Sharon Bzostek

Race, Ethnicity, And The Education Gradient In Health

Using pooled data from the 2000-2006 National Health Interview Survey, we document how the relationship between education and a broad range of health measures varies by race/ethnicity and nativity. We found that education is a more powerful determinant of health behaviors and outcomes for some groups than it is for others. In addition, the education differentials for foreign-born groups are typically more modest than those for corresponding native-born populations. We also show how the education-health relationship varies across Hispanic and Asian subgroups. We argue that any intervention for eliminating health disparities must take these patterns into account.

Young Adults’ Roles as Partners and Parents in the Context of Family Complexity

Using data from the 1979 and 1997 cohorts of the National Longitudinal Survey of Youth, we estimate the proportions of young men and women who will take on a variety of partner and parent roles by age 30, and describe how these estimates have changed between cohorts. We then draw on identity theory and related theoretical work to consider how the multiple family roles that young adults are likely to occupy—both over their life course and at a single point in time—may influence interfamily and intrafamily relationships. Our discussion highlights key implications of identity theory as it relates to family complexity and proposes several hypotheses for future empirical research, such as the greater likelihood of role conflict in families with greater complexity and limited resources. Our analysis suggests that families may be less likely to function—economically and socially—as cohesive units than has been the case in the past and than most existing policies assume.

Family Structure Experiences and Child Socioemotional Development During the First Nine Years of Life: Examining Heterogeneity by Family Structure at Birth

A vast amount of literature has documented negative associations between family instability and child development, with the largest associations being in the socioemotional (behavioral) domain. Yet, prior work has paid limited attention to differentiating the role of the number, types, and sequencing of family transitions that children experience, as well as to understanding potential heterogeneity in these associations by family structure at birth. We use data from the Fragile Families and Child Wellbeing Study and hierarchical linear models to examine associations of family structure states and transitions with children’s socioemotional development during the first nine years of life. We pay close attention to the type and number of family structure transitions experienced and examine whether associations differ depending on family structure at birth. For children born to cohabiting or noncoresident parents, we find little evidence that subsequent family structure experiences are associated with socioemotional development. For children born to married parents, we find associations between family instability and poorer socioemotional development. However, this largely reflects the influence of parental breakup; we find little evidence that socioemotional trajectories differ for children with various family structure experiences subsequent to their parents’ breakup.

Public Health Insurance and Health Care Utilization for Children in Immigrant Families

Objectives To estimate the impacts of public health insurance coverage on health care utilization and unmet health care needs for children in immigrant families. Methods We use survey data from National Health Interview Survey (NHIS) (2001–2005) linked to data from Medical Expenditures Panel Survey (MEPS) (2003–2007) for children with siblings in families headed by at least one immigrant parent. We use logit models with family fixed effects. Results Compared to their siblings with public insurance, uninsured children in immigrant families have higher odds of having no usual source of care, having no health care visits in a 2 year period, having high Emergency Department reliance, and having unmet health care needs. We find no statistically significant difference in the odds of having annual well-child visits. Conclusions for practice Previous research may have underestimated the impact of public health insurance for children in immigrant families. Children in immigrant families would likely benefit considerably from expansions of public health insurance eligibility to cover all children, including children without citizenship. Immigrant families that include both insured and uninsured children may benefit from additional referral and outreach efforts from health care providers to ensure that uninsured children have the same access to health care as their publicly-insured siblings.