Showing papers in "Journal of Health and Social Behavior in 2017"

Why Do College Graduates Behave More Healthfully than Those Who Are Less Educated

Abstract: College graduates live much healthier lives than those with less education, but research has yet to document with certainty the sources of this disparity. This study examines why U.S. young adults who earn college degrees exhibit healthier behavior than those with less education. I use data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), which offers information on education and health behaviors across adolescence and young adulthood (N=14,265). Accounting for selection into college degree attainment substantially reduces the associations between college degree attainment and health behavior, but college degree attainment demonstrates a strong causal effect on young adult health. Financial, occupational, social, cognitive, and psychological resources explain less than half of the association between college degree attainment and health behavior. The healthier behaviors of college graduates are the result of sorting into educational attainment, embedding of human capital, and mechanisms other than socioeconomic and psychosocial resources.

Emerging Adulthood, Emergent Health Lifestyles: Sociodemographic Determinants of Trajectories of Smoking, Binge Drinking, Obesity, and Sedentary Behavior.

Abstract: During the transition to adulthood, many unhealthy behaviors are developed that in turn shape behaviors, health, and mortality in later life. However, research on unhealthy behaviors and risky transitions has mostly focused on one health problem at a time. In this article, we examine variation in health behavior trajectories, how trajectories cluster together, and how the likelihood of experiencing different behavior trajectories varies by sociodemographic characteristics. We use the National Longitudinal Study of Adolescent Health (Add Health) Waves I to IV to chart the most common health behavior trajectories over the transition to adulthood for cigarette smoking, alcohol consumption, obesity, and sedentary behavior. We find that health behavior trajectories cluster together in seven joint classes and that sociodemographic factors (including gender, parental education, and race-ethnicity) significantly predict membership in these joint trajectories.

Couple-Level Minority Stress: An Examination of Same-Sex Couples’ Unique Experiences.

Abstract: Social stress resulting from stigma, prejudice, and discrimination-"minority stress"-negatively impacts sexual minority individuals' health and relational well-being. The present study examined how being in a same-sex couple can result in exposure to unique minority stressors not accounted for at the individual level. Relationship timeline interviews were conducted with 120 same-sex couples equally distributed across two study sites (Atlanta and San Francisco), gender (male and female), and relationship duration (at least six months but less than three years, at least three years but less than seven years, and seven or more years). Directed content analyses identified 17 unique couple-level minority stressors experienced within nine distinct social contexts. Analyses also revealed experiences of dyadic minority stress processes (stress discrepancies and stress contagion). These findings can be useful in future efforts to better understand and address the cumulative impact of minority stress on relational well-being and individual health.

Black Deaths Matter: Race, Relationship Loss, and Effects on Survivors:

Abstract: Close relationships are a resource for mental and physical health that, like other social resources, is unequally distributed in the population. This article focuses on racial disparities in the loss of relationships across the life course. Racial disparities in life expectancy in the United States mean that black Americans experience the deaths of more friends and family members than do white Americans from childhood through later life. I argue that these losses are a unique type of stress and adversity that, through interconnected biopsychosocial pathways, contribute to disadvantage in health over the life course. I focus particularly on how the interconnected pathways associated with loss undermine opportunities for and increase risks to social ties throughout life, adding to disadvantage in health. I call on social scientists and policy makers to draw greater attention to this unique source of disadvantage for black children, adults, and families.

Health Lifestyles in Adolescence and Self-rated Health into Adulthood.

Abstract: Do health behaviors cluster together as health lifestyles in adolescence? Are these lifestyles socially patterned? Do these lifestyles impact physical health into adulthood? To answer these questions, we employed data from Waves 1 and 4 of the National Longitudinal Study of Adolescent to Adult Health (n = 7,827). Our latent class analysis revealed four health lifestyles: (a) low risk, (b) moderate risk with substance use, (c) moderate risk with inactivity, and (d) high risk. As suggested by health lifestyle theory, membership in these classes varied according to gender, race-ethnicity, and family structure. Consistent with the life course perspective, regression analyses indicated that those in the high-risk lifestyle tend to exhibit worse health in adolescence and adulthood than those in the low-risk lifestyle. Our findings confirm that socially patterned lifestyles can be observed in adolescence, and these lifestyles are potentially important for understanding the distribution of physical health across ...

Race, Socioeconomic Position, and Physical Health: A Descriptive Analysis.

