Dana Garbarski

Perceived social position and health: Is there a reciprocal relationship?

Recent work exploring the relationship between socioeconomic status and health has employed a psychosocial concept called perceived social position as a predictor of health. Perceived social position is likely the cognitive averaging (Singh-Manoux, Marmot, & Adler, 2005) of socioeconomic characteristics over time and, like other socioeconomic factors, is subject to interplay with health over the life course. Based on the hypothesis that health can also affect perceived social position, in this paper we used structural equation modeling to examine whether perceived social position and three different health outcomes were reciprocally related in the Wisconsin Longitudinal Study, a longitudinal cohort study of older adults in the United States. The relationship between perceived social position and health differed across health outcomes-self-reported health, the Health Utilities Index, and depressive symptoms-as well as across operationalization of perceived social position-compared to the population of the United States, compared to ones community, and a latent variable of which the two items are indicators. We found that perceived social position affected self-reported health when operationalized as latent and US perceived social position, yet there was a reciprocal relationship between self-reported health and community perceived social position. There was a reciprocal relationship between perceived social position and the Health Utilities Index, and depressive symptoms affected perceived social position for all operationalization of perceived social position. The findings suggest that the causal relationship hypothesized in prior studies--that perceived social position affects health--does not necessarily hold in empirical models of reciprocal relationships. Future research should interrogate the relationship between perceived social position and health rather than assume the direction of causality in their relationship.

The effects of response option order and question order on self-rated health

ObjectivesThis study aims to assess the impact of response option order and question order on the distribution of responses to the self-rated health (SRH) question and the relationship between SRH and other health-related measures.MethodsIn an online panel survey, we implement a 2-by-2 between-subjects factorial experiment, manipulating the following levels of each factor: (1) order of response options (“excellent” to “poor” versus “poor” to “excellent”) and (2) order of SRH item (either preceding or following the administration of domain-specific health items). We use Chi-square difference tests, polychoric correlations, and differences in means and proportions to evaluate the effect of the experimental treatments on SRH responses and the relationship between SRH and other health measures.ResultsMean SRH is higher (better health) and proportion in “fair” or “poor” health lower when response options are ordered from “excellent” to “poor” and SRH is presented first compared to other experimental treatments. Presenting SRH after domain-specific health items increases its correlation with these items, particularly when response options are ordered “excellent” to “poor.” Among participants with the highest level of current health risks, SRH is worse when it is presented last versus first.ConclusionWhile more research on the presentation of SRH is needed across a range of surveys, we suggest that ordering response options from “poor” to “excellent” might reduce positive clustering. Given the question order effects found here, we suggest presenting SRH before domain-specific health items in order to increase inter-survey comparability, as domain-specific health items will vary across surveys.

The Interplay between Child and Maternal Health Reciprocal Relationships and Cumulative Disadvantage during Childhood and Adolescence

While many studies use parental socioeconomic status and health to predict children’s health, this study examines the interplay over time between child and maternal health across childhood and adolescence. Using data from women in the National Longitudinal Study of Youth 1979 cohort and their children (N = 2,225), autoregressive cross-lagged models demonstrate a reciprocal relationship between child activity limitations and maternal health limitations in direct effects of child activity limitations on maternal health limitations two years later and vice versa—net of a range of health-relevant time-varying and time-invariant covariates. Furthermore, there are indirect effects of child activity limitations on subsequent maternal health limitations and indirect effects of maternal health limitations on subsequent child activity limitations via intervening health statuses. This study examines how the interplay between child and maternal health unfolds over time and describes how these interdependent statuses jointly experience health disadvantages.

