Second , we show that network composition , individual network central ity , and network structure are associated with important health behaviors and health and development outcomes in different context s across multiple levels of analysis and across distinct network types .
Lastly , we highlight the opportunities for health research ers and practitioners in LMICs to 1 ) design effective studies and interventions in LMICs that account for the sociocentric network positions of certain individuals and overall network structure , 2 ) measure the spread of outcomes or intervention externalities , and 3 ) enhance the effectiveness and efficiency of aid based on knowledge of social structure .
In low- and middle-income countries ( LMICs ) , naturally occurring social networks may be particularly vital to health outcomes as extended webs of social ties often are the principal source of various re sources .
Raising the Level of Analysis of Food-Borne Outbreaks: Food-Sharing Networks in Rural Coastal Ecuador
Objectives : Consuming contaminated food is a well-documented individual-level risk factor for diarrheal disease . The sharing of food also influences the distribution of diarrheal disease risk through a community and region . Underst and ing this social process at a population level is therefore an important dimension of risk not captured by st and ard individual-level analyses . We examined social networks related to food-sharing in rural villages at 2 scales : within a village , examining whether connections within these networks clustered or were uniformly spread ; and among villages , looking at whether food-sharing networks differed according to the village 's remoteness from a population center . Methods : We surveyed 2129 individuals aged 13 years and older in 2003–2004 , within a representative ( block-r and omized ) sample of 21 rural villages in Esmeraldas province , northern coastal Ecuador . We calculated degree ( number of social contacts ) for a social network defined by sharing food . Results : Networks of households sharing food differ according to remoteness from a metropolitan center . On average , residents living in “ far villages ” had 2 more social contacts than those in “ close villages , ” and 12 more years of residence in their village . Estimates of transmissibility ( a measure of outbreak potential ) based on network structure varied as much as 2-fold across these villages . Conclusions : Food-sharing practice s link particular households in rural villages and have implication s for the spread of food-borne pathogens . The food-sharing  networks in remote rural villages are heterogeneous and clustered , consistent with contemporary theories about disease transmitters . Network-based measures may offer tools for predicting patterns of disease outbreaks , as well as guidance for interventions
Second , we show that network composition , individual network central ity , and network structure are associated with important health behaviors and health and development outcomes in different context s across multiple levels of analysis and across distinct network types .
Lastly , we highlight the opportunities for health research ers and practitioners in LMICs to 1 ) design effective studies and interventions in LMICs that account for the sociocentric network positions of certain individuals and overall network structure , 2 ) measure the spread of outcomes or intervention externalities , and 3 ) enhance the effectiveness and efficiency of aid based on knowledge of social structure .
In low- and middle-income countries ( LMICs ) , naturally occurring social networks may be particularly vital to health outcomes as extended webs of social ties often are the principal source of various re sources .