were married. Most of the networks had similar (homophilic) actors according to certain sociodemographic characteristics - ethnicity, age, education and type of marriage. More than 90% of the networks had density greater than 50%, suggesting high cohesion in most networks. The majority of actors in these networks used injectable contraceptives. In some of the networks, few actors with the highest prominence (betweeness centrality) were not users of injectable contraceptives. CONCLUSION: The study illustrates the application and feasibility of ego SNA in identifying champions and opinion leaders among women of reproductive age group. It also shows the influence of social networks on the diffusion of community-based injectable contraceptives, and how homophilic and dense networks may have positive health externality. The interrelatedness of network members' decision to adopt a health innovation was also demonstrated by the findings of this study.
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Redes Comunitárias , Comportamento Contraceptivo , Anticoncepcionais , Difusão de Inovações , Comportamentos Relacionados com a Saúde , Aceitação pelo Paciente de Cuidados de Saúde , Rede Social , Adulto , Agentes Comunitários de Saúde , Tomada de Decisões , Atenção à Saúde/métodos , Feminino , Serviços de Saúde , Humanos , Relações Interpessoais , Liderança , Nigéria , Apoio Social , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: Associations between social networks and loneliness or social isolation are well established among older adults. Yet, limited research examines personal networks and participation on perceived loneliness and social isolation as distinct experiences among younger adults. Accordingly, we explore relationships among objective and subjective measures of personal networks with loneliness and isolation, comparing a younger and older cohort. METHODS: The UC Berkeley Social Networks Study offers unique cohort data on young (21-30 years old, n = 472) and late middle-age adults' (50-70 years old, n = 637) personal network characteristics, social participation, network satisfaction, relationship status, and days lonely and isolated via online survey or in-person interview. Negative binomial regression models were used to examine associations between social network characteristics, loneliness, and isolation by age group. RESULTS: Young adults reported twice as many days lonely and isolated than late middle-age adults, despite, paradoxically, having larger networks. For young adults, informal social participation and weekly religious attendance were associated with fewer days isolated. Among late middle-age adults, number of close kin and relationship status were associated with loneliness. Network satisfaction was associated with fewer days lonely or isolated among both age groups. CONCLUSION: Distinct network characteristics were associated with either loneliness or isolation for each cohort, suggesting network factors are independently associated with each outcome, and may fluctuate over time. Network satisfaction was associated with either loneliness or isolation among both cohorts, suggesting perceptions of social networks may be equally important as objective measures, and remain salient for loneliness and isolation throughout the life course.
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Solidão/psicologia , Satisfação Pessoal , Isolamento Social , Rede Social , Participação Social , Adulto , Fatores Etários , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
As part of the "Colombian Peace Process," victim assistance programs, actions for the reincorporation into civilian life of ex-combatants, and demobilized persons of the armed conflict have been developed as well as innovative instances of intervention in cases of posttraumatic stress. In this study, we surveyed 143 community leaders from the Department of Atlántico (Colombia), participants in a program for capacity building in rehabilitation and mediation strategies. With a mixed design in which we combine the analysis of personal networks, psychometric scales, and qualitative interviews, we describe the use that community mediators make of their personal skills, their personal network, and social media in their actions to confront social trauma and promote coexistence in the local community. The results show a significant relationship between the density of personal networks and the psychological sense of community. Paradoxically, the high social cohesion of the communities of people displaced by political violence seems to pose objective difficulties in reducing trauma. In the discussion, we indicate that the sociogeographic segregation derived from housing policies becomes an obstacle to the effective functioning of the coexistence and reintegration programs of victims and demobilized persons of the armed conflict. In this context, social media such as Facebook, Twitter, and WhatsApp are little used by community mediators in the development of their activities, which they perceive as reinforcing largely the dynamics of segregation of the displaced population.
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Conflitos Armados/psicologia , Participação da Comunidade/métodos , Refugiados/psicologia , Segregação Social/psicologia , Adulto , Colômbia/epidemiologia , Vítimas de Crime/psicologia , Feminino , Humanos , Liderança , Masculino , Pessoa de Meia-Idade , Percepção/fisiologia , Psicometria/métodos , Refugiados/estatística & dados numéricos , Mídias Sociais/instrumentação , Participação Social/psicologia , Inquéritos e Questionários , Violência/psicologiaRESUMO
This study advances research on the role of personal networks as sources of financial and emotional support in immigrants' close personal ties beyond the immediate family. Because resource scarcity experienced by members of immigrant communities is likely to disrupt normatively expected reciprocal support, we explored multi-level predictors of exchange processes with personal network members that involve (1) only receiving support, (2) only providing support, and (3) reciprocal support exchanges. We focus on an understudied case of Central Asian migrant women in the Russian Federation using a sample of 607 women from three ethnic groups-Kyrgyz, Tajik, Uzbek-who were surveyed in two large Russian cities-Nizhny Novgorod and Kazan. The survey collected information on respondents' demographic, socioeconomic, and migration-related characteristics, as well as characteristics of up to five individuals with whom they had a close relationship. Multi-level multinomial regression analyses were used to account for the nested nature of the data. Our results revealed that closer social relationships (siblings and friends) and greater levels of resources (income and regularized legal status) at both ego and alter levels were positively related to providing, receiving, and reciprocally exchanging financial and emotional support. Egos were more likely to provide financial assistance to transnational alters, whereas they were more likely to engage in mutual exchanges of emotional support with their network members from other countries. Personal network size and density showed no relationship with support exchanges. These findings provide a nuanced picture of close personal ties as conduits for financial and emotional support in migrant communities in a major, yet understudied, migrant-receiving context.