Interviewing Practices, Conversational Practices, and Rapport Responsiveness and Engagement in the Standardized Survey Interview

“Rapport” has been used to refer to a range of positive psychological features of an interaction, including a situated sense of connection or affiliation between interactional partners, comfort, willingness to disclose or share sensitive information, motivation to please, and empathy. Rapport could potentially benefit survey participation and response quality by increasing respondents’ motivation to participate, disclose, or provide accurate information. Rapport could also harm data quality if motivation to ingratiate or affiliate causes respondents to suppress undesirable information. Some previous research suggests that motives elicited when rapport is high conflict with the goals of standardized interviewing. The authors examine rapport as an interactional phenomenon, attending to both the content and structure of talk. Using questions about end-of-life planning in the 2003–2005 wave of the Wisconsin Longitudinal Study, the authors observe that rapport consists of behaviors that can be characterized as dimensions of responsiveness by interviewers and engagement by respondents. The authors identify and describe types of responsiveness and engagement in selected question-answer sequences and then devise a coding scheme to examine their analytic potential with respect to the criterion of future study participation. The analysis suggests that responsive and engaged behaviors vary with respect to the goals of standardization; some behaviors conflict with these goals, whereas others complement them.

Racial/ethnic disparities in midlife depressive symptoms: The role of cumulative disadvantage across the life course

This study examines the role of cumulative disadvantage mechanisms across the life course in the production of racial and ethnic disparities in depressive symptoms at midlife, including the early life exposure to health risk factors, the persistent exposure to health risk factors, and varying mental health returns to health risk factors across racial and ethnic groups. Using data from the over-40 health module of the National Longitudinal Study of Youth (NLSY) 1979 cohort, this study uses regression decomposition techniques to attend to differences in the composition of health risk factors across racial and ethnic groups, differences by race and ethnicity in the association between depressive symptoms and health risk factors, and how these differences combine within racial and ethnic groups to produce group-specific levels of--and disparities in--depressive symptoms at midlife. While the results vary depending on the groups being compared across race/ethnicity and gender, the study documents how racial and ethnic mental health disparities at midlife stem from life course processes of cumulative disadvantage through both unequal distribution and unequal associations across racial and ethnic groups.

Comparing self and maternal reports of adolescents’ general health status: Do self and proxy reports differ in their relationships with covariates?

PurposeGiven that mothers often—but do not always—report children’s health status in surveys, it is essential to gain an understanding of whether the relationship between children’s general health status and relevant covariates depends on who reports children’s general health status.MethodsUsing data from the first wave of the National Longitudinal Study of Youth 1997 cohort (Nxa0=xa06,466), a nationally representative sample of adolescents in the United States ages 12 to 17 in 1997, the study first examined the concordance between self and maternal reports of adolescents’ general health status. Then, self and maternal reports of adolescents’ general health status were each regressed on health-relevant covariates, and tests of differences in coefficients across the models were estimated.ResultsSelf and maternal reports of adolescents’ general health status are moderately concordant. Furthermore, the associations of adolescents’ general health status with adolescent BMI and the adolescent being female significantly differ across reporters, such that the negative relationships are even more negative with self compared to maternal reports of adolescents’ general health status. The associations of adolescents’ general health status with the measures of adolescents’ health limitations, maternal self-rated health, and certain sociodemographic covariates differ across reporters, such that each has axa0greater relationship with maternal compared to self-reports of adolescents’ general health status.ConclusionThe results are important for interpreting research on the causes and consequences of child and adolescent health, as results across studies may not be comparable if the reporter is not the same.

The effect of response option order on self-rated health: a replication study

PurposeFollowing calls for replication of research studies, this study documents the results of two studies that experimentally examine the impact of response option order on self-rated health (SRH).MethodsTwo studies from an online panel survey examined how the order of response options (positive to negative versus negative to positive) influences the distribution of SRH answers.ResultsThe results of both studies indicate that the distribution of SRH varies across the experimental treatments, and mean SRH is lower (worse) when the response options start with “poor” rather than “excellent.” In addition, there are differences across the two studies in the distribution of SRH and mean SRH when the response options begin with “excellent,” but not when the response options begin with “poor.”ConclusionThe similarities in the general findings across the two studies strengthen the claim that SRH will be lower (worse) when the response options are ordered beginning with “poor” rather than “excellent” in online self-administered questionnaires, with implications for the validity of SRH. The slight differences in the administration of the seemingly identical studies further strengthen the claim and also serve as a reminder of the inherent variability of a single permutation of any given study.

