Showing papers in "Journal of Health and Social Behavior in 2019"
TL;DR: Findings indicate higher disability, depressive, metabolic, and inflammatory risk for Hispanics relative to whites and similar health profiles among Hispanics and blacks and limited evidence of a healthy immigrant pattern among foreign-born Hispanics.
Abstract: Though Hispanics live long lives, whether a "Hispanic paradox" extends to older-age health remains unclear, as do the social processes underlying racial-ethnic and immigrant-native health disparities. Using data from the Health and Retirement Study (2004-2012; N = 6,581), we assess the health of U.S.- and foreign-born Hispanics relative to U.S.-born whites and blacks and examine the socioeconomic, stress, and behavioral pathways contributing to health disparities. Findings indicate higher disability, depressive, metabolic, and inflammatory risk for Hispanics relative to whites and similar health profiles among Hispanics and blacks. We find limited evidence of a healthy immigrant pattern among foreign-born Hispanics. While socioeconomic factors account for Hispanic-white gaps in inflammation, disparities in other outcomes persist after adjustment for socioeconomic status, due in part to group differences in stress exposure. Hispanics may live long lives, but their lives are characterized by more socioeconomic hardship, stress, and health risk than whites and similar health risks as blacks.
63 citations
TL;DR: The results demonstrate that multiple measures of gender allow researchers to disentangle how health is not only shaped by gender enactments but also shapes perceptions of gender and gender difference.
Abstract: This study leverages multiple measures of gender from a US national online survey (N = 1,508) to better assess how gender is related to self-rated health. In contrast to research linking feminine behaviors with good health and masculine behaviors with poor health, we find that masculinity is associated with better self-rated health for cisgender men, whereas femininity is associated with better self-rated health for cisgender women. The patterns are similar whether we consider self-identification or how people feel others perceive their gender, though reflected appraisals are most strongly associated with health for cisgender women. We also find that people who report they are seen as gender nonconforming report worse health, but only when this perception does not match their gender identification. Our results demonstrate that multiple measures of gender allow researchers to disentangle how health is not only shaped by gender enactments but also shapes perceptions of gender and gender difference.
60 citations
TL;DR: This article draws upon interview data with medical educators and students to detail how medical educators routinely offload the instruction on the social underpinnings and consequences of race onto students, particularly students of color.
Abstract: In their attempt to address racial disparities in the provision of healthcare, the U.S. medical profession has reproduced racial inequalities of their own. In this article, I draw upon interview data with medical educators and students to detail how medical educators routinely offload the instruction on the social underpinnings and consequences of race onto students, particularly students of color. I develop the concept of the conscripted curriculum to capture how students' social identities are utilized by educators in the professionalization process. While there are exceptions in curricular approaches, most educators create the conscripted curriculum by eliciting students to share their social experiences with race in the small group setting while only providing students with didactic material on biological understandings of race. As a result, students of color report experiencing more emotionally exhausting and unrewarded labor than their white peers, and educators further devalue the social implications of race for healthcare.
46 citations
TL;DR: Using census and Vital Statistics data, life-table methods are applied to calculate cause-specific years of life lost between ages 25 and 84 by sex and educational rank for non-Hispanic blacks and whites in 1990 and 2015, which underline the speculative nature of attempts to attribute trends in life-expectancy inequity to an epidemic of despair.
Abstract: Discussion of growing inequity in U.S. life expectancy increasingly focuses on the popularized narrative that it is driven by a surge of "deaths of despair." Does this narrative fit the empirical evidence? Using census and Vital Statistics data, we apply life-table methods to calculate cause-specific years of life lost between ages 25 and 84 by sex and educational rank for non-Hispanic blacks and whites in 1990 and 2015. Drug overdoses do contribute importantly to widening inequity for whites, especially men, but trivially for blacks. The contribution of suicide to growing inequity is unremarkable. Cardiovascular disease, non-lung cancers, and other internal causes are key to explaining growing life expectancy inequity. Results underline the speculative nature of attempts to attribute trends in life-expectancy inequity to an epidemic of despair. They call for continued investigation of the possible weathering effects of tenacious high-effort coping with chronic stressors on the health of marginalized populations.
