Lindsay R. Wilkinson

Childhood Disadvantage and Health Problems in Middle and Later Life Early Imprints on Physical Health

Drawing from cumulative inequality theory, we examine the relationship between childhood disadvantage and health problems in adulthood. Using two waves of data from Midlife Development in the United States, we investigate whether childhood disadvantage is associated with adult disadvantage, including fewer social resources, and the effect of lifelong disadvantage on health problems measured at the baseline survey and a 10-year follow-up. Findings reveal that childhood socioeconomic disadvantage and frequent abuse by parents are generally associated with fewer adult social resources and more lifestyle risks. Health problems, in turn, are affected by childhood disadvantage and by lifestyle risks, especially smoking and obesity. Not only was early disadvantage related to health problems at the baseline survey, but childhood socioeconomic disadvantage and frequent abuse also were related to the development of new health problems at the follow-up survey. These findings reveal the imprint of early disadvantage on health decades later and suggest greater attention to resources, even during midlife, can interrupt the chain of risks.

Childhood (Mis)fortune, Educational Attainment, and Adult Health: Contingent Benefits of a College Degree?

College-educated adults are healthier than other people in the United States, but selection bias complicates our understanding of how education influences health. This article focuses on the possibility that the health benefits of college may vary according to childhood (mis)fortune and people’s propensity to attain a college degree in the first place. Several perspectives from life course sociology offer competing hypotheses as to whether the most or the least advantaged see the greatest return of a college education. The authors use a national survey of middle-age American adults to assess risk of two cardiovascular health problems and mortality. Results from propensity score and hierarchical regression analysis indicate that the protective effect of college attainment is indeed heterogeneous. Further, the greatest returns are among those least likely to experience this life course transition (i.e., compensatory leveling). Explanations for this selection effect are offered, along with several directions for future research on the health benefits of completing college.

Accumulated Financial Strain and Women’s Health Over Three Decades

OBJECTIVE Drawing from cumulative inequality theory, this research examines how accumulated financial strain affects womens self-rated health in middle and later life. METHOD Using data from the National Longitudinal Survey of Mature Women (1967-2003), we employ random-coefficient growth curve models to examine whether recurring financial strain influences womens health, above and beyond several measures of objective social status. Predicted probabilities of poor health were estimated by the frequency of financial strain. RESULTS Financial strain is associated with rapid declines in womens health during middle and later life, especially for those women who reported recurrent strain. Changes in household income and household wealth were also associated with womens health but did not eliminate the effects due to accumulated financial strain. DISCUSSION Accumulated financial strain has long-term effects on womens health during middle and later life. The findings demonstrate the importance of measuring life course exposure to stressors in studies of health trajectories.

Alternative Measures of Self-Rated Health for Predicting Mortality Among Older People: Is Past or Future Orientation More Important?

PURPOSE The purpose of this study was to compare the prognostic validity of alternative measures of health ratings, including those that tap temporal reflections, on adult mortality. DESIGN AND METHODS The study uses a national sample of 1,266 Americans 50-74 years old in 1995, with vital status tracked through 2005, to compare the effect of 3 types of health ratings on mortality: conventional indicator of self-rated health (SRH), age comparison form of SRH, and health ratings that incorporate temporal dimensions. Logistic regression was used to estimate the odds of mortality associated with alternative health ratings while adjusting for health conditions, lifestyle factors, and status characteristics and resources. RESULTS Self-rated health was a consistent predictor of mortality, but the respondents expected health rating-10 years in the future-was an independent predictor. Future health expectations were more important than past (recalled change) in predicting mortality risk: People with more negative expectations of future health were less likely to survive. IMPLICATIONS The findings reveal the importance of future time perspective for older people and suggest that it is more useful to query older people about their future health expectations than about how their health has changed.

Financial Strain and Mental Health Among Older Adults During the Great Recession

OBJECTIVES The economic recession has garnered the interest of many scholars, with much attention being drawn to how the recession has affected labor force participation, household wealth, and even retirement decisions. Certainly, the Great Recession has influenced the financial well-being of older adults, but has it had discernible effects on mental health? METHOD This study draws on 5,366 respondents from the Health and Retirement Study (2006-2010) to examine objective and subjective measures of financial well-being in the period surrounding the Great Recession. Guided by cumulative inequality theory, this research investigates whether the economic downturn contributed to worsening anxiety and depressive symptoms over a 4-year period. RESULTS Results from linear fixed effects models reveal that decreases in objective financial resources were associated with increased financial strain during the Great Recession. Unlike the objective indicators, however, financial strain was a strong and robust predictor of worsening mental health between 2006 and 2010. DISCUSSION Building on prior research, this study elucidates the factors that shape financial strain and provides evidence that the Great Recession not only affected the financial well-being of older adults but also had adverse effects on mental health.

