bluuebunny/crossref_metadata_2025 huggingface dataset:
Does Income Inequality Harm Health? New Cross-National Evidence
Authors: Beckfield Jason
Published: January 2010

The provocative hypothesis that income inequality harms population health has sparked a large body of research, some of which has reported strong associations between income inequality and population health. Cross-national evidence is frequently cited in support of this important hypothesis, but the hypothesis remains controversial, and the cross-national work has been criticized for several methodological shortcomings. This study replicates previous work using a larger sample (692 observations from 115 countries over the 1947–1996 period), a wider range of statistical controls, and fixed-effects models that address heterogeneity bias. The relationship between health and inequality shrinks when controls are included. In fixed-effects models that capture unmeasured heterogeneity, the association between income inequality and health disappears. The null findings hold for two measures of income inequality: the Gini coefficient and the share of income received by the poorest quintile of the population. Analysis of a sample of wealthy countries also fails to support the hypothesis.
Income Inequality, Race, and Child Well-being: An Aggregate Analysis in the 50 United States
Authors: Mcleod Jane D. , Nonnemaker James M. , Call Kathleen Thiede
Published: January 2010

Interest in income inequality as a predictor of health has exploded since the mid-1990s. Recent analyses suggest, however, that the effect of income inequality on population health is not robust to a control for the racial composition of the population. That observation raises two interpretational questions. First, does income inequality have an independent effect on population health? Second, what does the effect of racial composition on population health mean? We use data from the Urban Institute's Assessing the New Federalism project and the Kids Count Databook to evaluate the aggregate effects of income inequality on diverse measures of child well-being (e.g., infant mortality, high school drop-out rates) in the 50 U.S. states. We replicate the finding that, net of the racial/ethnic composition of the population, the effects of income inequality are not significant. Moreover, the effects of racial composition on child well-being appear to be compositional (i.e., they reflect the less positive outcomes observed among racial/ethnic minorities) rather than contextual (i.e., representing the independent influence of social context). Whereas cross-level effects are still possible, our results cast doubt on the health relevance of these aggregate characteristics of the population.
Education and the Changing Shape of the Income Gradient in Health
Authors: Schnittker Jason
Published: January 2010

Research on the social determinants of health has increasingly sought to understand the relative importance of different features of socioeconomic status. Much of the ensuing debate has wavered between education and income, with recent research leaning increasingly toward income. This research has not, however, consistently explored interactions between different features of socioeconomic status and, in trying to understand the independent effects of different components of socioeconomic status, may have missed important features of socioeconomic position. With an eye toward examining how features of socioeconomic status combine and coalesce, this paper examines variation in the income-health association by level of education. Theories derived both from medical sociology and health economics suggest synergistic interactions between income and education, but they are unclear as to the direction and magnitude of these interactions. Results from two large and nationally representative data sets (the 1996–1997 Community Tracking Study and the 1972–2000 General Social Survey) indicate that the positive relationship between income and health varies substantially in both its strength and shape by level of education. Education improves health, and its effects are larger at lower levels of income. Moreover, education reduces the strength and curvature of the income-health relationship. Consequently, those with more education have better health for all levels of income, and fewer income-based disparities exist among the well educated than among the less well educated. The linear “gradient” relationship between income and health is, thus, more characteristic of groups with higher levels of education. Additional analyses indicate that these interactions existed in the United States in each of the last three decades. The results are discussed in light of theory regarding the perpetuation of health disparities, as well as current debates regarding the apparent incompatibility of distributive versus aggregative goals in health policy.
Socioeconomic Status, Smoking, and Health: A Test of Competing Theories of Cumulative Advantage
Authors: Pampel Fred C. , Rogers Richard G.
Published: January 2010

Although both low socioeconomic status and cigarette smoking increase health problems and mortality, their possible combined or interactive influence is less clear. On one hand, the health of low status groups may be harmed least by unhealthy behavior such as smoking because, given the substantial health risks produced by limited resources, they have less to lose from damaging lifestyles. On the other hand, the health of low status groups may be harmed most by smoking because lifestyle choices exacerbate the health problems created by deprived material conditions. Alternatively, the harm of low status and smoking may accumulate additively rather than multiplicatively. We test these arguments with data from the 1990 U.S. National Health Interview Survey, and with measures of morbidity and mortality. For ascribed statuses such as gender, race, and ethnicity, and for the outcome measure of mortality, the results favor the additive argument, whereas for achieved status and morbidity, the results support the vulnerability hypothesis—that smoking inflicts greater harm among disadvantaged groups.
The Career of the Mentally Ill: An Integration of Psychiatric, Labeling/Social Construction, and Lay Perspectives
Authors: Gove Walter R.
Published: January 2010

