A new study reveals that sick teens are more isolated than other kids, but they do not necessarily realize it and often think their friendships are stronger than they actually are.
The findings rely on surveys conducted before the Internet era made it easier for outsider kids to reach out to teens like themselves. Still, the study offers insight into the role that health plays in the relationships between people, said lead author and sociologist Steven Haas.
Health is both a cause and a consequence of how many friends you have and how many people you have to support you, said Haas, an assistant professor at Arizona State University.
For about 30 years, weve seen that people who have more friends -- and can get things from their friends like money or social support, all kinds of things that friends give each other -- are healthier and live longer. Few people have looked at the opposite side of the coin: Can the health of people affect the size of peoples social networks and their place in them?
In the new study, published in the December issue of the Journal of Health and Social Behavior, Haas and colleagues examined the results of a 1994-1996 survey of teenagers that asked them to name their friends. The study authors focused on 2,060 teens and explored the connections between them and their classmates.
Roughly, two-thirds of teens rated their health as excellent or very good. The researchers looked most closely at the other kids about a third of the total who said their health was good, fair or poor. They might have suffered from conditions like asthma, obesity, deafness or blindness, Haas said.
The less healthy kids are in smaller networks over time compared to their healthier peers, Haas said. The kids dont perceive themselves as having fewer friends. If you ask them to list them, they list the same number of friends as the healthy kids do.
But if you ask the other kids who theyre friends with, theyre much less likely to nominate the sick kids as their friends. In essence, the sicker kids tend to overstate how strong some of their friendships are, he said.
It gets worse. The sicker kids are 20 percent more likely to have no friends, Haas said. That means that no one in the school lists them as one of their friends, Haas said.
The study does not say which came first for the sicker kids -- isolation or poorer health. However, it is clear that being sick doesnt make you fun to be around. It can be taxing on your friends and they have to do a lot of emotional support and try to make you feel better, Haas said. At the same time, individuals who are depressed cant do the things we have to do to help our friends like support them and spend time with them.
Robert Crosnoe, a sociologist and professor at the University of Texas at Austin, said he is a fan of the study. While it might seem obvious that good health boosts friendships and vice versa, he said, it is not something scientists have done a good job of studying, largely because there are not good data.
He also pointed to a potential bonus to helping kids become healthier. The findings, he said, suggest that school health services, to the extent that they work, could have effects on high-school peer dynamics that adults find so complex and mysterious, not just health itself.
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Haas SA, Schaefer DR, Kornieko O. Health and the structure of adolescent social networks. J Health Soc Behav 51(4), 2010.