45 citations
TL;DR: An integrated theory about contextual factors in FGMC is proposed and tested using multilevel discrete-time hazard models in a nationally representative sample of 7,535 women with daughters who participated in the 2014 Kenya Demographic and Health Survey, finding that a daughter’s adjusted hazard of FGMC was lower if she had an uncut mother who disfavored FGMC and lived in a community that was more opposed to FGMC.
Abstract: Female genital mutilation/cutting (FGMC) is a human rights violation with adverse health consequences. Although prevalence is declining, the practice persists in many countries, and the individual ...
30 citations
TL;DR: As work–family conflict has become a fact of life for many contemporary workers, the results contribute by highlighting the importance of using couple-level data and testing longitudinal crossover effects to provide a fuller understanding of such conflict's health consequences.
Abstract: This study examines dual-earner couples to determine whether changes in work-family conflict predict changes in one's own (i.e., actor effects) or partner's (i.e., partner effects) health and well-being as well as gender differences in these relationships. Using data from 1,001 dual-earner couples in Wave 6 and Wave 8 of the German Family Panel survey (Pairfam), we found (1) significant actor effects for all outcomes, with stronger actor effects among men than women on mental health; (2) significant partner effects for life satisfaction and mental health, with stronger partner effects among men than women on life satisfaction; and (3) stronger actor effects than corresponding partner effects for life satisfaction and mental health. As work-family conflict has become a fact of life for many contemporary workers, our results contribute by highlighting the importance of using couple-level data and testing longitudinal crossover effects to provide a fuller understanding of such conflict's health consequences.
29 citations
TL;DR: The 1998-to-2014 Health and Retirement Study was used to evaluate how the levels of depressive symptoms changed following gray divorce versus widowhood, and both the negative consequences of marital dissolution and the beneficial effects of repartnership for mental health persisted for several years.
Abstract: The doubling of the divorce rate among individuals over age 50 during the past 20 years underscores the urgency of studying the consequences of gray divorce and subsequent repartnering for adult well-being. We filled this gap by using the 1998-to-2014 Health and Retirement Study to evaluate how the levels of depressive symptoms changed following gray divorce versus widowhood. Individuals who divorced or became widowed already had experienced higher levels of depressive symptoms before dissolution relative to those who remained married. Compared with those who became widowed, those who transitioned to divorce experienced a lower elevation and a shorter time to recovery in depressive symptoms. When repartnering, both groups experienced similar magnitudes of initial reduction and subsequent rates of increase. Both the negative consequences of marital dissolution and the beneficial effects of repartnership for mental health persisted for several years, although ultimately they reverted to their predissolution levels of depressive symptoms.
29 citations
TL;DR: It is found that children who report more frequent instances of discrimination have mothers whose self-rated health declines more rapidly between ages 40 and 50 years, and it is concluded that the negative health impacts of discrimination are likely to operate in a bidirectional fashion across key family relationships.
Abstract: A growing body of research suggests that maternal exposure to discrimination helps to explain racial disparities in children’s health. However, no study has considered if the intergenerational heal...
26 citations
TL;DR: In the full model, it is shown that self-esteem and stress exposure offset each other, resulting in a null association between race and mood disorders and a reduced association betweenrace and distress.
Abstract: The tendency for blacks to report similar or better mental health than whites has served as an enduring paradox in the mental health literature for the past three decades. However, a debate persists about the mechanisms that underlie this paradox. Drawing on the stress process framework, we consider the counterbalancing roles of self-esteem and traumatic stress exposure in understanding the "black-white paradox" among U.S. adolescents. Using nationally representative data, we observe that blacks have higher levels of self-esteem than whites but also encounter higher levels of traumatic stress exposure. Adjusting for self-esteem reveals a net higher rate of mood disorders and distress among blacks relative to whites, and differences in traumatic stress exposure mediate this association. In the full model, we show that self-esteem and stress exposure offset each other, resulting in a null association between race and mood disorders and a reduced association between race and distress.
23 citations
TL;DR: C cumulative exposure to racial discrimination and bullying victimization had incremental negative effects on socioemotional difficulties and higher accumulated exposure to both stressors across time was associated with increased body mass index z-scores and risk of overweight/obesity.
