Who would ask whom for health advice? The structural anatomy of health advice networks among middle-aged and older adults

Social relationships provide opportunities to exchange and obtain health advice. Not only close confidants may be perceived as sources of health advice, but also acquaintances met in places outside a closed circle of family and friends, e.g., in voluntary organizations. This study is the first to analyze the structure of complete health advice networks in three voluntary organizations and compare them with more commonly studied close relationships. To this end, we collected data on multiple networks and health outcomes among 143 middle-aged and older adults (mean age = 53.9 years) in three carnival clubs in Germany. Our analyses demonstrate that perceived health advice and close relationships overlap only by 34%. Moreover, recent advances in exponential random graph models (ERGMs) allow us to illustrate that the network structure of perceived health advice differs starkly from that of close relationships. For instance, we found that advice networks exhibited lower transitivity and greater segregation by gender and age in comparison to networks of close relationships. We also found that actors with poor physical health perceive less individuals as health advisors than those with good physical health. Our findings suggest that community settings, such as voluntary associations, provide a unique platform for exchanging health advice and information among both close and distant network members.