How participants report their health status: cognitive interviews of self-rated health across race/ethnicity, gender, age, and educational attainment

BackgroundSelf-rated health (SRH) is widely used to measure subjective health. Yet it is unclear what underlies health ratings, with implications for understanding the validity of SRH overall and across sociodemographic characteristics. We analyze participants’ explanations of how they formulated their SRH answer in addition to which health factors they considered and examine group differences in these processes.MethodsCognitive interviews were conducted with 64 participants in a convenience quota sample crossing dimensions of race/ethnicity (white, Latino, black, American Indian), gender, age, and education. Participants rated their health then described their thoughts when answering SRH. We coded participants’ answers in an inductive, iterative, and systematic process from interview transcripts, developing analytic categories (i.e., themes) and subdimensions within. We examined whether the presence of each dimension of an analytic category varied across sociodemographic groups.ResultsOur qualitative analysis led to the identification and classification of various subdimensions of the following analytic categories: types of health factors mentioned, valence of health factors, temporality of health factors, conditional health statements, and descriptions and definitions of health. We found differences across groups in some types of health factors mentioned—corresponding, conflicting, or novel with respect to prior research. Furthermore, we also documented various processes through which respondents integrate seemingly disparate health factors to formulate an answer through valence and conditional health statements. Finally, we found some evidence of sociodemographic group differences with respect to types of health factors mentioned, valence of health factors, and conditional health statements, highlighting avenues for future research.ConclusionThis study provides a description of how participants rate their general health status and highlights potential differences in these processes across sociodemographic groups, helping to provide a more comprehensive understanding of how SRH functions as a measure of health.

Greeting and Response: Predicting Participation from the Call Opening

Although researchers have used phone surveys for decades, the lack of an accurate picture of the call opening reduces our ability to train interviewers to succeed. Sample members decide about participation quickly. We predict participation using the earliest moments of the call; to do this, we analyze matched pairs of acceptances and declinations from the Wisconsin Longitudinal Study using a case-control design and conditional logistic regression. We focus on components of the first speaking turns: acoustic-prosodic components and interviewers actions. The sample members hello is external to the causal processes within the call and may carry information about the propensity to respond. As predicted by Pillet-Shore (2012), we find that when the pitch span of the sample members hello is greater the odds of participation are higher, but in contradiction to her prediction, the (less reliably measured) pitch pattern of the greeting does not predict participation. The structure of actions in the interviewers first turn has a large impact. The large majority of calls in our analysis begin with either an efficient or canonical turn. In an efficient first turn, the interviewer delays identifying themselves (and thereby suggesting the purpose of the call) until they are sure they are speaking to the sample member, with the resulting efficiency that they introduce themselves only once. In a canonical turn, the interviewer introduces themselves and asks to speak to the sample member, but risks having to introduce themselves twice if the answerer is not the sample member. The odds of participation are substantially and significantly lower for an efficient turn compared to a canonical turn. It appears that how interviewers handle identification in their first turn has consequences for participation; an analysis of actions could facilitate experiments to design first interviewer turns for different target populations, study designs, and calling technologies.

Interviewers’ Ratings of Respondents’ Health: Predictors and Association With Mortality

ObjectivesnRecent research indicates that survey interviewers ratings of respondents health (IRH) may provide supplementary health information about respondents in surveys of older adults. Although IRH is a potentially promising measure of health to include in surveys, our understanding of the factors contributing to IRH remains incomplete.nnnMethodsnWe use data from the 2011 face-to-face wave of the Wisconsin Longitudinal Study, a longitudinal study of older adults from the Wisconsin high school class of 1957 and their selected siblings. We first examine whether a range of factors predict IRH: respondents characteristics that interviewers learn about and observe as respondents answer survey questions, interviewers evaluations of some of what they observe, and interviewers characteristics. We then examine the role of IRH, respondents self-rated health (SRH), and associated factors in predicting mortality over a 3-year follow-up.nnnResultsnAs in prior studies, we find that IRH is associated with respondents characteristics. In addition, this study is the first to document how IRH is associated with both interviewers evaluations of respondents and interviewers characteristics. Furthermore, we find that the association between IRH and the strong criterion of mortality remains after controlling for respondents characteristics and interviewers evaluations of respondents.nnnDiscussionnWe propose that researchers incorporate IRH in surveys of older adults as a cost-effective, easily implemented, and supplementary measure of health.