Abstract: This study examined how cumulative exposure to racial discrimination and bullying victimization influences the health of Australian adolescents (n = 2802) aged 10 to 11 years (19.3% visible ethnic minorities [nonwhite, non-Indigenous]; 2.6% Indigenous) using data from three waves (2010-2014) of the nationally representative Longitudinal Study of Australian Children (LSAC). Cumulative exposure to racial discrimination and bullying victimization had incremental negative effects on socioemotional difficulties. Higher accumulated exposure to both stressors across time was associated with increased body mass index z-scores and risk of overweight/obesity. Studies that examine exposure to single risk factors such as bullying victimization or racial discrimination at one time point only are likely to miss key determinants of health for adolescents from stigmatized racial-ethnic backgrounds and underestimate their stressor burden.
23 citations
TL;DR: Using data on 3,159 mothers from the National Longitudinal Survey of Youth 1979 in a series of lagged dependent variable regression models, it is found that a child’s incarceration is associated with declines in maternal health between ages 40 and 50.
Abstract: Parents' relationships with their adult children play an important role in shaping mid and later life health. While these relationships are often sources of support, stressors in the lives of children can compromise parents' health as they age. I consider that a child's incarceration is also a stressor that could imperil parents' health through social, emotional, and economic strains that parents may experience as a result. Using data on 3,159 mothers from the National Longitudinal Survey of Youth 1979 in a series of lagged dependent variable regression models, I find that a child's incarceration is associated with declines in maternal health between ages 40 and 50. These associations are largest for mothers who had grandchildren by their child at the time of the child's incarceration. I close by discussing the implications of child incarceration for intergenerational ties and other social determinants of midlife health.
TL;DR: A typology of attribution is presented, which demonstrates that patients’ attributions of responsibility to staff and/or to patients are informed by two dimensions of responsibility: basis and contingency.
Abstract: This study examines how patients conceptualize "responsibility" for their healthcare and make sense of the complex boundaries between patient and professional roles. Focusing on the specific case of patient safety, narrative methods were used to analyze semistructured interviews with 28 people recently discharged from hospital in England. We present a typology of attribution, which demonstrates that patients' attributions of responsibility to staff and/or to patients are informed by two dimensions of responsibility: basis and contingency. The basis of responsibility is the reason for holding an individual or group responsible. The contingency of responsibility is the extent to which that attribution is contextually situated. The article contributes to knowledge about responsibility in complex organizational environments and offers a set of conceptual tools for exploring patients' understanding of responsibility in such contexts. There are implications for addressing patient engagement in care, within and beyond the field of patient safety.
TL;DR: It is suggested that school advantage is a developmental context of adolescence that has modest implications for intracohort differences in aspects of later life cognition.
Abstract: To advance understanding of how social inequalities from childhood might contribute to cognitive aging, we examined the extent to which school context in adolescence was associated with individuals' cognitive performance more than 50 years later. Using data from 3,012 participants in the Wisconsin Longitudinal Study (WLS), we created an aggregate measure of school-level structural advantage, with indicators such as the proportion of teachers who had at least five years of teaching experience and spending per pupil. Multilevel models indicated that secondary school advantage was associated with small benefits in language/executive function at age 65 among older adults who had lower academic achievement in secondary school. Findings suggest that school advantage is a developmental context of adolescence that has modest implications for intracohort differences in aspects of later life cognition.
TL;DR: The analysis finds that the American medical profession, unlike its British counterpart, focused on defending private medicine rather than protecting its power to “diagnose” the medical necessity of abortions, and that constitutionalism promoted rights discourses that partially crowded out medical ones.
Abstract: Comparative-historical research on medicalization is rare and, perhaps for that reason, largely ignores political institutions, which tend to vary more across countries than within them. This article proposes a political-institutional theory of medicalization in which health care policy legacies, political decentralization, and constitutionalism shape the preferences, discourses, strategies, and influence of actors that seek or resist medicalization. The theory helps explain why abortion has been more medicalized in Britain than the United States. The analysis finds that the American medical profession, unlike its British counterpart, focused on defending private medicine rather than protecting its power to "diagnose" the medical necessity of abortions; that American political decentralization aided the establishment of abortion on request by encouraging strategic innovation and learning that shaped social movement strategies, medical issue avoidance, and the growth of nonhospital clinics; and finally, that constitutionalism promoted rights discourses that partially crowded out medical ones.
