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Author: Green, Lisa H.
Resulting in 2 citations.
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Green, Lisa H. |
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Race/Ethnicity, Socioeconomic Experience and Adult Health Presented: San Diego, CA, AcademyHealth Annual Research Meeting, June 2004 Cohort(s): NLSY79 Publisher: AcademyHealth Keyword(s): Depression (see also CESD); Ethnic Differences; Gender Differences; Health Factors; Health/Health Status/SF-12 Scale; Life Course; Modeling; Morbidity; Occupational Prestige; Racial Differences; Socioeconomic Factors Permission to reprint the abstract has not been received from the publisher. Research Objective: To better elucidate the role of socioeconomic experience in the race/ethnicity and health relationship among working-age adults, this study examines multiple domains of socioeconomic experience within a lifecourse paradigm. The aims of this study are to identify the racial/ethnic differences in global health outcomes among working age adults, and to determine what role individual-level socioeconomic experience has in explaining these differences. Study Design: Sex and sex-race stratified multivariate linear regression models were used to examine the impact of education, occupational prestige and 19 year income on five health outcomes (SF-12 Physical and Mental Health Summary Scores, depression, major morbidities and minor morbidities) measured at age 40. Data were drawn from the National Longitudinal Survey of Youth 1979 for the years 1979-2000.... Those who have reached age 40 and answered the age 40 health module were included (n=3,154) in this study. Principal Findings: In sex stratified models, socioeconomic factors alone fully accounted for observed disparities, and provided a protective effect for major and minor morbidities among black and Mexican respondents, compared to white counterparts. Income in particular played a strong role in explaining racial/ethnic differences. The sex and race stratified models revealed that socioeconomic factors impact different population groups in different ways. Income appeared to have a lagged effect among black men and women, and no effect on Mexican men and women. Education exhibited a gradient effect for most sex-race categories and occupational prestige had minimal to no effect on health outcomes of respondents, compared to white counterparts. Income in particular played a strong role in explaining racial/ethnic differences. In sex and race stratified models, income appeared to have a lagged effect among black men and women, and no effect on Mexican men and women. Education exhibited a gradient effect for most sex-race categories and occupational prestige had minimal to no effect on health outcomes. Conclusions: This study addresses gaps in the literature on whether more complex and perhaps more robust definitions of socioeconomic experience attenuate observed racial/ethnic disparities in health, and on how such socioeconomic patterns over the life course predict health in adulthood. Health status is also key to understanding the health of working adults, where morbidity is relatively low and mortality is disproportionately dominated by HIV, injury and homicide. The working age population represents the most productive segment of the U.S. population, both economically and socially, and represents a much overlooked subgroup ripe for preventive health intervention. Understanding the health differentials and needs during this productive time period, prior to more significant and rapid health declines in later life, are critical. Prior reviews have examined mortality or disease endpoints (e.g. cardiovascular, cancer, other morbidity) with substantially less attention paid to more global concepts of health. Additional research capturing both the longitudinal and contextual dimensions of socioeconomic experience in a broader population is still needed. |
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Bibliography Citation
Green, Lisa H. "Race/Ethnicity, Socioeconomic Experience and Adult Health." Presented: San Diego, CA, AcademyHealth Annual Research Meeting, June 2004. |
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Green, Lisa H. |
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Socioeconomic Experience, Race/Ethnicity and Adult Health Ph.D. Dissertation, The Johns Hopkins University, October 2004. DAI-A 65/04, p. 1550, Oct 2004 Cohort(s): NLSY79 Publisher: UMI - University Microfilms, Bell and Howell Information and Learning Keyword(s): Census of Population; Depression (see also CESD); Ethnic Differences; Family Income; Health/Health Status/SF-12 Scale; Income Distribution; Modeling; Morbidity; Neighborhood Effects; Racial Differences; Socioeconomic Factors Objective. This study examines the role of individual- and neighborhood-level socioeconomic characteristics over time in predicting adult health outcomes for individuals of different racial/ethnic backgrounds. Data. The study population was drawn from the National Longitudinal Survey of Youth (NLSY79) with respondents' census tract residence matched with 2000 Decennial Census data. The NLSY79 cohort is a nationally representative sample of the non-institutionalized, civilian population aged 14–21 in 1979, surveyed annually and now biennially from 1979 to the present. Those who had answered the age 40 health module were included in this study (n = 3,154). Methods. Sex and sex-race/ethnicity stratified multivariate linear regression models were used to examine the impact of education, occupational standing, income and neighborhood characteristics on five health outcomes (SF-12 Physical and Mental Health Summary Scores, depression, major morbidities and minor morbidities) measured at age 40. Census tract “neighborhoods” were characterized by racial/ethnic make-up, median family income, percent affluent, and percent of idle youth. Results. In sex stratified models, individual-level socioeconomic factors alone fully accounted for observed racial/ethnic disparities in overall physical health and depression symptom levels, and provided a protective effect for major and minor morbidities among black and Mexican respondents, compared to white counterparts. Income appeared to have a positive, but lagged effect among black men and women, and no effect on Mexican men and women. Education exhibited a positive gradient effect for most sex-race categories and occupational standing had minimal to no effect on health outcomes. Neighborhood factors did not explain racial/ethnic health differentials beyond individual level socioeconomic experience, though tract-level socioeconomic resources had a protective effect on health, while the proportion of idle youth had a decidedly negative effect, particularly for women. Conclusions. Results suggest that policies addressing socioeconomic inequities may reap significant health benefits, particularly with respect to addressing racial/ethnic health disparities. Programs aimed at improving education, income distribution and earnings should be considered in the health disparities discussion. Additional research on the pathways through which socioeconomic factors influence health are needed to better guide such program endeavors. |
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Bibliography Citation
Green, Lisa H. Socioeconomic Experience, Race/Ethnicity and Adult Health. Ph.D. Dissertation, The Johns Hopkins University, October 2004. DAI-A 65/04, p. 1550, Oct 2004. |