Elizabeth M. Lawrence

Happiness and longevity in the United States

This is the first study to our knowledge to examine the relationship between happiness and longevity among a nationally representative sample of adults. We use the recently-released General Social Survey-National Death Index dataset and Cox proportional hazards models to reveal that overall happiness is related to longer lives among U.S. adults. Indeed, compared to very happy people, the risk of death over the follow-up period is 6% (95% CI 1.01-1.11) higher among individuals who are pretty happy and 14% (95% CI 1.06-1.22) higher among those who are not happy, net of marital status, socioeconomic status, census division, and religious attendance. This study provides support for happiness as a stand-alone indicator of well-being that should be used more widely in social science and health research.

The Relationship Between Education and Health: Reducing Disparities Through a Contextual Approach

Adults with higher educational attainment live healthier and longer lives compared with their less educated peers. The disparities are large and widening. We posit that understanding the educational and macrolevel contexts in which this association occurs is key to reducing health disparities and improving population health. In this article, we briefly review and critically assess the current state of research on the relationship between education and health in the United States. We then outline three directions for further research: We extend the conceptualization of education beyond attainment and demonstrate the centrality of the schooling process to health; we highlight the dual role of education as a driver of opportunity but also as a reproducer of inequality; and we explain the central role of specific historical sociopolitical contexts in which the education-health association is embedded. Findings from this research agenda can inform policies and effective interventions to reduce health disparities and improve health for all Americans.

Health lifestyles across the transition to adulthood: Implications for health

Research has long established the importance of individual health behaviors such as cigarette smoking for adult morbidity and mortality. However, we know little about how health behaviors cluster into health lifestyles among adolescents and young adults in the United States, or in turn, how such health lifestyles are associated with young adult health outcomes. This study establishes health lifestyles as distinct group phenomena at three developmental time points in a single cohort: late adolescence (ages 15-17), early adulthood (ages 20-24), and young adulthood (ages 26-31). We then identify the associations between these health lifestyles and young adult health outcomes. We use the National Longitudinal Study of Adolescent to Adult Health (Add Health), a nationally representative sample of U.S. adolescents followed into adulthood, and latent class analysis and regression models. We uncover diverse health lifestyles among adolescents, early adults, and young adults; however, few individuals engaged in a consistently salubrious lifestyle at any developmental stage. People with less healthy lifestyles also tended to exhibit poorer health in young adulthood. Our results showed that young adult health lifestyles were significantly associated with young adult cardiovascular risk. Moreover, health lifestyles in each of the three developmental stages were associated with young adult self-rated health, and accounting for lifestyles in later stages explained some of these associations. Overall, this study suggests a portrait of problematic health lifestyles among a nationally representative cohort of young Americans, with associated patterns of relatively poor physical health among those with poor health lifestyles.

Racial/Ethnic Patterns of Kindergarten School Enrollment in the United States†

Enrollment into unequal schools at the start of formal education is an important mechanism for the reproduction of racial/ethnic educational inequalities. We examine whether there are racial/ethnic differences in school enrollment options at kindergarten, the start of schooling. We use nationally representative data from the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B) to model whether parents seek information about their childs school before enrolling, whether parents move to a location so that a child can attend a certain school, or whether parents enroll their child in a school other than the assigned public school. Results indicate that enrollment patterns differ greatly across race/ethnicity. Whereas Black families are the most likely to seek information on a schools performance, White families are the most likely to use the elite option of choosing their residential location to access a particular school. These differences persist when controlling for socioeconomic status and sociogeographic location. Kindergarten enrollment patterns preserve the advantages of White families, perpetuating racial/ethnic disparities through multiple institutions and contributing to intergenerational processes of social stratification. Research should continue to examine specific educational consequences of housing inequities and residential segregation.

