Rachel Donnelly

Death of family members as an overlooked source of racial disadvantage in the United States

Significance Due to historical racial inequalities in the United States, including poverty, inadequate health care, and criminal victimization, black Americans die at much higher rates than white Americans. How the consequences of these elevated rates reverberate across family networks warrants attention. If blacks die at higher rates and earlier in the life course than whites, then blacks lose more loved ones from childhood through adulthood. Through the damaging effects of grief and other mechanisms, such losses are likely to undermine multiple life course outcomes. By analyzing nationally representative datasets to compare black and white Americans on the likelihood of losing family members over the life course, this study documents an intergenerational process with corrosive effects on black families and communities. Long-standing racial differences in US life expectancy suggest that black Americans would be exposed to significantly more family member deaths than white Americans from childhood through adulthood, which, given the health risks posed by grief and bereavement, would add to the disadvantages that they face. We analyze nationally representative US data from the National Longitudinal Study of Youth (n = 7,617) and the Health and Retirement Study (n = 34,757) to estimate racial differences in exposure to the death of family members at different ages, beginning in childhood. Results indicate that blacks are significantly more likely than whites to have experienced the death of a mother, a father, and a sibling from childhood through midlife. From young adulthood through later life, blacks are also more likely than whites to have experienced the death of a child and of a spouse. These results reveal an underappreciated layer of racial inequality in the United States, one that could contribute to the intergenerational transmission of health disadvantage. By calling attention to this heightened vulnerability of black Americans, our findings underscore the need to address the potential impact of more frequent and earlier exposure to family member deaths in the process of cumulative disadvantage.

Physical Illness in Gay, Lesbian, and Heterosexual Marriages Gendered Dyadic Experiences

The inclusion of same-sex married couples can illuminate and challenge assumptions about gender that are routinely taken for granted in studies of physical illness. We analyze gender dynamics in gay, lesbian, and heterosexual marriages with in-depth interview data from 90 spouses (45 couples) to consider how spouses co-construct illness experiences in ways that shape relationship dynamics. Overall, findings indicate that men tend to downplay illness and thus provide minimal care work, whereas women tend to construct illness as immersive and involving intensive care work—in both same-sex and different-sex marriages. Yet same-sex spouses describe similar constructions of illness much more so than different-sex couples, and as such, same-sex spouses describe less illness-related disagreement and stress. These findings help inform policies to support the health of gay and lesbian, as well as heterosexual, patients and their spouses, an important goal given health disparities of gay and lesbian populations.

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.

Planning for Future Care and the End of Life: A Qualitative Analysis of Gay, Lesbian, and Heterosexual Couples:

Two key components of end-of-life planning are (1) informal discussions about future care and other end-of-life preferences and (2) formal planning via living wills and other legal documents. We leverage previous work on the institutional aspects of marriage and on sexual-minority discrimination to theorize why and how heterosexual, gay, and lesbian married couples engage in informal and formal end-of-life planning. We analyze qualitative dyadic in-depth interviews with 45 midlife gay, lesbian, and heterosexual married couples (N = 90 spouses). Findings suggest that same-sex spouses devote considerable attention to informal planning conversations and formal end-of-life plans, while heterosexual spouses report minimal formal or informal planning. The primary reasons same-sex spouses give for making end-of-life preparations are related to the absence of legal protections and concerns about discrimination from families. These findings raise questions about future end-of-life planning for same- and different-sex couples given a rapidly shifting legal and social landscape.

Health and Health Behavior Concordance between Spouses in Same-Sex and Different-Sex Marriages:

Research shows that heterosexual spouses are concordant on a variety of health and health behavior outcomes. Yet, little is known about patterns of concordance between spouses in same-sex marriages, or whether concordance patterns differ for spouses in same- and different-sex marriages. Using descriptive techniques, we analyze survey data from both spouses in 121 gay, 168 lesbian, and 122 heterosexual married couples to examine health and health behavior concordance. We find that gay and lesbian couples are more concordant than heterosexual couples on several health and health behavior outcomes. Differences in concordance between gay and lesbian couples are also found. Findings suggest that the pathways through which concordance occurs may differ in important ways for same-sex and different-sex unions.