This paper provides a new way of conceptualizing the career of the mentally ill. Most persons who experience an episode of a serious mental disturbance lead a normal life, while a few persons lead lifetimes that revolve around their mental disorders. The processes leading to either result can only be understood by integrating the traditional labeling and psychiatric perspectives with lay understandings of the concepts of “mental illness” and “nervous breakdowns.” A selection of key concepts from these perspectives leads to a better understanding of the different paths persons take as they move through the pre-patient, in-patient, and post-patient phases of the “career of the mentally ill.” This perspective makes understandable a number of counterintuitive relationships. For example, it explains why most hospitalized mental patients (1) have a negative stereotype of the “mentally ill,” (2) do not perceive themselves as “mentally ill, yet (3) perceive themselves as benefiting from treatment, and (4) do not progress into a career of secondary deviance.
Neighborhood Socioeconomic Disadvantage and Access to Health Care
Authors: Kirby James B. , Kaneda Toshiko
Published: January 2010

Most research on access to health care focuses on individual-level determinants such as income and insurance coverage. The role of community-level factors in helping or hindering individuals in obtaining needed care, however, has not received much attention. We address this gap in the literature by examining how neighborhood socioeconomic disadvantage is associated with access to health care. We find that living in disadvantaged neighborhoods reduces the likelihood of having a usual source of care and of obtaining recommended preventive services, while it increases the likelihood of having unmet medical need. These associations are not explained by the supply of health care providers. Furthermore, though controlling for individual-level characteristics reduces the association between neighborhood disadvantage and access to health care, a significant association remains. This suggests that when individuals who are disadvantaged are concentrated into specific areas, disadvantage becomes an “emergent characteristic” of those areas that predicts the ability of residents to obtain health care.
Anger in Black and White: Race, Alienation, and Anger
Authors: Mabry J. Beth , Kiecolt K. Jill
Published: January 2010

Using data from the 1996 General Social Survey and the 1973 Chicago Crowding Study, we test the hypotheses that African Americans feel and express more anger than whites, that sense of control (versus powerlessness) lessens anger and mistrust increases anger, and that these indicators of alienation affect anger differently for African Americans and whites. We find that when age and gender are controlled, African Americans neither feel nor express more anger than whites, despite having a lower average sense of control and higher mistrust. This is partly because the effects of sense of control and mistrust on anger differ by race. Sense of control reduces feelings of anger and anger expression more for African Americans than whites. Mistrust increases feelings of anger for whites, but not African Americans. The results provide further evidence that, in the stress process, social structural location may moderate the effects of “detriments” and “resources” on emotional upset.
Differential Labeling of Mental Illness by Social Status: A New Look at an Old Problem
Authors: Thoits Peggy A.
Published: January 2010

Whether the higher rates of mental hospitalization and involuntary treatment for marginal social groups are due to differential labeling or simply to the occurrence of higher rates of disorder in these groups remains unresolved. I reexamine this issue with data from the National Comorbidity Survey (N = 5,877) that allow comparisons between disturbed individuals living in the community untreated and disturbed persons who have been hospitalized or seen a professional for their mental health problems under pressure or voluntarily. Contrary to labeling theory, members of lower status groups are not consistently overrepresented among those who have been hospitalized or seen a professional against their will. Consistent with self-labeling theory, persons with greater education and those not in poverty are disproportionately present among individuals who sought treatment by choice. Additional analyses show that factors that predict service utilization are important determinants of mental health service use but do not account systematically for status disparities in hospital or outpatient treatment, especially disparities by poverty status. Although I do not confirm a central tenet of labeling theory here, the negative consequences of labeling and stigma continue to be well-supported in the literature.
Birth Weight and Mothers' Adverse Employment Change
Authors: Dooley David , Prause Joann
Published: January 2010

Low birth weight has been linked at the aggregate level to unemployment rates and at the individual level to subjective distress. We hypothesize that maternal underemployment, including unemployment, involuntary part-time work, and low wage work predicts decreased birth weight. The relationship of birth weight to maternal employment changes during pregnancy was studied prospectively in 1,165 singleton first births in the National Longitudinal Survey of Youth data set. Controlling for other significant risk factors, women who shifted from adequate employment to underemployment had significantly lighter babies. Plausible mediators of this relationship were explored, including prenatal health care, gestational age, and mother's weight gain, with results varying by type of underemployment. Two interactions also suggested that underemployment reduced the beneficial effect of mother's weight gain on birth weight. These findings were partially replicated for low birth weight (< 2,500 grams), indicating the medical significance of the effect.
Family Structure and Mental Health: The Mediating Effects of Socioeconomic Status, Family Process, and Social Stress
Authors: Barrett Anne E. , Turner R. Jay
Published: January 2010

