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While much research examines the consequences of deinstitutionalization for caregivers, few studies address support mobilization strategies used by patients themselves. We examine the relationship between mental health patients’ needs, their activation of network ties for health discussion, and network dynamics during the course of treatment. We hypothesize that patients strategically activate their network ties for support that matches their needs. Linking activation to network dynamics, we also propose that patients with greater needs exhaust their supportive relationships and experience more network turnover.

We draw on a dataset of new mental health patients (N=173) and their associated network members (N=4,144) observed over three years. Random-intercept regression models test the relationship between patients’ needs and (1) network tie activation for health discussion and (2) network turnover.

Although the overall level of need does not predict network tie activation, mental health patients are more likely to activate network ties who provide support that matches their expressed needs for discussion, emotional, and financial support (although not instrumental or informational support). In addition, patients with elevated needs experience increased network turnover. Strategic activation and its unintended consequence together suggest a revolving door of support for patients in crisis.

In the post-deinstitutionalization era, patients’ informal social safety nets must compensate for needs that are left unmet by deficits in the formal treatment system. We find that patients seek out network members who are well-equipped to help them cope with the onset of illness. At the same time, network activation may lead to instability as high-need patients churn through supportive relationships. Future research should examine the consequences of tie activation and support needs for network dynamics in different treatment contexts.

Purpose: The goal of Volume 21 of Advances in Medical Sociology, entitled Sexual and Gender Minority Health, is to showcase recent developments and areas for future research related to the health, well-being, and healthcare experiences of LGBTQA+ (Lesbian, Gay, Transgender, Queer, Asexual, and related communities that do not identify as heterosexual) persons and communities.

Approach: In this introduction to the volume, we trace the historical development of research on sexual and gender minority (SGM) health, discussing how priorities, theories, and evidence have evolved over time. We conclude with brief suggestions for future research and an overview of the articles presented in this volume.

Findings: Research on SGM health has flourished in the past two decades. This trend has occurred in conjunction with a period of intense social, political, and legal discourse about the civil rights of SGM persons, which has increased understanding and recognition of SGM experiences. However, recent advances have often been met with resistance and backlash rooted in enduring social stigma and long histories of discrimination and prejudice that reinforce and maintain health disparities faced by SGM populations.

Value: Our review highlights the need for additional research to understand minority stress processes, risk factors, and resiliency, particularly for those at the intersection of SGM and racial/ethnic or socioeconomic marginality.

Latinos in the United States have poor outcomes for periodontal and dental health. However, a detailed description of the mechanisms driving these patterns has only recently started to be addressed in the literature. In the current study, we explore relationships between individual-level characteristics of Mexican immigrants, properties of their networks, and experiences of dental problems. Specifically, using data from an urban community of Mexican immigrants to the American Midwest (n = 332), this study examines how characteristics of oral health matters (OHM) discussion networks and individual-level sociodemographic characteristics are associated with four adverse oral health outcomes. The results provide strong support for relationships between immigrants’ network characteristics and dental problems. We find that people with more dental problems talk about these issues more frequently with network ties. Conversely, stronger relationships with OHM discussion networks, as measured by mean closeness, are predictive of fewer dental problems. In addition, we identify a link between perceptions of alters’ knowledge about teeth, mouth, and gums and egos reporting better oral health outcomes. The observed patterns are suggestive of mechanisms of social influence that are well replicated in the social, medical, and public health literatures, but that have seldom been empirically tested in the domain of oral health. Though preliminary, our findings suggest a potential explanatory role for social networks in some of the most important questions and problems in oral health disparities research. In all, our findings suggest that social network members are active participants in the management and response to oral health problems in this immigrant group and should be considered an important factor in the development and course of diseases.

Purpose: In this chapter, we develop a concept of social biographies which draws on social network and life course theories to examine how a diverse set of social relationships impacts health of sexual and gender minority (SGM) people over time.

Design/methodology/approach: We provide an overview of several decades of research on SGM people's social relationships, organizing this research within a social biographies framework.

Findings: We theorize about the importance of both the structure and content of SGM people's social networks for health, how these social relationships interact with each other, how these social biographies and their impacts shift across SGM cohorts and over the life course, and how they further are shaped by the intersection of a range of factors (e.g., race/ethnicity, social class).

Social biographies can remain constant or change over time, and relationships of all types and durations have the power to significantly improve or undermine health. This is in part because social ties both buffer and exacerbate the inimical effects of stress on health.

Originality/value: Traditional conceptualizations of relationships fail to reflect the diversity of relationships in SGM lives. Studying this diversity deepens our view of how social biographies influence health and how health inequities between SGM and cisgender and heterosexual (cishet) populations emerge. Studying social biographies of SGM people using theoretical and methodological tools from life course and social network perspectives reveals existing voids in the current literature, enabling researchers to better understand the shifting nature of social relationships in the twenty-first century.