Childhood Adversity, Daily Stress, and Marital Strain in Same-Sex and Different-Sex Marriages

Childhood adversity has enduring consequences for individuals throughout life, including increased reactivity to stress that may contribute to marital strain in adulthood. Past research on gendered experiences of heterosexual spouses raises questions about how the influence of childhood adversity might differ for men and women in same-sex marriages. We analyze dyadic diary data from 756 individuals in 106 male same-sex, 157 female same-sex, and 115 different-sex marriages to consider how childhood adversity moderates the association between daily stress and marital strain. Results suggest that the negative consequences of daily stress for marital strain are amplified by past childhood adversity with variation for men and women in same- and different-sex unions, such that women and those in same-sex marriages may experience some protection from the adverse consequences of childhood adversity.

Gender, Socioeconomic Status, and Diet Behaviors within Brazilian Families

Existing literature documents the key role that parents play in transmitting diet behaviors to their children; however, less is known about differences by parent and child gender within families, especially with attention to household socioeconomic status (SES). We use nationally representative household data from Brazil and ask how parent-child associations of diet behavior differ by gender within lower- and higher-SES households. Results indicate that both maternal and paternal diet behaviors are associated with sons’ and daughters’ diet behaviors, but the strength of these associations differs depending on the gender of both the parent and the child. Moreover, gender differences in parent-child diet resemblance exist primarily in lower-, but not in higher-SES households. These findings are important for understanding health processes that occur within families and lead to disparities across generations, especially in a middle-income country undergoing sharp economic and nutritional changes.

Can Spouses Buffer the Impact of Discrimination on Depressive Symptoms?: An Examination of Same-sex and Different-sex Marriages

Discrimination due to personal characteristics (e.g., gender, sexuality, appearance) is a common yet stressful experience that is detrimental to mental health. Prior work has not considered how spouses in same- and different-sex marriages help each other cope with discrimination despite the importance of marriage for managing stress and adversity. We analyze survey data collected from both spouses in same-sex and different-sex marriages within the United States (N = 836 individuals) to examine whether support from spouses weakens the impact of discrimination on depressive symptoms. Results suggest that discrimination contributes to depressive symptoms, but greater support from spouses buffers the mental health consequences of discrimination. Individuals in same-sex marriages report more spousal support than individuals in different-sex marriages, even after accounting for experiences of discrimination. Same-sex couples may get needed spousal support, whereas women married to men receive the least spousal support and may be vulnerable to stressors that challenge mental health.

Same-sex Couples Devote More Attention to End-of-Life Plans than Heterosexual Couples

Engaging in end-of-life planning enhances the quality of later-life caregiving, health, and death. In this brief, Mieke Beth Thomeer, along with PRC doctoral student Rachel Donnelly, PRC director Debra Umberson, and Corinne Reczek reports on end-of-life planning among same-sex and different-sex married couples. They find that same-sex spouses devote considerable attention to informal planning conversations and formal end-of-life plans while heterosexual spouses report minimal formal or informal planning.

How Spouses Influence Each Other’s Health Habits in Same-Sex Compared to Different-Sex Marriages

Decades of research have highlighted how, compared to men, women do more work to influence their spouse’s health habits, to the health benefit of men. In this brief, PRC director Debra Umberson, PRC doctoral student Rachel Donnelly and PRC postdoctoral fellow Amanda Pollitt show that gay and lesbian spouses, like heterosexual spouses, actively work to influence each other’s health habits. Policymakers and others should highlight the ways marriage can promote health in same-sex as well as different-sex couples while also paying attention to gender differences in some of these relationship dynamics.