Although numerous studies reveal differences in mental health by the structure of one's family of origin, there remains debate regarding the processes generating these patterns. Using a sample of young adults (19–21 years) in Miami-Dade County in Florida, this study examines the explanatory significance of three presumed correlates of family type: socioeconomic status, family processes, and level of social stress. Consistent with prior research, our results reveal higher levels of depressive symptoms among those from stepfamilies, single parent families, and single parent families with other relatives present, compared with mother-father families. All three presumed correlates make significant independent contributions to the prediction of depressive symptomatology. Substantial mediating effects also are observed for all three explanatory dimensions. Collectively, they completely or largely explain observed family type variations in mental health risk.
Neighborhood Influences on Adolescent Cigarette and Alcohol Use: Mediating Effects through Parent and Peer Behaviors
Authors: Chuang Ying-Chih , Ennett Susan T. , Bauman Karl E. , Foshee Vangie A.
Published: January 2010

The influence of neighborhoods on adolescent behaviors has received increasing research attention. In the present study, we use structural equation models to specify pathways from neighborhoods to adolescent cigarette and alcohol use through parental closeness, parental monitoring, parent substance use, and peer substance use. We use a national sample with 959 adolescents 12 to 14 years of age whose residential addresses were matched with 1990 Census tracts to provide neighborhood characteristics. We found that for adolescent cigarette use low socioeconomic status (SES) neighborhoods were associated with increased parental monitoring, which was further associated with decreased adolescent cigarette use. For adolescent alcohol use, high SES neighborhoods were associated with increased parent drinking, which was further associated with increased adolescent alcohol use. Low SES neighborhoods were associated with increased parental monitoring and increased peer drinking, which were in turn associated with decreased and increased adolescent alcohol use, respectively.
Stress, Health, and the Life Course: Some Conceptual Perspectives
Authors: Pearlin Leonard I. , Schieman Scott , Fazio Elena M. , Meersman Stephen C.
Published: January 2010

This article proposes several conceptual perspectives designed to advance our understanding of the material and experiential conditions contributing to persistent disparities in rates of morbidity and mortality among groups unequal in their social and economic statuses. An underlying assumption is that these disparities, which are in clear evidence at mid- and late life, may be anchored to earlier circumstances of the life course. Of particular interest are those circumstances resulting in people with the least privileged statuses having the greatest chances of exposure to health-related stressors. Among the stressors closely linked to status and status attainment are those that continue or are repeated across the life course, such as enduring economic strain and discriminatory experiences. Also taking a long-range toll on health are circumstances of stress proliferation, a process that places people exposed to a serious adversity at risk for later exposure to additional adversities. We suggest that this process can be observed in instances of trauma, in early out-of-sequence transitions, and in the case of undesired changes that disrupt behaviors and relationships in established roles. Effective effort to close the systemic health gaps must recognize their structural underpinnings.
A Changed America? The Effects of September 11th on Depressive Symptoms and Alcohol Consumption
Authors: Knudsen Hannah K. , Roman Paul M. , Johnson J. Aaron , Ducharme Lori J.
Published: January 2010

In the weeks following the terrorist attacks of September 11, 2001, social commentators argued that America had profoundly “changed.” In light of these arguments and the literature on disasters, we examine the immediate and longer-term mental health consequences of September 11th using a national sample of fulltime American workers. We model the effects of temporal proximity to the attacks on depressive symptoms and alcohol consumption, while controlling for demographic characteristics. Our data revealed a significant increase in the number of depressive symptoms reported during the 4 weeks after the attacks. In the subsequent weeks, levels of depressive symptoms returned to pre-September 11th levels. Contrary to expectations, there was some indication of decreased alcohol consumption after September 11th, although these effects were modest. These analyses provide little support for popular assertions that September 11th resulted in lasting and measurable impacts on Americans' well-being.
Stress, Life Events, and Socioeconomic Disparities in Health: Results from the Americans' Changing Lives Study
Authors: Lantz Paula M. , House James S. , Mero Richard P. , Williams David R.
Published: January 2010

