Mieke Beth Thomeer

Race, Gender, and Chains of Disadvantage Childhood Adversity, Social Relationships, and Health

We use a life course approach to guide an investigation of relationships and health at the nexus of race and gender. We consider childhood as a sensitive period in the life course, during which significant adversity may launch chains of disadvantage in relationships throughout the life course that then have cumulative effects on health over time. Data from a nationally representative panel study (Americans’ Changing Lives, N = 3,477) reveal substantial disparities between black and white adults, especially pronounced among men, in the quality of close relationships and in the consequences of these relationships for health. Greater childhood adversity helps to explain why black men have worse health than white men, and some of this effect appears to operate through childhood adversity’s enduring influence on relationship strain in adulthood. Stress that occurs in adulthood plays a greater role than childhood adversity in explaining racial disparities in health among women.

Family Status and Mental Health: Recent Advances and Future Directions

Some of the earliest and most well-known sociological studies showed that marriage was beneficial to mental health, marriage benefited the mental health of men more than women, and parenthood caused psychological distress, especially for women. However, recent longitudinal research, reviewed in this chapter, questions these basic relationships. Recent studies show that though marriage is associated with improved mental health, these improvements are more modest than previously suggested and depend on other factors such as marital quality, race, and age. Cohabitors have higher psychological well-being than the single, though not as high as the married. Longitudinal studies suggest no gender difference in the average mental health benefit associated with transition into marriage. Recent research confirms that parenthood increases psychological distress, especially for young single parents. Future research should use an intersectionality framework to examine how multiple stratification systems work together to influence the relationship between family status and mental health.

Gendered emotion work around physical health problems in mid- and later-life marriages☆

The provision and receipt of emotion work-defined as intentional activities done to promote anothers emotional well-being-are central dimensions of marriage. However, emotion work in response to physical health problems is a largely unexplored, yet likely important, aspect of the marital experience. We analyze dyadic in-depth interviews with husbands and wives in 21 mid- to later-life couples to examine the ways that health-impaired people and their spouses provide, interpret, and explain emotion work. Because physical health problems, emotion work, and marital dynamics are gendered, we consider how these processes differ for women and men. We find that wives provide emotion work regardless of their own health status. Husbands provide emotion work less consistently, typically only when the husbands see themselves as their wifes primary source of stability or when the husbands view their marriage as balanced. Notions of traditional masculinity preclude some husbands from providing emotion work even when their wife is health-impaired. This study articulates emotion work around physical health problems as one factor that sustains and exacerbates gender inequalities in marriage with implications for emotional and physical well-being.

Marital Processes around Depression: A Gendered and Relational Perspective.

Despite extensive evidence of the importance of marriage and marital processes for mental health, little is known about the interpersonal processes around depression within marriage and the extent to which these processes are gendered. We use a mixed-methods approach to explore the importance of gender in shaping processes around depression within marriage. We approach this in two ways: First, using quantitative longitudinal analysis of 2,601 couples from the Health and Retirement Study (HRS), we address whether depressive symptoms in one spouse shape the other spouse’s depressive symptoms and whether men or women are more influential in this process. We find that a wife’s depressive symptoms influence her husband’s future depressive symptoms, but a husband’s depressive symptoms do not influence his wife’s future symptoms. Second, we conduct a qualitative analysis of in-depth interviews with 29 couples wherein one or both spouses experienced depression to provide additional insight into how gender impacts depression and reactions to depression within marriage. Our study points to the importance of cultural scripts of masculinity and femininity in shaping depression and emotional processes within marriage and highlights the importance of applying a gendered couple-level approach to better understand the mental health effects of marital processes.

How Do Race and Hispanic Ethnicity Affect Nursing Home Admission? Evidence From the Health and Retirement Study

OBJECTIVES This study investigates how health- and disability-based need factors and enabling factors (e.g., socioeconomic and family-based resources) relate to nursing home admission among 3 different racial and ethnic groups. METHOD We use Cox proportional hazard models to estimate differences in nursing home admission for non-Hispanic whites, non-Hispanic blacks, and Hispanics from 1998 to 2010 in the Health and Retirement Study (N = 18,952). RESULTS Racial-ethnic differences in nursing home admission are magnified after controlling for health- and disability-based need factors and enabling factors. Additionally, the degree to which specific factors contribute to risk of nursing home admission varies significantly across racial-ethnic groups. DISCUSSION Our findings indicate that substantial racial and ethnic variations in nursing home admission continue to exist and that Hispanic use is particularly low. We argue that these differences may demonstrate a significant underuse of nursing homes for racial and ethnic minorities. Alternatively, they could signify different preferences for nursing home care, perhaps due to unmeasured cultural factors or structural obstacles.

Marital Histories and Heavy Alcohol Use among Older Adults.