TL;DR: While Hispanics with strong attitudes toward familial support have fewer symptoms of depression and anxiety, those who report high referent familism display worse mental health outcomes, and the results challenge assumptions thatfamilism is responsible for the comparably better health of foreign-born Hispanics.
Abstract: It is well known that Hispanic immigrants exhibit better physical and mental health than their U.S.-born counterparts. Scholars theorize that stronger orientations toward the family, also known as familism, could contribute to this immigrant advantage. Yet, little work directly tests whether familial attitudes may be responsible for the favorable health of foreign-born Hispanics. We investigate this possibility using biomarkers, anthropometrics, and mental health assessments from the Hispanic Community Health Study/Study of Latinos (N = 4,078). Results demonstrate that the relationship between familial attitudes and health vary depending on the outcome assessed. While Hispanics with strong attitudes toward familial support have fewer symptoms of depression and anxiety, those who report high referent familism display worse mental health outcomes. We find little evidence that familism is linked to physical health or that immigrant generation moderates the relationship of interest. Our results challenge assumptions that familism is responsible for the comparably better health of foreign-born Hispanics.
TL;DR: It is found that higher childhood SES leads to slower cognitive decline, partially due to lower levels of cardiometabolic risk, however, these pathways operate entirely through adult socioeconomic attainment.
Abstract: Socioeconomic conditions in childhood predict cognitive functioning in later life. It is unclear whether poor childhood socioeconomic status (SES) also predicts the acceleration of cognitive decline. One proposed pathway is via cardiometabolic risk, which has been linked to both childhood SES and earlier onset of cognitive impairment. Using data from the Health and Retirement Study, we examine the impact of childhood SES on cognitive trajectories over six years and test whether it operates through increased cardiometabolic risk and adult SES. We find that higher childhood SES leads to slower cognitive decline, partially due to lower levels of cardiometabolic risk. However, these pathways operate entirely through adult socioeconomic attainment. The results have important implications for future trends in cognitive population health within the context of growing social inequality and reduced social mobility.
TL;DR: It is found that women are more strongly influenced by their partners’ distress than men, regardless of whether they are married to a man or a woman, and that this relationship is particularly strong for women with male spouses.
Abstract: Ample work stresses the interdependence of spouses’ psychological distress and that women are more influenced by their spouse’s distress than men. Yet previous studies have focused primarily on het...
TL;DR: Results showed how social and practical concerns explain donors’ decisions to donate blood after the occurrence of life events, and theoretical implications for further studies on prosocial and health-related behavior are discussed.
Abstract: This article examines how blood donation loyalty changes across the life course as a result of life events. Previous studies have shown that life events affect involvement in prosocial behavior, po...
TL;DR: The present study extends prior research on the links between social adversity and aging by employing more comprehensive measures of adversity and a new gene expression index of aging to test models regarding the impact of social adversity on speed of aging.
Abstract: The present study extends prior research on the links between social adversity and aging by employing more comprehensive measures of adversity and a new gene expression index of aging. Hierarchical regression and 20 years of data from a sample of 381 black Americans were used to test models regarding the impact of social adversity on speed of aging. Consistent with the early life sensitivity model, early adversity continued to predict accelerated aging after controlling for adult adversity. Contrary to the pathway model, adult adversity was not related to aging following controls for early adversity. The cumulative stress model received partial support as high adversity during adulthood amplified the effect of early adversity on aging. Finally, consonant with the social change model, low adversity during adulthood buffered the effect of early adversity on aging. These findings held after controlling for health behaviors such as smoking, diet, and exercise.
TL;DR: Investigation of the relationship between parent–adult child coresidence and parental mental health among U.S. adults ages 50+, distinguishing between parents stably living with and without adult children and those who transitioned into or out of coresidence with an adult child finds that transitions to coresidence that occurred in the southern United States or involved out-of-work children were particularly depressing for parents.
Abstract: Although many studies have examined contemporary increases in parent-adult child coresidence, questions about what this demographic shift means for the well-being of parents remain. This article draws on insights from the life course perspective to investigate the relationship between parent-adult child coresidence and parental mental health among U.S. adults ages 50+, distinguishing between parents stably living with and without adult children and those who transitioned into or out of coresidence with an adult child. Based on analyses of the 2008 to 2012 waves of the Health and Retirement Study (N = 11,277), parents with a newly coresidential adult child experienced an increase in depressive symptoms relative to their peers without coresidential adult children. Further analyses suggest that transitions to coresidence that occurred in the southern United States or involved out-of-work children were particularly depressing for parents. These findings highlight the significance of evolving intergenerational living arrangements for the well-being of older adults.