It has been hypothesized that exposure to stress and negative life events is related to poor health outcomes, and that differential exposure to stress plays a role in socioeconomic disparities in health. Data from three waves of the Americans' Changing Lives study (n = 3,617) were analyzed to investigate prospectively the relationship among socioeconomic indicators, five measures of stress/negative life events, and the health outcomes of mortality, functional limitations, and self-rated health. The results revealed that (1) life events and other types of stressors are clearly related to socioeconomic position; (2) a count of negative lifetime events was positively associated with mortality; (3) a higher score on a financial stress scale was predictive of severe/moderate functional limitations and fair/poor self-rated health at wave 3; and (4) a higher score on a parental stress scale was predictive of fair/poor self-rated health at wave 3. The negative effects of low income on functional limitations attenuated to insignificance when waves 1 and 2 stress/life event measures were controlled for, but other socioeconomic disparities in health change remained sizable and significant when adjusted for exposure to stressors. The results support the hypothesis that differential exposure to stress and negative life events is one of many ways in which socioeconomic inequalities in health are produced in society.
The Self and Mental Health: Self-Salience and the Emergence of Internalizing and Externalizing Problems
Authors: Rosenfield Sarah , Lennon Mary Clare , White Helene Raskin
Published: January 2010

How do schemas about self-salience—the importance of the self versus the collective in social relations—affect mental health? We propose that self-salience shapes the likelihood of experiencing internalizing or externalizing problems. Schemas that privilege others over the self increase the risk of internalizing symptoms, including depressive symptoms and anxiety, whereas those that privilege the self over others predispose individuals to externalizing behaviors of antisocial behavior and substance abuse. Furthermore, we propose that these schemas contribute to the gender differences that exist in these problems. We test these predictions with data from adolescents, the stage at which these problems and the gender differences in them arise. Results show that self-salience underlies both internalizing and externalizing problems. In addition, schemas about self-salience help explain the gender differences found in mental health problems.
Clarifying the Relationship Between Parenthood and Depression
Authors: Evenson Ranae J. , Simon Robin W.
Published: January 2010

Unlike other major adult social roles in the United States, parenthood does not appear to confer a mental health advantage for individuals. However, while research has examined parental status differences in emotional well-being, relatively little is known about variations in emotional distress among parents. In this article, we clarify the relationship between parenthood and current symptoms of depression using data from the National Survey of Families and Households. The analyses provide support for our first hypothesis: Parenthood is not associated with enhanced mental health since there is no type of parent who reports less depression than nonparents. We also find support for our second hypothesis: Certain types of parenthood are associated with more depression than others. Additionally, although we find marital status differences in symptoms among parents, there are no gender differences in the association between parenthood and depression. We discuss the implications of our findings for ongoing theoretical debates about the advantages of social role involvement for mental health as well as the meaning of contemporary parenthood in the United States.
Household Income Histories and Child Mental Health Trajectories
Authors: Strohschein Lisa
Published: January 2010

Although it is widely accepted that low household income is associated with worse child mental health, less is known about whether income histories, often differentiated into stable and dynamic components, also matter. Using longitudinal data from the Child Supplement of the National Longitudinal Study of Youth, comprising the repeated measures of children ages 4 to 14 from 1986 to 1998 inclusive, I estimate generalized linear mixed models to evaluate the influence of household income histories on child depression and antisocial behavior over time. Results indicate that, at initial interview, low household income is associated with higher levels of depression and antisocial behavior; subsequent improvements in household income reduce child mental health problems. Further, the effect of initial household income on the rate of change in child depression attenuates as children grow older, whereas for antisocial behavior the effect of initial household income becomes stronger over time. These findings highlight the importance of understanding the ways in which children are influenced by their families' income histories.
Financial Strain over the Life Course and Health among Older Adults
Authors: Kahn Joan R. , Pearlin Leonard I.
Published: January 2010

This paper focuses on financial strain across the life course as a condition underlying health inequalities observed in later life. The analysis is based on data from 1,167 adults 65 years and older collected as part of the “Aging, Stress and Health Study.” Relying on retrospective data about hardship experienced over the life course, we find that long-term financial hardship is reflected in a range of health outcomes at late life, even after controlling for the effects of current financial circumstances. Moreover, the sheer persistence of hardship matters more than its episodic occurrence or timing, so that the health effects of early hardship may be obviated if followed by no further hardship. This pattern of findings is consistent with the notion of allostatic load, the cumulative damage done to health and well-being under the burden of an unrelenting stressor in a critically important life domain.
Multiple Roles and Mental Health in Cross-Cultural Perspective: The Elderly in the United States and Japan
Authors: Kikuzawa Saeko
Published: January 2010