Abstract: A substantial and long-standing body of research supports the widely held conclusion that socioeconomic position (SEP) is a primary determinant of physical health risk. However, supporting evidence derives almost entirely from studies of dominantly white populations, and more recent research suggests that this relationship may vary across race-ethnicity. This article considers the extent to which such evidence applies to African Americans. It does so by examining the within-race relationships between SEP and physical health utilizing alternative research definitions of health and a nearly exhaustive array of measures of SEP. The results offer minimal support for SEP as a fundamental cause of disease among African Americans. They do not challenge the widely held view that health differences are rooted in the fundamental conditions of social context and experience. Rather, they indicate that these conditions tend to be defined more by being black than by being of lower SEP.

Working Hours Mismatch, Macroeconomic Changes, and Mental Well-being in Europe:

Abstract: This study explores the association between involuntarily working less or more than the standard workweek and poor mental well-being, and whether this relationship is dependent upon (changing) national-level unemployment and gross domestic product growth rates. Data from the European Social Survey Round 2 (2004-2005) and Round 5 (2010) were analyzed. The sample included 16,224 male and 16,184 female employees. Mental well-being was assessed by the World Health Organization Well-being Index. Three-level linear multilevel modeling was used to account for clustering of employees within research years and countries. Working involuntary long hours was positively associated with poor mental well-being for men. For women, working voluntary long, involuntary long, and involuntary short hours were positively associated with poor mental well-being. The mental well-being of women working voluntary and involuntary long hours was negatively influenced by deteriorating economic conditions. This study suggests women are more vulnerable to the effects of long working hours and working hours mismatch on mental well-being, especially during difficult economic periods.

Children’s Education and Parents’ Trajectories of Depressive Symptoms:

Abstract: Using five waves of the Taiwanese Longitudinal Study of Aging (1996–2011), we investigate (1) the association between family members’ education and the age trajectories of individuals’ depressive s...

Contesting and Differentially Constructing Uncertainty: Negotiations of Contraceptive Use in the Clinical Encounter.

Abstract: Most women of reproductive age have access to highly effective contraception, and all available methods are associated with side effects. Whether a woman will experience side effects is uncertain, however, which can pose challenges for clinicians who discuss the methods with patients. In this study, we analyze 102 contraceptive counseling visits to understand how clinicians discursively construct knowledge in the context of uncertainty. We find that while some present the uncertainty of side effects in a straightforward, patient-accessible way, others negotiate their predictions by (1) differentially constructing uncertainty, suggesting that positive side effects are likely and negative side effects are unlikely, and (2) contesting uncertainty, presenting the risk of serious side effects as controllable. In the end, these strategies deemphasize consideration of negative side effects in women's contraceptive decision making. Our results demonstrate the importance of elucidating the translation, instantiation, and construction of medical uncertainty both in theory and in practice.

Depression, Work and Family Roles, and the Gendered Life Course:

Abstract: Despite the importance of employment for shaping mental health over the life course, little is known about how the mental health benefits of employment change as individuals age through their prime employment and child-rearing years. This study examines the National Longitudinal Survey of Youth, 1979 Cohort ( N = 8,931), following respondents from their late 20s to mid-50s. Results suggest that among women, the aging of children is especially salient for shaping the mental health consequences of employment. Young children diminish the protective effect of mothers' full- and part-time employment, but the salubrious effects of paid work increase as children get older. The benefit of employment for men's mental health also changes over time, but it is the aging of men themselves rather than their children that alters the magnitude of full-time employment's protective effect. Findings suggest the contribution of employment to life course mental health remains tethered to traditional gender roles.

A Twin Study on Perceived Stress, Depressive Symptoms, and Marriage.

Abstract: Marriage is associated with reductions in both perceived stress and depressive symptoms, two constructs found to be influenced by common genetic effects. A study of sibling twins was used to test whether marriage decreases the proportion of variance in depressive symptoms accounted for by genetic and environmental effects underlying perceived stress. The sample consisted of 1,612 male and female twin pairs from the University of Washington Twin Registry. The stress-buffering role of marriage was tested relative to two unmarried groups: the never married and the divorced. Multivariate twin models showed that marriage reduced genetic effects of perceived stress on depressive symptoms but did not reduce environmental effects. The findings suggest a potential marital trade-off for women: access to a spouse may decrease genetic effects of perceived stress on depressive symptoms, although marital and family demands may increase environmental effects of perceived stress on depressive symptoms.

