John Mirowsky

Neighborhood Disadvantage, Disorder, and Health*

We examine the question of whether living in a disadvantaged neighborhood damages health, over and above the impact of personal socioeconomic characteristics. We hypothesize that (1) health correlates negatively with neighborhood disadvantage adjusting for personal disadvantage, and that (2) neighborhood disorder mediates the association, (3) partly because disorder and the fear associated with it discourage walking and (4) partly because they directly impair health. Data are from the 1995 Community, Crime, and Health survey, a probability sample of 2,482 adults in Illinois, with linked information about the respondents census tract. We find that residents of disadvantaged neighborhoods have worse health (worse self-reported health and physical functioning and more chronic conditions) than residents of more advantaged neighborhoods. The association is mediated entirely by perceived neighborhood disorder and the resulting fear. It is not mediated by limitation of outdoor physical activity. The daily stress associated with living in a neighborhood where danger, trouble, crime and incivility are common apparently damages health. We call for a bio-demography of stress that links chronic exposure to threatening conditions faced by disadvantaged individuals in disadvantaged neighborhoods with physiological responses that may impair health.

Age and depression.

In this study, the relationship between age and depression is analyzed, looking for effects of maturity, decline, life-cycle stage, survival, and historical trend. The data are from a 1990 sample of 2,031 U.S. adults and a 1985 sample of 809 Illinois adults. The results show that depression reaches its lowest level in the middle aged, at about age 45. The fall of depression in early adulthood and rise in late life mostly reflects life-cycle gains and losses in marriage, employment, and economic well-being. Depression reaches its highest level in adults 80 years old or older, because physical dysfunction and low personal control add to personal and status losses. Malaise from poor health does not create a spurious rise of measured depression in late adulthood. However, some of the differences among age groups in depression reflect higher education in younger generations, and some reflect different rates of survival across demographic groups that also vary in their levels of depression.

Dividing work, sharing work, and in-between: marriage patterns and depression.

Marriages in the United States are shifting from the complementary type, in which the husband is employed and the wife cares for the household and children, to the parallel type, in which both spouses are employed and both are responsible for the housework. This change, however, is far from complete. Disjunctions in the institution of marriage may be stressful and emotionally disturbing. We hypothesize that the effect of a wifes employment on her depression and her husbands depends on their preferences for her employment and on whether the husband helps with the housework. Using data from a national sample of 680 couples interviewed in 1978, we find that both spouses are less depressed when the wifes employment status is consistent with their preferences. Also, wives are less depressed if their husbands help with the housework, and husbands are not more depressed as a result of helping. These factors lead to the highest depression in transitional marriages. The lowest depression is in parallel marriages.

Explaining the social patterns of depression: control and problem solving--or support and talking?

Research on the social patterns of depression in the community finds consistently that high levels of education and income, being male, and being married are associated with lower levels of depression. We attempt to explain these patterns as the result of two essential social perceptions: the sense of controlling ones own life rather than being at the mercy of powerful others and outside forces, and the sense of having a supportive and understanding person to talk to in times of trouble. In theory, the sense of control reduces depression because it encourages active problem solving, and the sense of support reduces depression because it provides others to talk to. We find evidence for the first proposition: persons who feel in control of their lives are more likely to attempt to solve problems. Perceived control and problem solving decrease depression and largely explain the effects of income and education on depression. We find, however, that support has mixed effects. Support decreases depression, but talking to others when faced with a problem, which increases with the level of support, increases depression. Support explains a small part of the effect of marriage on depression. Control and support have an interactive effect on depression, suggesting that control and support can substitute for one another to decrease depression: a high level of one reduces the need for the other, and a low level of one is remedied by a high level of the other.