This paper examines how multiple roles affect the mental health of the elderly in Japan and the United States, two countries with vastly different cultures. Hypotheses were drawn based on the cultural differences in role experiences, and these hypotheses are tested by analyzing nationally representative samples of the elderly in these countries. The results show that Americans are more likely to be involved in roles related to family, work, and community, while the Japanese are more likely to be involved in only those roles related to family and work. Multiple roles are also found to be less beneficial for the mental health of Japanese elderly compared to American counterparts. National differences in the effects of individual roles and role configurations on mental health are also documented. Overall, the results show the importance of broad cultural contexts for understanding the relationship between roles and mental health.
The Nature of Work and the Stress of Higher Status
Authors: Schieman Scott , Whitestone Yuko Kurashina , Van Gundy Karen
Published: January 2010

Are occupational and work conditions associated with work-to-home conflict? If so, do those associations vary by gender? Among a sample of adults in Toronto, Canada, we found that men and women in higher-status occupations reported higher levels of work-to-home conflict than workers in lower-status jobs. In addition, we observed higher levels of work-to-home conflict among workers who are self-employed and among those with more job authority, demands, involvement, and longer hours. The only significant gender-contingent effect was found for nonroutine work, which is associated positively with work-to-home conflict among men but not women. Higher levels of job demands, involvement, and hours among individuals in higher-status occupations significantly contribute to occupation-based differences in work-to-home conflict. Moreover, despite some overlap, these work conditions have largely independent associations with work-to-home conflict. Results generally support the “stress of higher status” hypothesis among both women and men. Although higher-status positions yield many rewards, such positions are not impervious to inter-role stress, and this stress may offset those rewards.
Does Caregiving Increase Poverty among Women in Later Life? Evidence from the Health and Retirement Survey
Authors: Wakabayashi Chizuko , Donato Katharine M.
Published: January 2010

Given the rapid aging of the U.S. population and reductions in federal funding, elder care has become a major issue for many families. This paper focuses on a long-term consequence of elder care by asking how caring for elderly parents affects women's subsequent risks of living in poverty. Using longitudinal data from the Health and Retirement Study, we examine whether and how caregiving for parents in 1991 increases women's risks of living in households with incomes less than the poverty threshold, receiving public assistance, and receiving Medicaid in 1999. Our findings illustrate that caregiving in earlier life raises women's poverty risks in later life by intensifying the negative effects of stopping work and declining health on women's economic well-being.
Personal Agency in the Stress Process
Authors: Thoits Peggy A.
Published: January 2010

Stress researchers have typically controlled for the role of personal agency, or self-selection, in the stress process, rather than examining it. People in better mental health (those with high levels of coping resources and low levels of distress or disorder) should be more likely to exercise agency. Such individuals should, through problem-solving efforts and purposeful acts, experience fewer negative controllable events and more positive controllable events in their lives and be able to transform or compensate for stressors that they cannot avoid or eliminate. These agentic processes may account for the stress-buffering effects of coping resources; and, because coping resources are unequally distributed by social status, these processes should further help to explain how status differences in mental health are maintained and amplified over time.
Health Selection and the Process of Social Stratification: The Effect of Childhood Health on Socioeconomic Attainment
Authors: Haas Steven A.
Published: January 2010

This study investigates whether childhood health acts as a mechanism through which socioeconomic status is transferred across generations. The study uses data from the Panel Study of Income Dynamics to track siblings and to estimate fixed-effects models that account for unobserved heterogeneity at the family level. The results demonstrate that disadvantaged social background is associated with poor childhood health. Subsequently, poor health in childhood has significant, direct, and large adverse effects on educational attainment and wealth accumulation. In addition, childhood health appears to have indirect effects on occupational standing, earnings, and wealth via educational attainment and adult health status. The results further show that socioeconomic health gradients are best understood as being embedded within larger processes of social stratification.
Mistrusting Companies, Mistrusting the Tobacco Industry: Clarifying the Context of Tobacco Prevention Efforts That Focus on the Tobacco Industry
Authors: Thrasher James F. , Jackson Christine
Published: January 2010