Culture, Styles of Institutional Interactions, and Inequalities in Healthcare Experiences.

Abstract: In this study, I examine how parents’ cultural knowledge shapes experiences navigating the healthcare system after a child is diagnosed with cancer and the extent to which differential styles of he...

Social Disadvantage, Severe Child Abuse, and Biological Profiles in Adulthood.

Abstract: Guided by the stress process model and the life course perspective, we hypothesize: (1) that childhood abuse is concentrated, in terms of type and intensity, among socially disadvantaged individuals, and (2) that experiencing serious abuse contributes to poor biological profiles in multiple body systems in adulthood. Data came from the Biomarker subsample of Midlife in the United States (2004–2006). We used latent class analysis to identify distinct profiles of childhood abuse, each reflecting a combination of type and severity. Results indicate that disadvantaged groups, women, and those from disadvantaged families are at greater risk of experiencing more severe and multiple types of abuse. Those with more severe and multifaceted childhood abuse show greater physiological dysregulation. Childhood abuse experiences partially accounted for the social status differences in physiological profiles. Our findings underscore that differential exposure to serious childhood stressors plays a significant role in ge...

Planning for Future Care and the End of Life: A Qualitative Analysis of Gay, Lesbian, and Heterosexual Couples.

Abstract: Two key components of end-of-life planning are (1) informal discussions about future care and other end-of-life preferences and (2) formal planning via living wills and other legal documents. We le...

Insecure People in Insecure Places: The Influence of Regional Unemployment on Workers’ Reactions to the Threat of Job Loss

Abstract: Social comparison theory predicts that unemployment should be less distressing when the experience is widely shared, but does this prediction extend beyond the unemployed to those who are at risk o...

Disability and Activity-related Emotion in Later Life: Are Effects Buffered by Intimate Relationship Support and Strain?

Abstract: We use daily diary data from the Disability and Use of Time supplement to the 2013 Panel Study of Income Dynamics ( n = 1,162) to evaluate (1) the extent to which marital/partner support and strain moderate the effects of disability on five activity-related emotions (happiness, calm, sadness, frustration, worry) and overall negative and positive emotion among older married, cohabiting, and dating persons and (2) whether such patterns differ significantly by gender. Marital support buffers against negative emotions and increases feelings of calm among severely impaired women. By contrast, support intensifies negative emotions and decreases feelings of calm among severely impaired men. Relationship strain also intensifies the effect of severe impairment on men's frustration, sadness, worry, and negative mood but has negligible effects on the negative emotions of men with low impairment and women. Frequent support and criticism may threaten highly impaired older men's sense of autonomy and emotional well-being.

A Global Perspective on Religious Participation and Suicide.

Abstract: Although sociological research in the Durkheimian tradition has generally accepted that religious involvement protects against suicide, few studies have examined this theoretical proposition outside Western industrialized settings. Using multilevel models to analyze data from the World Health Organization Mortality Database and the World Values Survey (1981-2007) across 42 countries in seven geographical-cultural regions, this study explores whether religious participation is more protective against suicide in some regions than others and, if so, why. Results indicate that while religious participation is protective in Latin America, eastern Europe, northern Europe, and English-speaking countries, it may aggravate the risk of suicide in East Asia, western Europe, and southern Europe. This regional variation is the result of differences in both the degree of integration/regulation of religious communities and suicide underreporting. Overall, the findings support the network perspective of Durkheim's classical theory and suggest that researchers should be more cautious about suicide underreporting in less industrialized settings.

Children’s Sense of Control as a Determinant of Adult Health: Causation, Mediation, and Spuriousness:

Abstract: Previous research suggests higher levels of education instill a greater sense of internal control that promotes health in adulthood. We propose that the sense of control has its origins in early childhood and that prior research has possibly misattributed a mediational role to sense of control in adulthood. Using a conceptual framework that includes these early influences, we employ data from the 1970 British Cohort Study ( N = 9,855), examining the extent to which the association between education and adult health is spurious due to these early childhood factors. We find that the internal sense of control as assessed in childhood and adolescence has profound influences on both education and health in early adulthood and that a substantial portion of the latter association is spurious. We conclude that the sense of control is an important health-related factor originating early in life, influencing both health and education later in adulthood.

