Catherine Walker O’Neal

Is Working Later in Life Good or Bad for Health? An Investigation of Multiple Health Outcomes

OBJECTIVES To examine the mutual influences between changes in work status and multiple dimensions of health outcomes (immediate memory, physical disability, and depressive symptoms) over later years. METHODS We used a subsample of 8,524 older adults who participated in the Health and Retirement Study from 1998 to 2008 and were 62 years or older in 1998 to examine work status and health outcomes after controlling for age and background characteristics. RESULTS We present results of cross-lagged auto-regressive models. Work status (level of work) predicted subsequent residual changes in immediate memory over time, whereas immediate memory predicted subsequent residual changes in work status over time, even after controlling for physical disability and depressive symptoms. Similar results were indicated for the associations between work status and physical disability and depressive symptoms over time. DISCUSSION Consistent with social causation and social selection traditions, the findings support bi-directional associations among changes in work status (the level of work), immediate memory, physical disability, and depressive symptoms in later years. Practical implications are discussed.

Economic pressure and health and weight management behaviors in African American couples: A family stress perspective

This study extends the family stress model by examining the influence of economic pressure on health and weight management behaviors mediated by depressive symptoms and spousal support among 506 African American married couples. The actor–partner interdependence model accounted for the interdependent nature of relationships. Findings support the family stress model; yet pathways differed slightly for husbands and wives. Economic pressure directly influenced depressive symptoms and spousal support. Spousal support was a buffer against poor health and weight management behaviors for husbands, while depressive symptoms exacerbated poor health and weight management behaviors for wives. These mechanisms have implications for practitioners who promote African American couples’ well-being.

Life dissatisfaction and eating behaviors among older African Americans: The protective role of social support

ObjectivesTo examine (a) the influences of life dissatisfaction and dietary social support on eating behaviors (a high-fat diet and fruit/vegetable consumption) of older African Americans and (b) the moderating role of perceived dietary social support on the association between their life dissatisfaction and unhealthy eating behaviors.DesignBaseline data from a larger intervention study of mid-life and older African Americans. The study incorporated a quasi-experimental design with random selection of participants, stratifying for age and gender.SettingSix churches in North Florida.ParticipantsOne hundred and seventy-eight (132 females and 46 males with a median age of 60) older African Americans.MeasurementsA structured questionnaire elicited personal data as well as information on eating behaviors, life dissatisfaction, and perceived dietary social support.ResultsOlder African Americans with more cumulative life adversity, as reflected by high life dissatisfaction, had significantly poorer eating behaviors including the consumption of a high-fat diet and low intake of fruits and vegetables. Older African Americans’ dietary choices were also associated with their perceived social support. More importantly, perceived social support acted as a buffer to mitigate the influence of life dissatisfaction on older African Americans’ eating behaviors.ConclusionLife dissatisfaction places older African Americans at risk for unhealthy eating behaviors. However, high levels of dietary social support can protect older African Americans from the influence of life dissatisfaction on unhealthy eating behaviors. There are practical implications of this research for health interventions and programming.

Early Community Contexts, Race/Ethnicity and Young Adult CVD Risk Factors: The Protective Role of Education

Using a sample of 13,500 adolescents (53% female and 47% male) who participated in all four waves of the National Longitudinal Study of Adolescent Health, this study used multilevel regression to examine the influence of early structural community adversity (as measured by rates of community poverty, single-parent headed families, and two indicators of employment) and racial/ethnic status on cardiovascular disease (CVD) risk factors of young adults (systolic blood pressure, diastolic blood pressure, and mean arterial pressure). The moderating role of youth’s socioeconomic attainment was also examined. Results indicate that early community adversity and African American racial status place young adults at risk for CVD. Youth’s socioeconomic attainment does not erase the persistent influences of early community adversity and African American racial status on CVD risk. However, the level of education attained can protect African American young adults and those experiencing early community adversity from CVD risk factors.

The influence of working later in life on memory functioning

This article examines the influence of work status on subsequent memory trajectories in later years. Using a subsample of 8165 older adults who participated in the Health and Retirement Study and were 65 years or older in 2002, we examined work status and memory functioning after controlling for age and demographic characteristics. In growth curve analyses, work status predicted the rate of immediate memory decline from 2002 to 2006 with full-time employed individuals showing less immediate memory decline after controlling for age. However, work status categories were not associated with subsequent age-adjusted delayed memory trajectories. The findings from these growth curve analyses support the hypothesis that working late in life helps to impede immediate memory declines that often occur in later years.