Campaigns to prevent adolescent smoking increasingly depict the tobacco industry as deceitful and exploitative. This study was undertaken to determine how adolescents' expectations about the trustworthiness of companies, in general, influence the pathway through which anti-tobacco industry campaigns prevent smoking. Structural equation modeling was used with survey data from 6,670 adolescents, ages 12 to 17. In the first model, statistically significant coefficients were associated with paths from mistrust of companies to mistrust of the tobacco industry, from mistrust of the tobacco industry to anti-tobacco industry attitudes, and from anti-tobacco industry attitudes to smoking. In models stratified by mistrust of companies, paths from mistrust of the tobacco industry to anti-tobacco industry attitudes and from anti-tobacco industry attitudes to smoking appeared comparable among youth with both high and low mistrust of companies. These results suggest that anti-tobacco industry campaigns resonate with youth because of youths' trust-related values and expectations.
The Construction of Fear: Americans' Preferences for Social Distance from Children and Adolescents with Mental Health Problems
Authors: Martin Jack K. , Pescosolido Bernice A. , Olafsdottir Sigrun , Mcleod Jane D.
Published: January 2010

Debates about children's mental health problems have raised questions about the reliability and validity of diagnosis and treatment. However, little research has focused on social reactions to children with mental health problems. This gap in research raises questions about competing theories of stigma, as well as specific factors shaping prejudice and discrimination toward those children. Here, we organize a general model of stigma that synthesizes previous research. We apply a reduced version of this model to data from a nationally representative sample responding to vignettes depicting several stigmatizing scenarios, including attention-deficit/hyperactivity disorder (ADHD), depression, asthma, or “normal troubles.” Results from the National Stigma Study—Children suggest a gradient of rejection from highest to lowest, as follows: ADHD, depression, “normal troubles,” and physical illness. Stigmatizing reactions are highest toward adolescents. Importantly, respondents who label the vignette child's situation as a mental illness compared to those who label the problem as a physical illness or a “normal” situation report greater preferences for social distance, a pattern that appears to result from perceptions that the child is dangerous.
The Social Antecedents of Anger Proneness in Young Adulthood
Authors: Turner R. Jay , Russell David , Glover Regan , Hutto Pamela
Published: January 2010

Anger has been shown to be an important factor in occupational maladjustment, family conflict, physical and sexual assault, criminal behavior, and substance abuse. It has also been linked with such adverse health outcomes as hypertension, heart disease, and cancer. Focusing on anger proneness, conceptualized as a relatively enduring propensity to experience and express anger, this article examines both early and recent antecedent factors that predict and may condition levels of anger proneness. The roles of both prospectively and retrospectively assessed factors are considered. Data from an ethnically diverse and representative sample of young adults reveals clear gender differences and, at least for short-tempered anger, decreasing levels of anger with increasing socioeconomic status. Prior exposure to violent events, prior exposure to other forms of social stress, and certain personal attributes were found to be significant antecedents of both hostility and short-tempered forms of anger proneness.
Socioeconomic Position and Health: The Differential Effects of Education versus Income on the Onset versus Progression of Health Problems
Authors: Herd Pamela , Goesling Brian , House James S.
Published: January 2010

This article seeks to elucidate the relationship between socioeconomic position and health by showing how different facets of socioeconomic position (education and income) affect different stages (onset vs. progression) of health problems. The biomedical literature has generally treated socioeconomic position as a unitary construct. Likewise, the social science literature has tended to treat health as a unitary construct. To advance our understanding of the relationship between socioeconomic position and health, and ultimately to foster appropriate policies and practices to improve population health, a more nuanced approach is required—one that differentiates theoretically and empirically among dimensions of both socioeconomic position and health. Using data from the Americans' Changing Lives Study (1986 through 2001/2002), we show that education is more predictive than income of the onset of both functional limitations and chronic conditions, while income is more strongly associated than education with the progression of both.
Early Childbearing, Marital Status, and Women's Health and Mortality after Age 50
Authors: Henretta John C.
Published: January 2010

This article examines the relationship between a woman's childbearing history and her later health and mortality, with primary focus on whether the association between them is due to early and later socioeconomic status. Data are drawn from the Health and Retirement Study birth cohort of 1931–1941. Results indicate that, conditional on reaching midlife and controlling for early and later socioeconomic status, a first birth before age 20 is associated with a higher hazard of dying. In addition, having an early birth is associated with a higher prevalence of reported heart disease, lung disease, and cancer in 1994. Being unmarried at the time of the first birth is associated with earlier mortality, but this association disappears when midlife socioeconomic status is controlled. The number of children ever born does not significantly affect mortality but is associated with prevalence of diabetes.
Creative Work and Health
Authors: Mirowsky John , Ross Catherine E.
Published: January 2010

