Investigating the mechanism of marital mortality reduction: The transition to widowhood and quality of health care

While it is well known that the widowed suffer increased mortality risks, the mechanism of this survival disadvantage is still under investigation. In this article, we examine the quality of health care as a possible link between widowhood and mortality using a unique data set of 475,313 elderly couples who were followed up for up to nine years. We address whether the transition to widowhood affects the quality of care that individuals receive and explore the extent to which these changes mediate the elevated mortality hazard for the widowed. We analyze six established measures of quality of health care in a fixed-effect framework to account for unobserved heterogeneity. Caregiving and acute bereavement during the transition to widowhood appear to distract individuals from taking care of their own health care needs in the short run. However, being widowed does not have long-term detrimental effects on individuals’ ability to sustain contact with the formal medical system. Moreover, the short-run disruption does not mediate the widowhood effect on mortality. Nevertheless, long after spousal death, men suffer from a decline in the quality of informal care, coordination between formal and informal care, and the ability to advocate and communicate in formal medical settings. These findings illustrate women’s centrality in the household production of health and identify important points of intervention in optimizing men’s adjustment to widowhood.     

Mortality attributable to obesity among middle-aged adults in the united states

Obesity is considered a major cause of premature mortality and a potential threat to the longstanding secular decline in mortality in the United States. We measure relative and attributable risks associated with obesity among middle-aged adults using data from the Health and Retirement Study (1992–2004). Although class II/III obesity (BMI _ 35.0 kg/m2) increases mortality by 40% in females and 62% in males compared with normal BMI (BMI = 18.5-24.9), class I obesity (BMI = 30.0-34.9) and being overweight (BMI = 25.0-29.9) are not associated with excess mortality. With respect to attributable mortality, class II/III obesity (BMI _ 35.0) is responsible for approximately 4% of deaths among females and 3% of deaths among males. Obesity is often compared with cigarette smoking as a major source of avoidable mortality. Smoking-attributable mortality is much larger in this cohort: about 36% in females and 50% in males. Results are robust to confounding by preexisting diseases, multiple dimensions of socioeconomic status (SES), smoking, and other correlates. These findings challenge the viewpoint that obesity will stem the long-term secular decline in U.S. mortality.     

Comment: there may be compositional effects,but they do not work that way*

This analysis joins the debate on how declines in marriage have shifted the composition of the unmarried and married populations in the United States, and how compositional shifts have affected nonmarital birth rates. Gray, Stockard, and Stone (2006) presented one model for compositional effects that Ermisch (2009) challenged with alternative statistical tests. I propose an alternative model for compositional shifts based not on theory but on observed marriage and fertility patterns. The results from this alternative model are consistent with Ermisch’s findings yet support Gray et al.’s general case that compositional effects have had an important infiuence on nonmarital birth rates.     

Forced Migration and Mortality in the Very Long Term: Did Perestroika Affect Death Rates Also in Finland?

In this article, we analyze mortality rates of Finns born in areas that were ceded to the Soviet Union after World War II and from which the entire population was evacuated. These internally displaced persons are observed during the period 1971-2004 and compared with people born in the same region but on the adjacent side of the new border. We find that in the 1970s and 1980s, the forced migrants had mortality rates that were on par with those of people in the comparison group. In the late 1980s, the mortality risk of internally displaced men increased by 20% in relation to the expected time trend. This deviation, which manifests particularly in cardiovascular mortality, coincides with perestroika and the demise of the Soviet Union, which were events that resulted in an intense debate in civil society about restitution of the ceded areas. Because state actors were reluctant to engage, the debate declined after some few years, and after the mid-1990s, the death risk again approached the long-term trend. Our findings indicate that when internally displaced persons must adjust to situations for which appropriate coping behaviors are unknown, psychosocial stress might arise several decades after their evacuation.     

Large,But Adaptable? A Successful Population Policy and Its Long Term Effects

A restrictive population policy led to almost doubling the number of newborns from one year to another in Romania in the 1960s. Twenty years later, this large generation (of women) enters a marriage market with few eligible older mates, in a society where marriage is a must. In this article, I analyze this social experiment within the broader frame of the marriage squeeze/two sex models. Using various data from censuses and surveys, I argue that the marriage market is flexible even when is confronted with disproportionately large cohorts. If the social pressure toward marriage is strong, the marriage rates do not necessarily fall, but the mating age patterns change.

Life Course Perspectives on the Links Between Poverty and Obesity During the Transition to Young Adulthood

Increasing obesity among Americans is a serious issue in the US, especially in the pediatric and young adult population. We use a longitudinal design to examine the relationship between childhood poverty/welfare receipt and obesity onset and continuity from adolescence into young adulthood using three waves of the National Longitudinal Study of Adolescent Health. We include multiple measures of disadvantage that co-occur with poverty and model potential mediating mechanisms within a life course framework. We find a significant effect of poverty/welfare receipt in childhood on obesity outcomes for females, but not for males. However, other measures of socioeconomic disadvantage such as neighborhood poverty, and low parental education are related to obesity in both males and females. Poverty may impact female obesity through the mediating effects of physical activity, inadequate sleep, skipping breakfast and certain forms of parental monitoring, while race is an important confounder of poverty’s influence. This paper highlights the important influence of poverty and other aspects of social disadvantage on obesity outcomes during this critical transition to adulthood. Implications of this research include physical activity and parenting interventions for low-income youth. In addition, governmental efforts should be made to increase physical activity opportunities in poor neighborhoods.

Revisiting das gupta: Refinement and extension of standardization and decomposition

Standardization and decomposition are established and widely used demographic techniques for comparing rates and means between groups with differences in composition. The difference in rates and means has heretofore been resolved in terms of the contribution of variables to compositional effects for each variable and an overall rate effect. This study demonstrates that the resolution of differences is attainable at the categorical level for both compositional effects and rate effects. Refinements to Das Gupta’s equations yield a complete decomposition because of the additivity of categorical compositional and rate effects. Other refinements allow the decomposition of polytomous variables. Extensions to the method provide for the decomposition of the standard deviation and the multivariate index of dissimilarity.     

Parental characteristics and the schooling progress of the children of immigrant and U.S.-born blacks

In this study, I examine disparities in schooling progress among children born to immigrant and U.S.-born blacks. I find that in one- and two-parent families, children born to black immigrants are less likely to fall behind in school than those born to U.S.-born blacks. In two-parent immigrant families, children born to two immigrant parents have a significant schooling advantage over children born to one immigrant parent. While children born to two immigrant parents in the wealthiest black immigrant families do better in the second generation than in the first, the reverse is observed among children in less wealthy families. These findings contribute in two ways to our understanding of the assimilation processes of children born to black immigrant parents. First, they show that there is a positive association between the number of immigrant parents in a family and children’s schooling performance. Second, they suggest that disparities in the assimilation patterns of the children of black immigrants are a likely product of the interaction between their parental characteristics and the socioeconomic circumstances of their families.