Explaining the Association between Early Adversity and Young Adults’ Diabetes Outcomes: Physiological, Psychological, and Behavioral Mechanisms

Previous studies have documented that early adversity increases young adults’ risk for diabetes resulting in morbidity and comorbidity with adverse health conditions. However, less is known about how inter-related physiological (e.g., body mass index [BMI]), psychological (e.g., depressive symptoms), and behavioral mechanisms (e.g., unhealthy eating and sedentary behavior) link early adversity to young adults’ diabetes outcomes, although these mechanisms appear to stem from early stressful experiences. The current study tested the patterning of these longitudinal pathways leading to young adults’ diabetes using a nationally representative sample of 13,286 adolescents (54% female) over a period of 13 years. The findings indicated that early adversity contributed to elevated BMI, depressive symptoms, and stress-related health behaviors. The impact of these linking mechanisms on hierarchical diabetes outcomes (i.e., prediabetes and diabetes) remained significant after taking their associations with each other into account, showing that these mechanisms operate concurrently. The findings emphasize the importance of early detection for risk factors of young adults’ diabetes in order to minimize their detrimental health effects.

Control Over Work, Positive Self, and Health Among African American Husbands and Wives

Using a sample of 344 dual-earner African American married couples, this study examined the effect of control over work on depressive symptoms and physical health with a dyadic model. The mediating role of personal resources capturing positive self-evaluations (i.e., self-esteem and mastery) was also examined. The association between wives’ control over work and wives’ physical and mental health was mediated by wives’ positive self. Although husbands’ control over work was not directly associated with husbands’ physical or mental health, it was associated with their sense of positive self, which influenced their level of depressive symptoms and physical health. No cross-spouse influences were found, suggesting a lack of interdependence for African American husbands and wives. The practical implications of this research include the value of work organization policies that may increase workers’ sense of control and personal resources as these variables are important to workers’ health outcomes.

Social stratification of general psychopathology trajectories and young adult social outcomes: A second-order growth mixture analysis over the early life course

BACKGROUND Research has documented heterogeneous developmental trajectories of specific symptoms, such as anxiety and depression, in late childhood and adolescence. Few studies, however, have examined the heterogeneity of general psychopathology (GPP) trajectories considering symptoms of anxiety, depression, and hostility in adolescence simultaneously. Identifying antecedents for distinct trajectory groups of GPP, and their respective consequences, may provide insight into the etiological underpinnings of social antecedents of different symptoms and inform the targets and timing of intervention. METHODS European American target adolescents (N=444, 53% female) evaluated three domain specific symptoms (i.e., symptoms of anxiety, depression, and hostility) as well as psychosocial risks and social consequences over 10 years (from 1990 [Wave 2] to 2001 [Wave 13]). First- and second-order growth mixture models (SOGMMs) were used to identify trajectories of GPP and specific symptoms from mid-adolescence through young adulthood, as well as their predictors and consequences. RESULTS A three-class model consisting of high and escalating (10.1%), high and decreasing (23.2%), and consistently low (66.7%) GPP emerged as the preferred solution. More predictors and outcomes were associated with membership in both the high and escalating and the high and declining classes of GPP compared to corresponding classes of the specific symptoms trajectories. LIMITATIONS Self-reported information regarding three symptoms may be a source of bias within the current study. CONCLUSION Our findings suggest that unified interventions and/or prevention efforts are needed to not only assess specific symptoms, but also to treat GPP in adolescence.

Cumulative Socioeconomic Adversity, Developmental Pathways, and Mental Health Risks During the Early Life Course

The current study examines two developmental risk pathways (an academic/economic pathway and a delinquency/interpersonal pathway) linking cumulative socioeconomic adversity to subsequent depressive symptoms and the interplay between these pathways and depressive symptoms using path analysis with a sample of 14,563 respondents from the National Longitudinal Study of Adolescent to Adult Health over a 13-year period. Minority youth comprised 49% of this nationally representative sample, including 21% Blacks, 16% Hispanics, 6% Asians, 2% Native Americans, and 4% multiracial youth. Cumulative socioeconomic adversity appears to initiate an adverse life course process involving depressive symptoms, academic/economic difficulties, and delinquency/interpersonal incompetency. It appears that mediating life experiences partially explain the persistent influence of socioeconomic adversity and the continuity of depressive symptoms over the early life course. A deeper understanding of this dynamic process provides insight into the prevention of emotional problems in these early life stages.

Examining change in social support and fruit and vegetable consumption in African American adults

ObjectiveTo examine (a) inter-individual variation in African Americans’ fruit and vegetable social support, behavior, and consumption trajectories by estimating latent growth curves (LGCs) and (b) the associations between these trajectories over time.DesignAs part of a larger intervention study, data were collected from mid-life and older African Americans yearly for three years. The study incorporated a quasi-experimental design with random selection of participants, stratifying for age and gender.SettingSix churches in North Florida.ParticipantsTwo hundred and thirty one (73% women; median age range of 57–63) older African Americans.MeasurementsA structured questionnaire elicited personal data as well as information on dietary social support, eating-related behaviors, and fruit and vegetable dietary intake.ResultsAge was positively associated with initial social support but negatively associated with the rate of change in social support. More important, the rate of change in dietary social support predicted eating-related behavior trajectories, which influenced the rate of change in fruit and vegetable consumption over time after controlling for the intervention.ConclusionThese findings illustrate the mediating role of eating-related behaviors and the inter-locking nature of social support, behavior and consumption trajectories. This research has implications for future research as well as community interventions and programs.