TL;DR: The authors used longitudinal qualitative data, including participant observation and semistructured interviews with workers within hospice care as their organizations shifted in response to a Medicare policy change, finding that the main innovation of hospice-the interdisciplinary team-is able to resist logics from the larger medical institution.
Abstract: There is no doubt that the organization of healthcare is currently shifting, partly in response to changing macrolevel policies. Studies of healthcare policies often do not consider healthcare workers' experiences of policy change, thus limiting our understanding of when and how policies work. This article uses longitudinal qualitative data, including participant observation and semistructured interviews with workers within hospice care as their organizations shifted in response to a Medicare policy change. Prior to the policy change, I find that the main innovation of hospice-the interdisciplinary team-is able to resist logics from the larger medical institution. However, when organizational pressures increase, managers and workers adjust in ways that reinforce medical logics and undermine the interdisciplinary team. These practices illustrate processes by which rationalization of healthcare affects workers' experiences and the type of care available to patients.
TL;DR: The official postmarketing system of PV is juxtapose with firsthand accounts of ADRs as found in 60 YouTube vlogs created by 29 individuals who recount debilitating reactions to fluoroquinolones, a common class of antibiotics.
Abstract: Sociologists have documented how the pharmaceutical industry has corrupted pharmacovigilance (PV), defined as the practices devoted to detecting and preventing adverse drug reactions (ADRs). In thi...
TL;DR: There are differences in peer effects on smoking initiation across schools that will be important to account for in network-based smoking interventions.
Abstract: This study uses recent data to investigate if smoking initiation diffuses through friendship networks over the high school period and explores if diffusion processes differ across schools. One thousand four hundred and twenty-five racially and ethnically diverse youth from four high schools in Los Angeles were surveyed four times over the high school period from 2010 to 2013. Probit regression models and stochastic actor-based models for network dynamics tested for peer effects on smoking initiation. Friend smoking was found to predict adolescent smoking, and smoking initiation diffused through friendship networks in some but not all of the schools. School differences in smoking rates and the popularity of smokers may be linked to differences in the diffusion of smoking through peer networks. We conclude that there are differences in peer effects on smoking initiation across schools that will be important to account for in network-based smoking interventions.
TL;DR: Analysis of 25 years of nationally representative panel data from the National Longitudinal Study of Youth indicates that adverse childhood experiences predict earlier age at first birth and greater odds of having a nonmarital first birth.
Abstract: Adverse childhood experiences (ACEs) have powerful consequences for health and well-being throughout the life course. We draw on evidence that exposure to ACEs shapes developmental processes central to emotional regulation, impulsivity, and the formation of secure intimate ties to posit that ACEs shape the timing and context of childbearing, which in turn partially mediate the well-established effect of ACEs on women's later-life health. Analysis of 25 years of nationally representative panel data from the National Longitudinal Study of Youth (NLSY79; n = 3,893) indicates that adverse childhood experiences predict earlier age at first birth and greater odds of having a nonmarital first birth. Age and marital status at first birth partially mediate the effect of ACEs on women's health at midlife. Implications for public health and family policy aimed at improving maternal and child well-being are discussed.
TL;DR: In the full model, individual-level sexual stigma is not associated with depressive symptoms, although there is significant variation in the association between individual stigma and depressive symptoms across clusters.
Abstract: In the Asia-Pacific region, individual sexual stigma contributes to elevated rates of depression among sexual minority men. Less well understood is the role of socio-structural sexual stigma despite evidence that social context influences the experience of stigma. We use data from the United Nations Multi-country Study on Men and Violence to conduct a multilevel test of associations between individual- and cluster unit-level indicators of sexual stigma and depressive symptoms among sexual minority men (n = 562). In the full model, individual-level sexual stigma is not associated with depressive symptoms, although there is significant variation in the association between individual stigma and depressive symptoms across clusters. Contrary to expectation, at the community level, homophobic injunctive norms are negatively associated with depressive symptoms. We discuss the implications for policies, programs, and future research to improve mental health among sexual minority men in the region.
