"An illustrative socio-biological cascade of the concentric model for health-bound networks: social determinants, social support and biological responses".

Introduction: Health has been associated with social support. Supported patients with complex health issues have a better chance of living healthier, longer lives and enjoying a better quality of life. Research indicates that physical, mental, and emotional health are connected to both biological and social determinants. Methods: This paper proposes a conceptual, society-to-biology model, the Concentric Model for Health-Bound Networks, that explores the complexity of social support and integrates the foundational principles of systems biology and systems thinking. This transdisciplinary model conceptualizes the sources of support for patients requiring care as dynamic, concentric social networks. The model is informed by current understanding of the interdependence between disease and social support. The Concentric Model for Health-Bound Networks attempts to clarify the configuration of care-intensive social support by maintaining and transforming diverse, overlapping webs of support that change dynamically. Drawing upon network science and systems thinking, this model examines how these approaches apply to the capacity of social support to improve health outcomes and inform clinical practice. Results: While the Concentric Model for Health-Bound Networks is untested, complex, care-intensive social support requires dynamic models that adapt to complexity. Via a transdisciplinary socio-biological approach called the Socio-Biological Cascade, feedback may co-occur across the Social Determinants of Health, social support, and biological processes. Type 2 diabetes management, with its overlap of complex biological processes and individualized health-related requirements, serves as a theoretical example of how social support informs the Socio-Biological Cascade and its possible implications for health. Discussion: Changes in the composition, quality, change over time, and structural integrity of health-bound support networks may mediate or modify relationships between social determinants of health and biological stress, inflammatory, and metabolic responses, thereby affecting chronic disease outcomes. It is hypothesized that the dynamics of patient-centered social support, informed by the Social Determinants of Health and applying the Socio-Biological Cascade and Concentric Model for Health-Bound Networks, can elucidate complex health outcomes.