We develop a gendered marital biography approach—which emphasizes the accumulating gendered experiences of singlehood, marriage, marital dissolution, and remarriage—to examine the relationship between marital statuses and transitions and heavy alcohol use. We test this approach using individual-level (n = 10,457) and couple-level (n = 2,170) longitudinal data from the Health and Retirement Study, and individual-level (n = 46) and couple-level (n = 42) in-depth interview data. Quantitative results show that marriage, including remarriage, reduces men’s but increases women’s drinking relative to being never married and previously married, whereas divorce increases men’s but decrease women’s drinking, with some variation by age. Our qualitative findings reveal that social control and convergence processes underlie quantitative results. We call attention to how men’s and women’s heavy drinking trajectories stop, start, and change direction as individuals move through their distinctive marital biography.

Sexual Minority Status and Self-Rated Health: The Importance of Socioeconomic Status, Age, and Sex

OBJECTIVES I examined how sexual minority status, as indicated by sex of sexual partners, is associated with self-rated health and how socioeconomic status suppresses and age and sex moderate this association. METHODS I used multinomial logistic regression to analyze aggregated data from the 1991 to 2010 General Social Survey, a population-based data set (n = 13,480). RESULTS Respondents with only different-sex partners or with any same-sex partners reported similar levels of health. With socioeconomic status added to the model, respondents with any same-sex partners reported worse health than those with only different-sex partners, but only if sexual intercourse with same-sex partners occurred in the previous 5 years. Age and sex moderated this relationship: having any same-sex partners was associated with worse health for women but not men and among younger adults only. CONCLUSIONS The relationship between sexual minority status and self-rated health varies across sociodemographic groups. Future research should use population-level data to examine other health outcomes and continue to explore how the intersection of sexual minority status and other sociodemographic indicators shapes health.

Instrumental- and Emotion-Focused Care Work During Physical Health Events: Comparing Gay, Lesbian, and Heterosexual Marriages

Objectives We consider emotion- and instrumental-focused care work and marital stress during significant physical health events in midlife gay, lesbian, and heterosexual marriages. Method We employ the factorial method, an extension of the actor-partner interdependence model, to analyze survey data from 808 midlife gay, lesbian, and heterosexual spouses in 404 unions. Results The amount of emotion- and instrumental-focused care work provided during physical health events, and the associations between care work and marital stress, depends on the gender of the respondent, gender of the spouse, and whether spouses are in a same-sex or different-sex union. For example, in both same- and different-sex marriages, women report providing more emotion-focused care work during their own health event than do men, and respondents report more health-related marital stress when the patient is a woman. Discussion Investigating how midlife same-sex and different-sex spouses care for each other during a spouses health event expands understandings of gendered aging experiences within marriage. Findings can elucidate health policies and clinical strategies that best support the health of men and women in same- and different-sex marriages.

Childhood Adversity and Men’s Relationships in Adulthood: Life Course Processes and Racial Disadvantage

OBJECTIVES Prior U.S. population studies have found that childhood adversity influences the quality of relationships in adulthood, with emerging research suggesting that this association might be especially strong for black men. We theorize psychosocial and behavioral coping responses to early life adversity and how these responses may link early life adversity to strain in mens relationships with their indeterminate partners and children across the life course, with attention to possible racial variation in these experiences and implications for later life well-being. METHOD We analyze in-depth interviews with 15 black men and 15 white men. We use qualitative analysis techniques to connect childhood experiences to psychosocial processes in childhood and behavioral coping strategies associated with relationship experiences throughout adulthood. RESULTS Black men describe much stronger and more persistent childhood adversity than do white men. Findings further suggest that childhood adversity contributes to psychosocial processes (e.g., diminished sense of mastery) that may lead to ways of coping with adversity (e.g., self-medication) that are likely to contribute to relationship difficulties throughout the life span. DISCUSSION A life course perspective directs attention to the early life origins of cumulative patterns of social disadvantage, patterns that extend to later life. Our findings suggest psychosocial and behavioral pathways through which early life adversity may constrain and strain mens relationships, possibly contributing to racial inequality in family relationships across the life span.

Binge Drinking and Depression The Influence of Romantic Partners in Young Adulthood

Although research shows that spouses influence each other’s health behaviors and psychological well-being, we know little about whether these patterns extend to young people in nonmarital as well as marital relationships. We use the National Longitudinal Study of Adolescent to Adult Health to consider how a romantic partner’s binge drinking and depression influence the respondent’s binge drinking and depression within 1,111 young adult couples and explore whether these processes are moderated by gender. We find that partners’ binge drinking is associated with increased odds of binge drinking for respondents and partners’ depression is associated with increased odds of depression for respondents. Further, depression among men is associated with reduced odds of binge drinking among their female partners. Findings suggest that processes of partner influence begin even in young adulthood with implications for cumulative effects on lifelong health behaviors and mental health.