TL;DR: Out of the four classes of women with differential levels of a combination of work and family duties, the group with the heaviest double burden has the highest average BMI, and those who have remained in this class for three or more waves of data have the highest BMI.
Abstract: Although chronic life strain is often found to be associated with adverse health outcomes, empirical research is lacking on the health implications of persistent role overload that many women around the world are subject to, the so-called double burden of work and family responsibilities. Using data from the Cebu Longitudinal Health and Nutrition Survey (1994-2012), we examined the linkage between time-use profiles and body mass index (BMI) trajectories for Filipino women over an 18-year span. Out of the four classes of women with differential levels of a combination of work and family duties, the group with the heaviest double burden has the highest average BMI. In addition, those who have remained in this class for three or more waves of data not only have higher BMI on average but also have experienced the steepest rate of increase in BMI upon transition from midlife to old age.
TL;DR: It is concluded that the widespread application of the homogeneity assumption probably masks differences in the determinants of recent use between previously untreated persons and former patients.
Abstract: Based on the premise that treatment changes people in ways that are consequential for subsequent treatment-seeking, we question the validity of an unrecognized and apparently inadvertent assumption in mental health services research conducted within a psychiatric epidemiology paradigm. This homogeneity assumption statistically constrains the effects of potential determinants of recent treatment to be identical for former patients and previously untreated persons by omitting treatment history or modeling only main effects. We test this assumption with data from the 2001-2003 Collaborative Psychiatric Epidemiology Surveys; the weighted pooled sample is representative of noninstitutionalized U.S. adults (18+; analytic n = 19,227). Contrary to the homogeneity assumption, some associations with recent treatment are conditional on past treatment, including psychiatric disorder and race-ethnicity-measures of need and treatment disparities, respectively. We conclude that the widespread application of the homogeneity assumption probably masks differences in the determinants of recent use between previously untreated persons and former patients.
TL;DR: Medical professionals are less authoritative when recommending human papillomavirus (HPV) vaccination versus other adolescent vaccines, particularly when addressing the need to vaccinate before sexual onset due to concerns of labeling the child as sexually active.
Abstract: Despite authority’s centrality to the medical profession, providers routinely forgo their medical authority during clinical encounters. Research focuses on patients challenging medical authority bu...
TL;DR: In this paper, the authors examined the association between maternal obesity and child's peer victimization and whether this association varies for white and black children, finding that the association was significant only for white children.
Abstract: Drawing on the intergenerational stress proliferation theory, the courtesy stigma thesis, and the buffering ethnic culture thesis, this study examines the association between maternal obesity and child's peer victimization and whether this association varies for white and black children. Based on longitudinal data from a nationally representative sample of mother-child pairs in the U.S. Panel Study of Income Dynamics Child Development Supplement, negative binomial models show that maternal obesity is associated with increased frequency of peer victimization, even after controlling for family socioeconomic status, child weight status, health status, self-esteem, and demographic characteristics. The association was significant only for white children. Given the developmental significance of child peer relations and the social disparities in obesity, future studies need to explicitly test causal mechanisms underlying the association to decide whether obesity may function as a family stressor (versus an individual stressor) that contributes to the intergenerational reproduction of inequality.
TL;DR: A conceptual model linking social background (race-ethnicity, socioeconomic status [SES]) to parental distress through children’s clinical profiles and parental beliefs about the nature and causes of their child's autism was evaluated.
Abstract: We used data from the 2011 Survey of Pathways to Diagnosis and Services (N = 1,420) to evaluate a conceptual model linking social background (race-ethnicity, socioeconomic status [SES]) to parental distress through children's clinical profiles and parental beliefs about the nature and causes of their child's autism. Children's clinical profiles varied by social background; white children and children of more highly educated and affluent parents were less likely to experience comorbid conditions and were more likely to be diagnosed with Asperger's. Parental beliefs also varied such that parents of racial-ethnic minority children and parents of lower SES perceived their child's condition as more uncertain and were less likely to attribute it to genetic causes. Parents of Hispanic children and with lower incomes were more likely to be upset by the child's condition. Although parental beliefs had independent associations with distress, children's clinical profiles contributed more to explaining variation in distress.