Age, Aging, and Mental Health

Generalizations regarding the epidemiology of aging and mental health are contingent on how one defines mental health. This chapter considers the relationship between age and both mental disorder and positive elements of mental health, positing that many older adults live with a low-grade concern or anxiety about the future coupled with fairly high levels of happiness. Using a life course perspective, mental health inequalities are summarized along several axes of stratification. Stress process, crisis, and cumulative inequality theories are profiled for advancing research on aging and mental health. The chapter concludes by identifying some of the frontiers for breakthrough discoveries regarding aging and mental health.

Does Occupational Mobility Influence Health among Working Women? Comparing Objective and Subjective Measures of Work Trajectories

Occupational mobility is highly valued in American society, but is it consequential to women’s health? Previous studies have yielded inconsistent results, but most measured occupational mobility by identifying transitions across occupational categories. Drawing from cumulative inequality theory, this study (1) compares objective and subjective measures of work trajectories and (2) examines the contributions of each to self-rated health. With 36 years of data from the National Longitudinal Survey of Mature Women (1967-2003), growth curve models are used to estimate the effects of middle-aged work trajectories on health among 2,503 U.S. women. Work trajectories as measured by the Duncan Socioeconomic Index predict health, but not after adjustment for perceived work trajectories and status characteristics. The findings reveal that subjective measures of occupational mobility provide important information for assessing health consequences of work transitions and that downward occupational mobility in middle age is deleterious to women’s health in later life.

Contextualization of Survey Data: What Do We Gain and Does It Matter?

Survey research designs that integrate contextual data have become more prevalent in recent decades, presumably to enable a more refined focus on the person as the unit of analysis and a greater emphasis on interindividual differences due to social forces and contextual conditions. This article reviews varied approaches to contextualizing survey data and examines the value of linking two data sources to respondent information: interviewer ratings and neighborhood information (measured via census tracts). The utility of an integrative approach is illustrated with data from the Health and Retirement Study. The results reveal modest gains by using a contextualized approach but also demonstrate that neglecting contextual factors may lead to misdirected substantive conclusions, especially for older racial and ethnic minorities. To enhance the ecological validity of survey data, investigators should select theoretically-meaningful contextual data for specific research questions and consider cross-level interactions.

Wealth in Middle and Later Life: Examining the Life Course Timing of Women’s Health Limitations

Background and Objectives Guided by cumulative inequality theory, this study poses two main questions: (a) Does womens poor health compromise household financial assets? (b) If yes, is wealth sensitive to the timing of womens health limitations? In addressing these questions, we consider the effect of health limitations on wealth at older ages, as well as examine how health limitations influence wealth over particular segments of the life course, giving attention to both the onset and duration of health limitations. Research Design and Methods Using 36 years of data from the National Longitudinal Survey of Mature Women, piecewise growth curve and linear regression models were used to estimate the effects of life course timing and duration of health limitations on household wealth. Results The findings reveal that women who experienced health limitations accumulated substantially less wealth over time, especially if the health limitations were manifest during childhood or early adulthood. Discussion and Implications This study identifies how early-life health problems lead to less wealth in later life.

Long-Term Effects of Age Discrimination on Mental Health:The Role of Perceived Financial Hardship

OBJECTIVES This study examines the role of work-related perceived age discrimination on womens mental health over the life course and tests whether financial strain mediates this relationship. METHODS Using the National Longitudinal Survey of Mature Women (1967-2003), we employ nested growth curve models to evaluate whether perceived age discrimination at work influences womens depressive symptoms and life satisfaction and whether perceived financial strain mediates this relationship. RESULTS Women who experienced age discrimination had greater overall depressive symptoms but not after controlling for financial strain. We found evidence that age discrimination affected financial strain, which, in turn, increased womens depressive symptoms. Women who reported age discrimination had lower odds of being in higher categories of overall life satisfaction; financial strain partially mediated the relationship but age discrimination remained a significant predictor. DISCUSSION Despite legal protection, age discrimination at work is frequent and has significant effects on womens mental health over the life course. Financial strain partially mediates this relationship, pointing to financial implications of perceived age discrimination for women and their families. Our findings have important policy and workplace implications, calling attention to ageism as a potent stressor for working womens mental health beyond those tied to sex or race.