As public health challenges like suicide and rising chronic illness rates continue to strain health care systems, new research from Indiana University suggests that the solution might lie in a more connected understanding of human health.
Distinguished Professor of Sociology Bernice Pescosolido
The publication, by Bernice Pescosolido, Distinguished Professor of Sociology in the College of Arts and Sciences at Indiana University Bloomington in the Proceedings of the National Academy of Sciences, has introduced an innovative approach called the Network Embedded Symbiome (NES) framework, which emphasizes the importance of collaborative network structures-family, friends, and community-and other relational systems in determining health outcomes.
Professor Pescosolido, who is also the founding director of IU's Irsay Institute for Sociomedical Sciences, proposes that understanding health requires not only looking at individual factors, like genetics and lifestyle, but also at the interactions across multiple networks that influence health in powerful ways. This shift could reshape how researchers approach diseases, policy, and interventions.
"Human health is not just biological, it's deeply social and connected," Pescosolido said. "This framework could help us understand why some communities thrive while others struggle with crises like suicide. The NES framework serves to identify problems, while also mapping out pathways that can lead to better health through network-based interventions."
Why Networks Matter
Pescosolido's framework builds on decades of research into the social determinants of health, which recognizes that factors like socioeconomic status and social relationships impact human well-being. NES adds a new layer, suggesting that the structure of a person's network-both supportive and stress-inducing-can dictate health outcomes. Rather than simply adding social factors to health data, NES analyzes how networks at various levels, from close-knit family circles to broad social influences, work together, for better or worse.
For example, the NES model illustrates how a community with strong social connections can act as a buffer during times of stress, potentially lowering suicide rates. Conversely, isolated individuals or communities with fractured relationships may experience higher health risks.
Suicide prevention provides a compelling case for the NES framework. The study draws on historical research linking social ties to mental health and shows that individuals embedded in supportive family, friend, or community networks may be more resilient in the face of suicidal thoughts. Conversely, people with limited or toxic networks may be at higher risk.
In her work Pescosolido also points to recent research showing that connecting individuals with healthy networks has significantly reduced suicide risk, revealing the feasibility, safety and promise of this approach. When scientists simulated the simple addition of social connections to people's networks, overall suicide risk was reduced and previously health individuals were not negatively affected.
According to the NES model, suicide prevention strategies should focus on fostering connections and counteracting isolation among individuals at different levels. This approach aligns with findings from the U.S. Centers for Disease Control, for example, that recommend connectedness as a preventive strategy for suicide. The NES model moves beyond individual therapy and medication, advocating for community-building initiatives as part of a more holistic approach to mental health.
Pescosolido learned much about what schools need from a recently published work by colleagues Anna Mueller, the Luther Dana Waterman Associate Professor of Sociology in the College at IU Bloomington, and Seth Abrutyn of the University of British Columbia, authors of Life under Pressure: The Social Roots of Suicide and What to Do About Them. The book focuses on a community that experienced a rash of suicides; the authors found that while the connectedness among the students mattered, the social structure and climate of the school, including the intense expectations of teachers, staff, and parents set a tone that mattered.
Currently, Pescosolido is working with Mueller in doing research on school staff in Indiana to assist the State in suicide prevention.
In addition, the NES model's implications extend beyond mental health. From chronic illness to infectious disease, the framework shows that network dynamics can accelerate or hinder health outcomes. By accounting for social and relational factors, policymakers and health providers could design interventions that are more effective and socially tailored.
For example, during the COVID-19 pandemic, communities with robust social networks managed better mental health outcomes despite physical isolation measures. In this light, the NES model could help public health officials identify communities at higher risk in future crises, based on their network structure and support levels.
Although this framework marks a significant step forward, Pescosolido acknowledges that implementing it will require a new way of collecting and interpreting health data. "Bringing collaborative community network data into mainstream health research is challenging, but the benefits could be transformative," she said.
As the NES model gains traction, it could redefine how health professionals approach complex health problems. By fostering more connected communities, this innovative framework might provide a new tool for improving health outcomes-one that is both scientific and rooted in the basic human need for connection.
If you or someone you know is experiencing thoughts of suicide or a mental health or substance use crisis, please call or text 988 to reach the Suicide & Crisis Lifeline and speak with a trained crisis specialist 24/7.
The IU Bloomington crisis line is available to students 24/7 by calling 812-855-5711, and choosing option 1 after-hours.
