Social Networks and Health Service Use by Parents After a Day Care Fire

Research on disaster recovery emphasizes the ability of individuals and communities to avoid the disintegration of social institutions. Part of this resource loss—including access to services—owes to the deterioration of social support post-disaster. In this paper, we consider a group of parents and caretakers affected by the trauma of a fire that injured or killed their children, and how the constellation of their relationships is associated not only with their grief, PTSD and depression, but with their use of physical and mental health services. In addition to sociodemographic and outcome measures, the sample of over 200 parents and caretakers were asked to list seven affected parents/caretakers and various aspects of their relationships with those people. The resulting network had identifiable subgroups as well as some people not connected to any of the others. The five cohesive subgroups that were identifiable in the network showed considerable variation in the extent to which the parents and caretakers in the different subgroups needed both physical and mental health services, which suggests that continued participation in some of these subgroups of relationships may be a risk factor. However, the same groups with high needs for health services also actually used greater health services, which suggests those same groups may be protective for people with high needs. Gendered differences provides some insight into these dynamics. Specifically, we found that very few men in these subgroups used health services, while high percentages of women in these subgroups used health services. Men and women not connected to the subgroups were similar to one another in their level of service use, somewhere between those of men and women in subgroups. Knowing these distinct social strategies of mothers, fathers and other family members for coping with trauma—and the correlates of those strategies—will permit social provisioning of health services, or at least socially targeted health services.