Researchers say the social network of someone with MS can have an impact on their health.

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Your choice of friends can help determine your lifestyle choices, healthy and unhealthy. Getty Images

The people you choose to hang out with may affect your health.

In fact, you may be choosing people that help you justify unhealthy habits.

For those living with multiple sclerosis, these kinds of choices can lead to worse symptoms and disabilities, according to experts from Harvard University.

People use social networks to find support, seek information, and channel their health behavior.

Researchers recently looked at the characteristics of these social networks for people living with multiple sclerosis (MS) and those at risk of developing the disease.

“The characteristics of people around you affect your own disability level,” said Dr. Amar Dhand, a research author and assistant professor of neurology at Brigham and Women’s Hospital at Harvard Medical School.

“The habits of people around you are very influential,” Dhand told Healthline. “If your friends exercise, take their medicine, go to the doctors, these influence your own disability report.”

This is independent of age, race, and gender, researchers said.

The study results were based on observations of 1,493 people who were enrolled in the Genes and Environment in Multiple Sclerosis (GEMS) project, a collection of people with a first-degree family history of MS.

The purpose of the GEMS project is to identify genetic and environmental risk factors, including the social environment.

The GEMS participants were asked to complete an online questionnaire assessing social networks and current neurological disability.

The questionnaire was live for six weeks, with reminders sent to those who didn’t respond. The estimated time to complete the survey was 10 to 20 minutes.

The questionnaire started with general questions about time of diagnosis, age, race, marital and employment status.

It also asked for self-reported disability ratings on eight disability factors. These were walking, using arms and hands, vision, speaking clearly, swallowing, cognition, sensation, and bowel and bladder function.

It then asked for names of those people who the participant shared important matters, socialized with, or sought support from in the past three months. The number of names listed was not limited.

The next set of questions analyzed the connections between each pair of the first 10 people in the network, including the strength of ties in 3 levels — strangers, weak, or strong. People with stronger connections may visit each other, travel together, or go to dinner.

The final set of questions inquired about characteristics and health habits of each of the first 10 people in their network.

Experts examined the percentage of the network members with negative health habits, including smoking, sedentary lifestyle, not visiting doctors regularly, and poor compliance with prescription medications.

The two areas that showed the greatest disability factors were those that did not go to a doctor regularly, and those deemed to have a negative health influence on the participant.

Social isolation can also be a result of unhealthy habits. It is a predictor of mortality comparable to smoking, hypertension, and physical inactivity.

“Choose your people wisely,” advised Dhand. “Be very cognizant of the people around you as to optimize your function and health wellness.”

Managing social networks is in the hands of the patient.

“Make your own network better,” said Dhand. “Otherwise, it can be toxic for your health.”

Dhand suggests the patient explore how they are choosing their network.

“Are you selecting folks that have bad habits so that you can enjoy them?” Dhand said.

“Your network may be filled with bad habits, but this one person has good habits,” he added. “Converse with the ones with bad habits and ask them to change. If not, possibly watch the amount of time with them. Spend time with the healthiest people.”

Social networks are not new in research. But, this new quantitative tool reveals specific social environments that could be targeted in clinical trials and eventually lead to a treatment plan.

“I’d love to see this inspire a type of therapy, such as network therapy,” Dhand said, “where it’s not focused on the biology of the disease but rather a therapeutic plan to help their social networks.”

This quantitative survey was designed to dig deeper than past efforts. It was also designed to be shared.

A version of the instrument is available for use in the REDCap Shared Library. Specific computer code is available at GitHub.

“We made this social network assessment tool public. It is open source so anyone can use it in their clinic or research project,” said Dhand. “We hope this changes the model of medicine from biological to social biological.”

This work was supported by National Institutes of Health (NIH) grants, the Football Players Health Study at Harvard University, and the National Multiple Sclerosis Society.

Editor’s Note: Caroline Craven is a patient expert living with MS. Her award-winning blog is, and she can be found on Twitter.