Kim M. Shuey

Cumulative Advantage Processes as Mechanisms of Inequality in Life Course Health1

While there is consistent evidence that inequality in economic resources follows a process of cumulative advantage, the application of this framework to another aspect of life course inequality, health, has not produced consensus. This analysis uses longitudinal data from the Panel Study of Income Dynamics to examine the over‐time relationship between health and socioeconomic status, considering how multiple dimensions of socioeconomic resources and economic history are related to health disparities as people age. The authors find cautious support for path‐ and duration‐dependent processes of cumulative advantage in health. Results suggest that in studies of mechanisms of inequality over time, the cumulative advantage process may appear to be bounded by age because of the disproportionate attrition and mortality of those with low socioeconomic status.

Cumulative Disadvantage and Black-White Disparities in Life-Course Health Trajectories

In this study, the authors use longitudinal data from the Panel Study of Income Dynamics and growth curve models to examine the utility of the concept of cumulative disadvantage as an explanation for race differences in life-course health (self-rated) in the United States. The authors ask whether socioeconomic resources equally benefit the health of Blacks and Whites, or if Whites receive higher rates of return to resources across the life course. The authors find that the relationship differs depending on the indicator of socioeconomic status that is examined. Education does not offer the same advantages for the health of Blacks as it does for Whites, particularly at higher levels of education, and this is compounded with age. In contrast, returns to income and wealth are similar for Blacks and Whites, and these resources remain equally important to protecting the health of Blacks and Whites across the life course. Over time, Blacks are at an increasing health disadvantage relative to Whites, a result that is not attenuated by educational attainment.

Ambivalence in Mother-Adult Child Relations: A Dyadic Analysis.

The concept of ambivalence represents an interactional process in which individuals evaluate social relations as simultaneously positive and negative. This study investigates ambivalence in interpersonal relations through an empirical analysis of relationships between aging mothers and their adult children from their joint perspectives. Multilevel models examine the influence of dependence on levels of ambivalence in relationship dyads as well as differences in levels of ambivalence between mothers and their adult children. Results suggest that ambivalence increases under conditions of potential dependence, rather than through the help that is more routinely exchanged among family members. Within the relationship, mothers experienced less ambivalence than their sons and daughters; overall findings demonstrate the importance of analyzing multiple perspectives in social relationships.

Disability Accommodation in Nonstandard and Precarious Employment Arrangements

This study, based on data from a large nationally representative sample of Canadian workers with disabilities, examines the relationship between employment arrangements and the accommodation of disability in the workplace. We address whether workers with disabilities in nonstandard arrangements are more likely to have unmet accommodation needs and if other key dimensions of precarious employment mediate the relationship between nonstandard work and accommodation. Results from multivariate models suggest that despite disability legislation, practices of workplace disability accommodation parallel the unequal distribution of other labor market protections, with workers in more precarious arrangements (i.e. those in nonpermanent, low-wage, and nonunion jobs) at greater risk of having unmet needs.

Gender and the Devolution of Pension Risks in the US

This article uses data from multiple waves of the Panel Study of Income Dynamics to examine inequality in the accumulation of pension balances in private accounts for two cohorts of workers in the US. The new occupational pension environment is characterized by the rise of defined contribution plans and the devolution of risk and responsibility for retirement saving. While men and women in this environment face new pension risks, women continue to bear greater risks associated with lower workplace earnings and family position. Unmarried women consistently have the greatest risk of low pension balances in defined contribution plans (DC) and individual retirement accounts (IRAs). Divorce, unstable employment histories and lower levels of education and income decrease pension savings. The authors conclude that although recent changes have increased women’s access to occupational pensions, these changes have preserved, and perhaps increased, familiar disadvantages associated with gender, marital status and labor market position.

Changing Demographics and New Pension Risks

This study used longitudinal data from the Panel Study of Income Dynamics to examine the hazards of pension saving associated with variations in household arrangements among two cohorts of older workers. Results from multivariate models predicting pension participation, plan type, and pension cash-out highlight that under the defined-contribution plans characteristic of the new pension environment, women continue to bear greater risks associated with family position and lower workplace earnings. Unmarried women were the most likely to be without any type of pension. High rates of divorce among recent cohorts coincide with the spread of individualized pensions and raise additional concerns about womens pension-related income security. Women are vulnerable to income and savings losses in response to marital dissolution, and findings provide evidence that these women are at greater risk of benefit loss due to pension cash-out. The results suggest that these risks may be even greater for younger cohorts of workers.