Employees with greater control over their own activities have better health. People who are employed give up some control over their own activities for pay, yet employment is associated with better health. Perhaps paid jobs provide resources for productive self-expression that make up for the loss of autonomy. We find that paid employment is associated with lower autonomy but greater creativity of one's work or other main daily activities. Both have positive associations with health. Creativity's association is larger, more statistically significant, and found in follow-up models as well as cross-sectional ones. The health advantage of being at the 60th versus the 40th percentile of creative work is equivalent to that of being 6.7 years younger or having two more years of education or 15 times greater household income. Education reduces the amount of autonomy lost in employment. Managerial authority and occupational attributes influence autonomy and creativity but otherwise have little or no association with health.
Obesity and Hospitalization over the Adult Life Course: Does Duration of Exposure Increase Use?
Authors: Schafer Markus H. , Ferraro Kenneth F.
Published: January 2010

Consistent with a new genre of research on life-course analyses of health-service use, this study explores the consequences of long-term exposure to a risk factor. Drawing from cumulative-disadvantage theory, the study examines whether obesity, especially chronic obesity, increases hospitalization admission and length of stay. Analyses make use of hospital records abstracted over 20 years from a national survey of adults 41 to 77 years of age at baseline (n = 4,574). Multiple measures of body weight are used to calculate adult obesity duration. Results reveal that obesity increased hospital admissions and length of stay over the 20 years studied. Among persons obese at any time during the study, years of obesity also led to longer stays. The findings highlight the utility of measures of the duration of risk exposure for both life-course studies of health and tests of cumulative-disadvantage theory.
The Times They Are a Changin': Marital Status and Health Differentials from 1972 to 2003
Authors: Liu Hui , Umberson Debra J.
Published: January 2010

Although the meanings and rates of being married, divorced, separated, never-married, and widowed have changed significantly over the past several decades, we know very little about historical trends in the relationship between marital status and health. Our analysis of pooled data from the National Health Interview Survey from 1972 to 2003 shows that the self-rated health of the never-married has improved over the past three decades. Moreover, the gap between the married and the never married has steadily converged over time for men but not for women. In contrast, the self-rated health of the widowed, divorced, and separated worsened over time relative to the married, and the adverse effects of marital dissolution have increased more for women than for men. Our findings highlight the importance of social change in shaping the impact of marital status on self-reported health and challenge long-held assumptions about gender, marital status, and health.
The Making of the “Women's Physician” in American Obstetrics and Gynecology: Re-Forging an Occupational Identity and a Division of Labor
Authors: Zetka James R.
Published: January 2010

After struggling as a surgical specialty, obstetrics and gynecology initiated its “women's physician” program in the 1970s. This program officially defined the mostly male obstetricians and gynecologists at that time as women's primary care physicians. Using archival data, this article explains this development as a response to the specialty's dishonored position within the medical division of labor. Whatever else it was intended to be, the women's physician program, in its most developed form, aimed to galvanize the various interests within obstetrics and gynecology behind a strategy to restructure the medical division of labor serving women so that obstetricians and gynecologists controlled both the upstream positions responsible for their own case referrals and the downstream positions to which they referred their difficult cases. The article illustrates the importance of integrating insights from both macro-institutional and intra-occupational explanatory frameworks in accounting for significant developments in medicine.
Schisms in the Church: National Health Service Systems and Institutional Divergence in England and Wales
Authors: Hughes David , Vincent-Jones Peter
Published: January 2010

Since devolution, the four countries of the United Kingdom have pursued strikingly different National Health Service (NHS) reforms. While England created a supply-side market more radical than the previous internal market system, Wales moved to a softer version of the purchaser/provider split emphasizing localism. This article deploys institutional theory to analyze the forces shaping change, and describes the hybrid forms of economic organization emerging, including the economic regulation model implemented in England. The schism that has resulted in separate NHS subsystems warrants a different analysis from the more familiar phenomenon of infield divergence. We argue that schism was triggered by political-regulatory influences rather than economic or other social institutional forces, and predict that other decentralized public health care systems may follow a similar path. While political-regulatory, normative, and cognitive institutional influences push in the same direction in Wales, the misalignment of political-regulatory and normative elements in England looks set to result in a period of organizational turbulence.
The Role of Work Group in Individual Sickness Absence Behavior
Authors: Väänänen Ari , Tordera Nuria , Kivimäki Mika , Kouvonen Anne , Pentti Jaana , Linna Anne , Vahtera Jussi
Published: January 2010

