Markus H. Schafer

The Stigma of Obesity Does Perceived Weight Discrimination Affect Identity and Physical Health

Obesity is widely recognized as a health risk, but it also represents a disadvantaged social position. Viewing body weight within the framework of stigma and its effects on life chances, we examine how perceived weight-based discrimination influences identity and physical health. Using national survey data with a 10-year longitudinal follow-up, we consider whether perceptions of weight discrimination shape weight perceptions, whether perceived weight discrimination exacerbates the health risks of obesity, and whether weight perceptions are the mechanism explaining why perceived weight discrimination is damaging to health. Perceived weight discrimination is found to be harmful, increasing the health risks of obesity associated with functional disability and, to a lesser degree, self-rated health. Findings also reveal that weight-based stigma shapes weight perceptions, which mediate the relationship between perceived discrimination and health.

Children of misfortune: early adversity and cumulative inequality in perceived life trajectories.

Adversity early in life may alter pathways of aging, but what interpretive processes can soften the blow of early insults? Drawing from cumulative inequality theory, the authors analyze trajectories of life evaluations and then consider whether early adversity offsets favorable expectations for the future. Results reveal that early adversity contributes to more negative views of the past but rising expectations for the future. Early adversity also has enduring effects on life evaluations, offsetting the influence of buoyant expectations. The findings draw attention to the limits of human agency under the constraints of early adversity—a process described as biographical structuration.

Age Identity, Gender, and Perceptions of Decline: Does Feeling Older Lead to Pessimistic Dispositions About Cognitive Aging?

OBJECTIVES Drawing on past studies of age identity, this article examined whether feeling older was associated with more pessimistic views about cognitive aging. METHODS Using respondents aged 55 years and older in the Midlife Development in the United States study, we estimated a series of linear regression models to predict peoples dispositions toward their cognitive aging. The main comparison is whether the effects of age identity on cognitive aging differ for men and women. RESULTS Beyond the effects of chronological age, older age identities were associated with more pessimistic dispositions about cognitive aging. This relationship, however, was found only among women. DISCUSSION Age identity shapes cognitive aging dispositions, though the gendered nature of this relationship remains somewhat unclear. The findings give further evidence about the far-reaching implications of age identity for successful aging and suggest that future work can explicate how subjective aging processes may differ by gender.

Childhood Misfortune as a Threat to Successful Aging: Avoiding Disease

PURPOSE The purpose of this study was to examine whether childhood misfortune reduces the likelihood of being disease free in adulthood. DESIGN AND METHODS This article used a sample of 3,000+ American adults, aged 25-74, who were first interviewed in 1995 and reinterviewed in 2005. Logistic regression was used to estimate the odds of avoiding disease at the first wave and remaining disease free a decade later. RESULTS Consistent with a life course view of successful aging, higher levels of childhood misfortune (e.g., abuse, financial strain) are associated with a lower probability of disease avoidance. This pattern was observed across a large set of chronic conditions and in multivariate analyses spanning both waves of the study. IMPLICATIONS Childhood misfortune has approximately equal consequences for adult disease avoidance as does the combined effect of moderate lifetime smoking and obesity. Efforts to alleviate adverse experiences for children may have long-term benefits for successful aging.

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.

Does childhood misfortune increase cancer risk in adulthood

Objective: To address the inconsistent findings on whether childhood misfortune increases adult cancer occurrence. Methods: This study uses longitudinal data from the National Survey of Midlife Development in the United States (MIDUS) that first sampled 3,032 respondents aged 25 to 74 during 1995-1996. A series of logistic regressions were estimated separately for men and women to test whether the effect of childhood misfortune on adult cancer was largely cumulative or specific to the type or profile of misfortune. Results: For men, additive childhood misfortune, physical abuse by father, and frequent abuse by either parent increased cancer risk. For women, physical abuse by mother and frequent abuse by either parent increased cancer risk. Discussion: Analyses revealed the importance of examining alternative specifications of childhood misfortune for men and women. Additive childhood misfortune predicted cancer for men only, whereas child abuse by parent of the same sex predicted cancer for men and women.

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.

Age Identity in Context: Stress and the Subjective Side of Aging

The passage of time is fundamentally experienced through people’s interaction with their social worlds. Life-course scholars acknowledge the multiple aspects of time-based experience but have given little attention to age identity in a dynamic context. Drawing from a stress-process model, we expected that turbulence within people’s family relations and health declines would produce increases in subjective age. Family role transitions were also examined as potential factors that would hasten subjective aging, but only to the extent that they produced stress. We used the Midlife Development in the United States study, a nationally representative longitudinal survey. Regression results show that turbulence within one’s family accelerated age identity and that the effect of diminishing psychosocial resources explained this relationship. For the most part, however, changes within family roles did not affect age identity. On the other hand, the incidence of chronic health problems increased subjective ages, and this relationship too was mediated by the depletion of psychosocial resources. The findings demonstrate an interconnection between the stress process and age identity. Broadening our conception of time-based experience with attention to the stress process offers exciting directions for future theory and research in life course sociology.

Trajectories of Body Mass and Self-Concept in Black and White Girls The Lingering Effects of Stigma

As a stigmatizing condition, obesity may lead to the internalization of devalued labels and threats to self-concept. Modified labeling theory suggests that the effects of stigma may outlive direct manifestations of the discredited characteristic itself. This article considers whether obesity’s effects on self-concept linger when obese youth enter the normal body mass range. Using longitudinal data from the National Growth and Health Study on 2,206 black and white girls, we estimated a parallel-process growth mixture model of body mass linked to growth models of body image discrepancy and self-esteem. We found that discrepancy was higher and self-esteem lower in formerly obese girls compared to girls always in the normal range and comparable to chronically obese girls. Neither body image discrepancy nor self-esteem rebounded in white girls despite reduction in body mass, suggesting that the effects of stigma linger. Self-esteem, but not discrepancy, did rebound in black girls.

Beyond the Barriers: Racial Discrimination and Use of Complementary and Alternative Medicine Among Black Americans

This article examines whether self-reported racial discrimination is associated with greater use of complementary and alternative medicine (CAM) and assesses whether the effects of reported racial discrimination are specific to the setting in which the unfair treatment occurred (i.e., medical or nonmedical settings). Data were drawn from the National Survey of Midlife Development in the United States (MIDUS) of Black adults aged 25 and older at baseline (N=201). Analyses account for multiple forms of discrimination: major lifetime discriminatory events and everyday discrimination (more commonplace negative occurrences). Using logistic and negative binomial regression, results reveal that racial discrimination was associated with a higher likelihood of using any type of CAM as well as using more modalities of CAM. Also, both discrimination in health care and discrimination in nonmedical contexts predicted greater use of CAM. The findings underscore the tenet that health care choices, while influenced by health status and availability of health care resources, are also shaped by perceived barriers. The experience of racial discrimination among Black people is associated with greater use of alternative means of health care, as a way to cope with the barriers they experience in institutional settings in the United States.