College-going and Trajectories of Drinking from Adolescence into Adulthood:

Abstract: To explore an exception to the association between educational attainment and health, this study unpacked variability in the drinking of U.S. college students by applying life course concepts to an...

Are You Still Bringing Me Down?: Romantic Involvement and Depressive Symptoms from Adolescence to Young Adulthood

Abstract: Romantic involvement and mental health are dynamically linked, but this interplay can vary across the life course in ways that speak to the social and psychological underpinnings of healthy development. To explore this variation, this study examined how romantic involvement was associated with trajectories of depressive symptomatology across the transition between adolescence and young adulthood. Growth mixture modeling of data from the National Longitudinal Study of Adolescent to Adult Health identified trajectories of depressive symptomatology as teens grew into their late 20s and early 30s (N = 8,712). Multinomial logistic techniques regressed these trajectories on adolescent and young adult romantic experiences. Adolescent dating was associated with increased depressive symptoms early on, particularly for girls, but this risk faded over time. For both boys and girls, trajectories of decreasing symptoms were associated with young adult unions but also the coupling of adolescent dating with young adult ...

The Spillover of Genomic Testing Results in Families: Same Variant, Different Logics.

Abstract: Due to heritability, next-generation genetic tests have the potential to affect family members beyond the patient being tested. Geneticists and genetic counselors, in dialogue with patients and their relatives, will need to establish for whom and in what way genomic testing results matter during the communication of testing results, indicating the spillover of presumed pathological variants. On the basis of video-recorded consultations of the return of exome results in a genetics clinic, we distinguish three different logics deployed to explain the relevance of the findings for the patient, extended family members, and unborn relatives. While geneticists tend to be cautious in interpreting findings for the patient and living relatives, the findings become more deterministic in the context of reproductive decision making. The presentation of results then establishes the causal role of variants and reflects back on disability as a state to be prevented, in the process establishing genetic ties between kin.

The Institutional Foundations of Medicalization: A Cross-national Analysis of Mental Health and Unemployment

Abstract: In this study, we question (1) whether the relationship between unemployment and mental healthcare use, controlling for mental health status, varies across European countries and (2) whether these differences are patterned by a combination of unemployment and healthcare generosity. We hypothesize that medicalization of unemployment is stronger in countries where a low level of unemployment generosity is combined with a high level of healthcare generosity. A subsample of 36,306 working-age respondents from rounds 64.4 (2005-2006) and 73.2 (2010) of the cross-national survey Eurobarometer was used. Country-specific logistic regression and multilevel analyses, controlling for public disability spending, changes in government spending, economic capacity, and unemployment rate, were performed. We find that unemployment is medicalized, at least to some degree, in the majority of the 24 nations surveyed. Moreover, the medicalization of unemployment varies substantially across countries, corresponding to the combination of the level of unemployment and of healthcare generosity.

Interdependent Career Types and Divergent Standpoints on the Use of Advanced Technology in Medicine.

Abstract: This paper uses the case of the uneven use of a robotic technology to explain how physicians with similar training come to engage in different medical practices. I develop a conceptual framework in...

The Association between Education and Mortality for Adults with Intellectual Disability.

Abstract: Although the relationship between education and mortality is well documented in the general population, it has not been examined for adults with intellectual disability. Informed by fundamental cause theory, I explore the association between education and mortality in a sample of 4,241 adults with intellectual disability from the 1986-2009 National Health Interview Survey with Linked Mortality Files through 2011. Cox regression models were utilized to analyze the predictive effect of education on mortality risk while taking into account birth cohort differences. Increased education was associated with lower mortality risk for adults with intellectual disability, and this relationship strengthened in later birth cohorts who had greater access to the public education system. Comparison with a sample of 21,205 adults without intellectual disability demonstrates that the association between education and mortality risk was not as robust for adults with intellectual disability and highlights the ongoing socioeconomic challenges faced by this population.

Cultural Guides, Cultural Critics: Distrust of Doctors and Social Support during Mental Health Treatment.