The purpose of our two-year follow-up study was to examine the effect of the social components of the work group, such as group absence norms and cohesion, on sickness absence behavior among individuals with varying attitudes toward work attendance. The social components were measured using a questionnaire survey, and data on sickness absence behavior were collected from the employers' records. The study population consisted of 19,306 Finnish municipal employees working in 1,847 groups (78% women). Multilevel Poisson regression modeling was applied. The direct effects of work group characteristics on sickness absence were mostly insignificant. In contrast, both of the social components of a work group had an indirect impact: The more tolerant the group absence norms (at both individual- and cross-level) and the lower the group cohesion (at the individual level), the more the absence behavior of an individual was influenced by his or her attitude toward work attendance. We conclude that work group moderates the extent to which individuals with a liberal attitude toward work attendance actually engage in sickness absence behavior.
Mothers' Community Participation and Child Health
Authors: Nobles Jenna , Frankenberg Elizabeth
Published: January 2010

We use rich data from the Indonesia Family Life Survey to assess the relationship between mothers' access to social capital via participation in community activities and their children's health. We exploit the advantages of longitudinal data and community fixed effects to mitigate some of the concerns about spuriousness and reverse causality that predominate in this literature. We find that children from families with relatively low levels of human and financial capital fare better with respect to health status when their mothers are more active participants in community organizations. In fact, the association between maternal participation and child health is strong and positive only for children from relatively disadvantaged backgrounds, as measured by their mothers' educational and household economic resources. The results suggest that in poorer settings community involvement may benefit disadvantaged families, possibly by providing resources and information that would otherwise be inaccessible.
Social Disconnectedness, Perceived Isolation, and Health among Older Adults
Authors: Cornwell Erin York , Waite Linda J.
Published: January 2010

Previous research has identified a wide range of indicators of social isolation that pose health risks, including living alone, having a small social network, infrequent participation in social activities, and feelings of loneliness. However, multiple forms of isolation are rarely studied together, making it difficult to determine which aspects of isolation are most deleterious for health. Using population-based data from the National Social Life, Health, and Aging Project, we combine multiple indicators of social isolation into scales assessing social disconnectedness (e.g., small social network, infrequent participation in social activities) and perceived isolation (e.g., loneliness, perceived lack of social support). We examine the extent to which social disconnectedness and perceived isolation have distinct associations with physical and mental health among older adults. Results indicate that social disconnectedness and perceived isolation are independently associated with lower levels of self-rated physical health. However, the association between disconnectedness and mental health may operate through the strong relationship between perceived isolation and mental health. We conclude that health researchers need to consider social disconnectedness and perceived isolation simultaneously.
Pathways to Adult Marijuana and Cocaine Use: A Prospective Study of African Americans from Age 6 to 42
Authors: Fothergill Kate E. , Ensminger Margaret E. , Green Kerry M. , Robertson Judith A. , Juon Hee Soon
Published: January 2010

This study examines pathways to adult marijuana and cocaine use in a cohort of African Americans from Woodlawn, an inner city community in Chicago. Assessments were conducted in first grade (age 6), adolescence (age 16), early adulthood (age 32), and in mid-adulthood (age 42). The “social adaptation life course” framework guided the focus on social adaptation, social bonds, and economic resources as predictors of adult drug use. Results indicate that more frequent substance use in adolescence and lower-income and less-frequent church attendance in early adulthood increase the risk of mid-life drug use. Shyness in first grade related inversely to later cocaine use and marijuana use (marginally significant). Indirect pathways to drug use also were identified. Gender differences were not significant. The findings show continuities in social maladaptation over time and the importance of social integration and economic resources in the early adult years.
Development of Mastery during Adolescence: The Role of Family Problem-solving
Authors: Conger Katherine Jewsbury , Williams Shannon Tierney , Little Wendy M. , Masyn Katherine E. , Shebloski Barbara
Published: January 2010

A sense of mastery is an important component of psychological health and well-being across the life-span; however, relatively little is known about the development of mastery during childhood and adolescence. Utilizing prospective, longitudinal data from 444 adolescent sibling pairs and their parents, our conceptual model proposes that family socioeconomic status (SES) in the form of parental education promotes effective family problem-solving, which, in turn, fosters adolescent mastery. Results show: (1) a significant increase in mastery for younger and older siblings, (2) parental education promoted effective problem-solving between parents and adolescents and between siblings but not between the parents themselves, and (3) all forms of effective family problem-solving predicted greater adolescent mastery. Parental education had a direct effect on adolescent mastery as well as the hypothesized indirect effect through problem-solving effectiveness, suggesting both a social structural and social process influence on the development of mastery during adolescence.