Ageing, disability and workplace accommodations

In most western nations, laws discourage discrimination in paid employment on the basis of disability, but for these policies to be of benefit, individuals must define their functional limitations as disabilities. There is a strong relationship between age and disability among those of working age, yet it is unclear whether older workers attribute their limitations to disability or to ‘ natural ageing ’. If the latter is true, they may not believe that they need or qualify for workplace accommodations (i.e. adaptations or interventions at the workplace). Similarly, if an employer ascribes a worker’s limitation to ‘ natural ageing ’, rather than to a disability, they may not offer compensatory accommodation. Using data from the Canadian 2001 Participation and Activity Limitation Survey, this paper asks whether workers who ascribe their functional limitation to ageing are as likely as those who do not to report a need for a workplace accommodation. It also addresses whether those who identify a need for compensatory accommodations and who ascribe their limitation to ageing have unmet workplace-accommodation needs. The findings suggest that, even when other factors are controlled, e.g. the type and severity of disability, the number of limiting conditions, gender, age, education, income and occupation, those who made the ageing attribution were less likely to recognise the need for an accommodation ; and among those who acknowledged a need, those who ascribed their disability to ageing were less likely to have their needs met.

Family structure and mothers’ mental health: A life course perspective on stability and change☆

Abstract We describe how a life course perspective can be used to examine the intersection of various patterns of stability or change in family structure over the life course with womens trajectories of psychological distress. Our approach in this chapter addresses both conceptual issues and methodological developments that we believe can advance our understanding of the intricate interplay between social structure and mental health over the life course. With information derived from life history calendars and a 14-year longitudinal study of a large sample of single and married mothers, we demonstrate how latent class cluster analysis can be used to construct trajectories of both family structure and psychological distress. We contend that such trajectories capture the dynamics of change over the life course. We conclude with a discussion of the ways in which four kinds of experiences may assist us in explaining variations in these trajectories. We argue that adversities in childhood and adolescence, precocious role transitions, early onset of depression, and the operant burden of stress each play important roles in influencing trajectories of family structure and psychological distress.

Economic hardship in childhood and adult health trajectories: An alternative approach to investigating life-course processes.

In this study, we advance existing research on health as a life course process by conceptualizing and measuring both childhood disadvantage and health as dynamic processes in order to investigate the relationship between trajectories of early life socioeconomic conditions and trajectories of health in midlife. We utilize a trajectory-based analysis that takes a disaggregated, person-centered approach to understand dynamic trajectories of health as latent variables that reflect the timing, duration and change in health conditions experienced by respondents over a period of 10 years in midlife as a function of stability and change in exposure to economic hardship in early life. Results from repeated-measures latent class analysis of longitudinal data from the Panel Study of Income Dynamics indicate that economic hardship in childhood has long-term, negative consequences for health both among individuals beginning life and remaining in poverty as well as those moving into poverty. In contrast, adults with more advantaged early life experiences, or who moved out of poverty during the period of observation, were at a lower risk of experiencing health trajectories characterized by the early onset or increasing risk of disease. We argue that a person-centered, disaggregated approach to the study of the relationship between socioeconomic status and health across the life course holds potential for the study of health inequality and that a greater focus on trajectory-based analysis is needed.

Life Course Pathways of Economic Hardship and Mobility and Midlife Trajectories of Health.

We utilize over 40 years of prospective data from the Panel Study of Income Dynamics (N = 1,229) and repeated-measures latent class analysis to examine how long-term patterns of stability and change in economic hardship from childhood to adulthood are related to subsequent trajectories of midlife health. We review conceptual and methodological approaches to examining health inequality across the life course and highlight the contribution of a person-centered, disaggregated approach to modeling health and its association with long-term pathways of economic resources, including changing resources associated with mobility. Findings suggest those who experienced early mobility out of economic hardship were less likely than those in persistent economic hardship to experience a high-risk health trajectory, while experiencing later mobility did not lessen this risk. We conclude with a call for further investigation into the role of social mobility and the timing, degree, and direction of change in investigations of health inequality.