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Why do people maintain ties with individuals whom they find difficult? Standard network theories imply that such alters are avoided or dropped. Drawing on a survey of over 1,100 diverse respondents who described over 12,000 relationships, we examined which among those ties respondents nominated as a person whom they "sometimes find demanding or difficult." Those so listed composed about 15 percent of all alters in the network. After holding ego and alter traits constant, close kin, especially women relatives and aging parents, were especially likely to be named as difficult alters. Non-kin described as friends were less, and those described as co-workers more, likely to be listed only as difficult alters. These results suggest that normative and institutional constraints may force people to retain difficult and demanding alters in their networks. We also found that providing support to alters, but not receiving support from those alters, was a major source of difficulty in these relationships. Furthermore, the felt burden of providing support was not attenuated by receiving assistance, suggesting that alters involved in reciprocated exchanges were not less often labeled difficult than were those in unreciprocated ones. This study underlines the importance of constraints in personal networks.
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Social network analysis has grown exponentially in recent years, giving rise to methodological innovations in different scientific disciplines. In psychology, social network analysis has been incorporated into studies of individual personality differences and has generated novel areas, such as network psychometrics and network interventions. In community psychology, a recent review examined the use of network analysis in American Journal of Community Psychology publications (Neal & Neal, American Journal of Community Psychology, 2017, 60, 279). Based on their study, the authors advise researchers to avoid using the fixed-choice name generator when possible, as one of the five methodological recommendations proposed. In this essay, I explain how the recent increase of name generators with a fixed number of alters when studying personal networks is originally linked to an interest in describing structural properties. Second, I analyze the pragmatic contributions of this method: establishing a limit of alters a priori can entail advantages in terms of standardization and comparability of personal networks. Finally, to contextualize the methodological debate, I argue that personal networks represent the diversity of contexts in which the individual participates and are naturally integrated into community surveys.
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Apoio Social , Humanos , Inquéritos e QuestionáriosRESUMO
This study compared compositional, social support, and structural characteristics of personal networks among women in residential (RT) and intensive outpatient (IOP) substance abuse treatment. The study sample included 377 women from inner-city substance use disorder treatment facilities. Respondents were asked about 25 personal network members known within the past 6 months, characteristics of each (relationship, substance use, types of support), and relationships between each network member. Differences between RT women and IOP women in personal network characteristics were identified using Chi-square and t-tests. Compared to IOP women, RT women had more substance users in their networks, more network members with whom they had used substances and fewer network members who provided social support. These findings suggest that women in residential treatment have specific network characteristics, not experienced by women in IOP, which may make them more vulnerable to relapse; they may therefore require interventions that target these specific network characteristics in order to reduce their vulnerability to relapse.