The Cardiovascular Health of Young Adults: Disparities along the Urban-Rural Continuum:

U.S. young adults coming of age in the early twenty-first century are the first cohort to grow up during the obesity epidemic; justifiably, there is much concern about their cardiovascular health. To date, however, no research has examined the extent to which there are disparities in young adult cardiovascular health across the urban-rural continuum. We examine this topic using data from the National Longitudinal Study of Adolescent to Adult Health (Add Health). We find that young adults who live in metropolitan core areas exhibit more favorable cardiovascular health than individuals who live in smaller communities and that population density largely accounts for this association. Further, individuals living in more densely populated areas in young adulthood relative to during adolescence have better cardiovascular health than those who live in areas similar or less dense than their adolescent residence. Our results strongly suggest that the physical and social features of communities represent important contexts for young adult cardiovascular health.

A Twenty-First Century Demographic Challenge: Comparatively Low Life Expectancy in the United States

The United States is currently characterized by a lower fertility rate and higher life expectancy than most countries around the world. However, overall U.S. life expectancy lags behind that of most low fertility (and high-income) countries. We review trends in U.S. life expectancy, as well as the most prominent causes of death and behavioral factors that contribute to the relatively higher mortality in the United States. Compared to other low fertility, highincome countries, U.S. males and females exhibit the highest age-specific mortality in early life, but average or better age-specific mortality at older ages. High mortality in the United States due to behavioral-related causes—cigarette smoking, obesity, alcohol and drug abuse, risky driving, use of firearms—is in part responsible for the lags in U.S. life expectancy compared to other low fertility, high-income countries. It will take very substantial reductions in U.S. age-specific mortality in the next few decades to achieve the levels of life expectancy already experienced by the vanguard countries of the world. Nevertheless, some trends in the United States appear favorable, and we are guardedly optimistic that the United States will continue to experience gains in U.S. life expectancy over the next few decades.

Racial/Ethnic Differences in Early-Life Mortality in the United States

Abstract U.S. early-life (ages 1–24) deaths are tragic, far too common, and largely preventable. Yet demographers have focused scant attention on U.S. early-life mortality patterns, particularly as they vary across racial and ethnic groups. We employed the restricted-use 1999–2011 National Health Interview Survey–Linked Mortality Files and hazard models to examine racial/ethnic differences in early-life mortality. Our results reveal that these disparities are large, strongly related to differences in parental socioeconomic status, and expressed through different causes of death. Compared to non-Hispanic whites, non-Hispanic blacks experience 60 percent and Mexican Americans 32 percent higher risk of death over the follow-up period, with demographic controls. Our finding that Mexican Americans experience higher early-life mortality risk than non-Hispanic whites differs from much of the literature on adult mortality. We also show that these racial/ethnic differences attenuate with controls for family structure and especially with measures of socioeconomic status. For example, higher mortality risk among Mexican Americans than among non-Hispanic whites is no longer significant once we controlled for mother’s education or family income. Our results strongly suggest that eliminating socioeconomic gaps across groups is the key to enhanced survival for children and adolescents in racial/ethnic minority groups.

Alcohol's collateral damage: Childhood exposure to problem drinkers and subsequent adult mortality risk

Abstract:The importance of childhood circumstances, broadly defined, for shaping adult health and longevity is well established. But the significance of one of the most prevalent childhood adversities—exposure to problem drinkers—has been understudied from a sociological perspective and remains poorly understood. We address this gap by drawing on cumulative inequality theory, using data from the 1988–2011 National Health Interview Survey-Linked Mortality Files, and estimating Cox proportional hazards models to examine the relationship between exposure to problem drinkers in childhood and adult mortality risk. Childhood exposure to problem drinkers is common (nearly one in five individuals were exposed) and elevates adult overall and cause-specific mortality risk. Compared to individuals who had not lived with a problem drinker during childhood, those who had done so suffered 17 percent higher risk of death (p < .001) over the follow-up period, net of age, sex, and race/ethnicity. We find compelling evidence that the duration, source, and intensity of exposure to problem drinkers in childhood contributes to inequality in adult mortality risk. Favorable socioeconomic status in adulthood does not ameliorate the consequences of childhood exposure to problem drinkers. The primary intervening mechanisms are risky behaviors, including adult drinking and smoking. The findings—which reveal that the influence of problem drinking is far reaching and long-term—should inform policies to improve childhood circumstances, reduce detrimental effects of problem drinking, and increase life expectancy.