Does Employment Affect Health

Employment correlates positively with health, but is employment cause or consequence? The social causation hypothesis says that employment improves the health of men and women. The selection hypothesis says that healthy people get and keep jobs more than unhealthy people do. We test both hypotheses using longitudinal data from a national probability sample (N = 2,436 interviewed in both years). In the equations representing social causation, full-time employment predicts slower declines in perceived health and in physical functioning for both men and women. Full-time employment has the same effect for both sexes. Among women, it also has the same effect for White and non-White, and for married and nonmarried. In the equations representing social selection, physical functioning increases the odds of getting or keeping a full-time job for both sexes. Perceived health increases the odds for women but not for men. In regard to homemaking among women, homemaking predicts significantly greater declines in health, but health has no effect on the odds of becoming or staying a homemaker.

Refining the association between education and health: the effects of quantity, credential, and selectivity.

We refine the established association between education and health by distinguishing three aspects of a person s education (quantity, credential, and selectivity) and by examining the mechanisms through which they may correlate with health. Data are from the 1995 Aging, Status, and the Sense of Control Survey, a representative U.S. national telephone survey of 2,593 respondents aged 18 to 95, with an oversample of elderly. Results show that physical functioning and perceived health increase significantly with years of formal education and with college selectivity for those with a bachelor s or higher degree, adjusting for age, sex, race, marital status, and parental education. The credential of a college degree has no net association with physical functioning and perceived health beyond the amount attributable to the additional years of schooling. Of the three aspects of education, years of schooling has the largest effect. Most of that association appears attributable to its correlation with work and economic conditions, social psychological resources, and health lifestyle. A large portion of the net association of college selectivity with physical functioning and perceived health appears attributable to health lifestyle.

Education, Personal Control, Lifestyle and Health: A Human Capital Hypothesis

The concept of human capital implies that education improves health because it increases effective agency. We propose that educations positive effects extend beyond jobs and earnings. Through education, individuals gain the ability to be effective agents in their own lives. Education improves physical functioning and self-reported health because it enhances a sense of personal control that encourages and enables a healthy lifestyle. We test three specific variants of the human-capital and learned-effectiveness hypothesis: (1) education enables people to coalesce health-producing behaviors into a coherent lifestyle, (2) a sense of control over outcomes in ones own life encourages a healthy lifestyle and conveys much of educations effect, and (3) educated parents inspire a healthy lifestyle in their children. Using data from a 1995 national telephone probability sample of U.S. households with 2,592 respondents, ages 18 to 95, a covariance structure model produces results consistent with the three hypotheses.

DISORDER AND DECAY The Concept and Measurement of Perceived Neighborhood Disorder

The authors develop and assess a scale of perceived neighborhood disorder. The scale of neighborhood disorder has high reliability, external validity, and shows interesting distinctions, and overlaps between physical and social disorder. It also shows that order and disorder are two ends of a single continuum.

Control or defense? depression and the sense of control over good and bad outcomes

Defense theory holds that defensive illusions guard well-being. People supposedly are least depressed if they claim responsibility for good outcomes and deny responsibility for bad ones. Control theory states that active, effective problem solving builds well-being; thus a sense of personal control and responsibility for both success and failure is associated with low levels of depression. Which theory is right? Regression analyses of the self-reports of 809 randomly selected Illinois residents show that a sense of responsibility for both successes and failures (instrumentalism) is associated with low levels of depression. There is no measurable benefit from claiming responsibility for the good things while denying responsibility for the bad (self-defense). Depression is associated with not feeling in control of good outcomes, or of bad outcomes, or of both. The sense of control reflects the reality of social and economic status. It explains part of the relationship between status and depression. We infer that defensive illusions are no substitute for genuine control.

Age and the sense of control.

Two large random-sample surveys of adults age 18 and over show high, stable mean levels of perceived control in the age range 18 through 50, followed by successive steps down in progressively older age groups. Physical impairment and low education account for much of the low sense of control-reported by older respondents. Education accounts for more of the age-group differences than does impairment. More than half of the age-group mean differences remain after adjustment. The results do not change substantially with added adjustment for other socioeconomic factors (race, sex, income, earnings, marital status, employment status) or other measures of physical aging (perceived health, malaise, aches and pains, exercise, and body weight). The relative importance of education suggests that intergenerational improvements in lifetime living and working conditions mnight account for much of the remaining association between old age and low sense of control