Abstract: Research on relationships and health often interprets culture as the passively transmitted “content” of social ties, an approach that overlooks the influence of cultural resources on relationships themselves. I propose that mental health patients seek social support partly based on cultural resources held by their network members, including members’ medical knowledge and beliefs. I test hypotheses using data from the Indianapolis Network Mental Health Study, an egocentric network survey of new mental health patients (N = 152) and their personal relationships (N = 1,868). Results from random-intercept regressions show that patients obtain support from network members who trust doctors and who have experience with mental problems. In contrast, network members who distrust doctors disproportionately cause problems for patients. I discuss how cultural resources can categorize network members as supportive cultural guides or disruptive cultural critics. Reconsidering how culture shapes relationships clarifies ...

Resisting Throughput Pressures: Physicians’ and Patients’ Strategies to Manage Hospital Discharge

Abstract: In recent years, quickly discharging patients has become a collective goal at hospitals, as excessive medical workups and extended hospital stays have been associated with unnecessary healthcare spending. Physicians, however, frequently encounter numerous barriers when trying to discharge patients. Presenting ethnographic and interview data collected from September 2010 to September 2013, this paper examines one of the most difficult discharge cases physicians encounter on the internal medicine service at a U.S. teaching hospital: resistant patients-patients and families who refuse to leave the hospital. As physicians try to discharge resistant patients, they are met with conflicting financial and professional incentives. Drawing from the sociological literature on professions, managerialism, and consumerism, I analyze the strategies physicians develop to manage these difficult discharge cases.

Beyond Health Effects?: Examining the Social Consequences of Community Levels of Uninsurance Pre-ACA.

Abstract: The lack of health insurance is traditionally considered a problem faced by individuals and their families. However, because of the geographically bounded organization and funding of healthcare in the United States, levels of uninsurance in a community may affect everyone living there. Health economists have examined how the effects of uninsurance spillover from the uninsured to the insured, negatively affecting healthcare access and quality for the insured. We extend research on uninsurance into the domain of sociologists by theorizing how uninsurance might exacerbate social inequalities and undermine social cohesion within communities. Using data from the Los Angeles Family and Neighborhood Survey, we show that individuals living in communities with higher levels of uninsurance report lower social cohesion net of other individual and neighborhood factors and discuss implications for implementation of the Affordable Care Act.

Social Context, Biology, and the Definition of Disorder.

Abstract: In recent years, medical sociologists have increasingly paid attention to a variety of interactions between social and biological factors. These include how social stressors impact the functioning of physiological systems, how sociocultural contexts trigger genetic propensities or mitigate genetic defects, and how brains are attuned to social, cultural, and interactional factors. This paper focuses on how both sociocultural and biological forces influence what conditions are contextually appropriate responses or disorders. It also suggests that some of the most obdurate health problems result from mismatches between natural genes and current social circumstances rather than from genetic defects. Finally, it examines how social environments have profound impacts on how much harm disorders create. It shows how sociological insights can help establish valid criteria for illnesses and indicates the complexities involved in defining what genuine disorders are.

Trading Equality for Health? Evaluating the Trade-off and Institutional Hypotheses on Health Inequalities in the Global South:

Abstract: It has been suggested that as medicine advances and mortality declines, socioeconomic disparities in health outcomes will grow. Yet, most research on this topic uses data from affluent Western democracies, where mortality is declining in small increments. We argue that the Global South represents the ideal setting to study this issue in a context of rapid mortality decline. We evaluate two competing hypotheses: (1) there is a trade-off between population health and health inequality such that reductions in under-five mortality are linked to higher levels of social inequality in health; and (2) institutional interventions that improve under-five mortality, like the expansion of educational systems and public health expenditure, are associated with reductions in inequalities. We test these hypotheses using data on 1,369,050 births in 34 low-income countries in the Demographic and Health Surveys from 1995 to 2012. The results show little evidence of a health-for-equality trade-off and instead support the ins...

Community Context and Child Health: A Human Capital Perspective.

Abstract: Human capital theory suggests that education benefits individuals’ and their children’s health through the educational skills people acquire in school. This perspective may also be relevant at the community level: the greater presence of adults with educational skills in a community may be a reason why living in a more highly educated setting benefits health. I use Demographic and Health Survey data for 30 sub-Saharan African countries to investigate whether the percentage of literate adults—specifically women—in a community is associated with children’s likelihood of survival. I characterize 13,785 African communities according to the prevalence of women who are literate. Multilevel discrete-time hazard models (N = 536,781 children) confirm that living in a community where more women are literate is positively associated with child survival. The study supports the conceptualization of literacy, and potentially other educational skills, as forms of human capital that can spill over to benefit others.