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BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has negatively affected the social fabric. OBJECTIVE: We evaluated the associations between personal social networks and neurological function in people with multiple sclerosis (pwMS) and controls in the prepandemic and pandemic periods. METHODS: During the early pandemic (March-December 2020), 8 cohorts of pwMS and controls completed a questionnaire quantifying the structure and composition of their personal social networks, including the health behaviors of network members. Participants from 3 of the 8 cohorts had additionally completed the questionnaire before the pandemic (2017-2019). We assessed neurological function using 3 interrelated patient-reported outcomes: Patient Determined Disease Steps (PDDS), Multiple Sclerosis Rating Scale-Revised (MSRS-R), and Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function. We identified the network features associated with neurological function using paired 2-tailed t tests and covariate-adjusted regressions. RESULTS: In the cross-sectional analysis of the pandemic data from 1130 pwMS and 1250 controls during the pandemic, having a higher percentage of network members with a perceived negative health influence was associated with worse disability in pwMS (MSRS-R: ß=2.181, 95% CI 1.082-3.279; P<.001) and poor physical function in controls (PROMIS Physical Function: ß=-5.707, 95% CI -7.405 to -4.010; P<.001). In the longitudinal analysis of 230 pwMS and 136 controls, the networks of all participants contracted, given an increase in constraint (pwMS-prepandemic: mean 52.24, SD 15.81; pwMS-pandemic: mean 56.77, SD 18.91; P=.006. Controls-prepandemic: mean 48.07, SD 13.36; controls-pandemic: mean 53.99, SD 16.31; P=.001) and a decrease in network size (pwMS-prepandemic: mean 8.02, SD 5.70; pwMS-pandemic: mean 6.63, SD 4.16; P=.003. Controls-prepandemic: mean 8.18, SD 4.05; controls-pandemic: mean 6.44, SD 3.92; P<.001), effective size (pwMS-prepandemic: mean 3.30, SD 1.59; pwMS-pandemic: mean 2.90, SD 1.50; P=.007. Controls-prepandemic: mean 3.85, SD 1.56; controls-pandemic: mean 3.40, SD 1.55; P=.01), and maximum degree (pwMS-prepandemic: mean 4.78, SD 1.86; pwMS-pandemic: mean 4.32, SD 1.92; P=.01. Controls-prepandemic: mean 5.38, SD 1.94; controls-pandemic: mean 4.55, SD 2.06; P<.001). These network changes were not associated with worsening function. The percentage of kin in the networks of pwMS increased (mean 46.06%, SD 29.34% to mean 54.36%, SD 30.16%; P=.003) during the pandemic, a change that was not seen in controls. CONCLUSIONS: Our findings suggest that high perceived negative health influence in the network was associated with worse function in all participants during the pandemic. The networks of all participants became tighter knit, and the percentage of kin in the networks of pwMS increased during the pandemic. Despite these perturbations in social connections, network changes from the prepandemic to the pandemic period were not associated with worsening function in all participants, suggesting possible resilience.
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COVID-19 , Esclerose Múltipla , Fenilenodiaminas , Humanos , COVID-19/epidemiologia , Estudos de Casos e Controles , Estudos Transversais , Esclerose Múltipla/epidemiologia , PandemiasRESUMO
In this study we use personal network analysis to examine the social relationships taking place throughout programme implementation. Previous literature on psychosocial intervention has used network analysis techniques to examine: (a) the interaction between participants, (b) the facilitators' link to the intervention target group, (c) the transfer of knowledge between experts and facilitators, and (d) the interaction of facilitators with each other. However, there has been little research on how facilitators connect with other figures in their organisational context, impacting both intervention fidelity and the fit of the programme to the local context. In this study we combine the analysis of personal networks with qualitative interviews with 102 teachers in 72 schools in Barranquilla (Colombia), with whom we describe the implementation of the psychoeducational programmes Pisotón and Metodologías Flexibles. The results show that programme implementation networks not only rely on facilitators but also on the contribution of the schools' director of studies, the coupling with the regular classroom teachers, and occasional collaborations from the rest of the school staff. After conducting a cluster analysis, we detected the existence of two types of personal networks, some based on the functioning of highly cohesive teams and others with a greater level of centralisation around the head of studies. Implementation networks not only enable the implementation of programme activities, but also the integration of the programme into educational organisations. In the discussion we reflect on how the analysis of facilitators' personal networks can be used to improve the process of programme implementation.
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Pessoal de Educação , Humanos , Avaliação de Programas e Projetos de Saúde , Instituições AcadêmicasRESUMO
The social networks surrounding intimate couples provide them with bonding and bridging social capital and have been theorized to be associated with their well-being and relationship quality. These networks are multidimensional, featuring compositional (e.g., the proportion of family members vs. friends) and structural characteristics (e.g., density, degree of overlap between spouses' networks). Most previous studies of couple networks are based on partners' global ratings of their network characteristics or network data collected from one member of the dyad. This study presents the analysis of "duocentric networks" or the combined personal networks of both members of a couple, collected from 207 mixed-sex newlywed couples living in low-income neighborhoods of Harris County, TX. We conducted a pattern-centric analysis of compositional and structural features to identify distinct types of couple networks. We identified five qualitatively distinct network types (wife family-focused, husband family-focused, shared friends, wife friend-focused, and extremely disconnected). Couples' network types were associated with the quality of the relationships between couples and their network contacts (e.g., emotional support) but not with the quality of the couples' relationship with each other. We argue that duocentric networks provide appropriate data for measuring bonding and bridging capital in couple networks.
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Medical crowdfunding is an accessible alternative for individuals to meet their unaffordable health needs. This study explores the role of personal networks in medical crowdfunding performance from the perspective of tie strength and whether gender inequality persists in the returns of personal networks in this survival context, using bilateral data of both the ego and the alters collected from a large representative medical crowdfunding platform in China. It is found that kin ties play a fundamental and predominant role while pseudo-kin ties, being less strong than kin ties in terms of mutual sentiment and reciprocal obligations to help each other, play an accumulative role and are more influential in increasing crowdfunding performance, and neighbour and other role relations have the weakest effect and contribution. Importantly, women are not discriminated against when mobilizing personal networks for medical crowdfunding as they enjoy the same returns of most personal ties as men do.