The Methuselah Effect: The Pernicious Impact of Unreported Deaths on Old-Age Mortality Estimates

We examine inferences about old-age mortality that arise when researchers use survey data matched to death records. We show that even small rates of failure to match respondents can lead to substantial bias in the measurement of mortality rates at older ages. This type of measurement error is consequential for three strands in the demographic literature: (1) the deceleration in mortality rates at old ages; (2) the black-white mortality crossover; and (3) the relatively low rate of old-age mortality among Hispanics, often called the “Hispanic paradox.” Using the National Longitudinal Survey of Older Men matched to death records in both the U.S. Vital Statistics system and the Social Security Death Index, we demonstrate that even small rates of missing mortality matching plausibly lead to an appearance of mortality deceleration when none exists and can generate a spurious black-white mortality crossover. We confirm these findings using data from the National Health Interview Survey matched to the U.S. Vital Statistics system, a data set known as the “gold standard” (Cowper et al. 2002) for estimating age-specific mortality. Moreover, with these data, we show that the Hispanic paradox is also plausibly explained by a similar undercount.     

The Life Course,Cohort Dynamics,and International Differences in Aging Trajectories

In recent years, population health research has focused on understanding the determinants of later-life health. Two strands of that work have focused on (1) international comparisons of later-life health and (2) assessing the early-life origins of disease and disability and the importance of life course processes. However, the less frequently examined intersection of these approaches remains an important frontier. The present study contributes to the integration of these approaches. We use the Health and Retirement Study family of data sets and a cohort dynamic approach to compare functional health trajectories across 12 high-income countries and to examine the role of life course processes and cohort dynamics in contributing to variation in those trajectories. We find substantial international variation in functional health trajectories and an important role of cohort dynamics in generating that variation, with younger cohorts often less healthy at comparable ages than the older cohorts they are replacing. We further find evidence of heterogeneous effects of life course processes on health trajectories. The results have important implications for future trends in morbidity and mortality as well as public policy.     

Public Sector Employment Inequality in the United States and the Great Recession

Historically in the United States, the public sector has served as an equalizing institution through the expansion of job opportunities for minority workers. This study examines whether the public sector continues to serve as an equalizing institution in the aftermath of the Great Recession. Using data from the Current Population Survey, I investigate changes in public sector employment between 2003 and 2013. My results point to a post-recession double disadvantage for black public sector workers: they are concentrated in a shrinking sector of the economy, and they are more likely than white and Hispanic public sector workers to experience job loss. These two trends are a historical break for the public sector labor market. I find that race and ethnicity gaps in public sector employment cannot be explained by differences in education, occupation, or any of the other measurable factors that are typically associated with employment. Among unemployed workers who most recently worked for the public sector, black women are the least likely to transition into private sector employment.     

Is the Association Between Education and Fertility Postponement Causal? The Role of Family Background Factors

A large body of literature has demonstrated a positive relationship between education and age at first birth. However, this relationship may be partly spurious because of family background factors that cannot be controlled for in most research designs. We investigate the extent to which education is causally related to later age at first birth in a large sample of female twins from the United Kingdom (N = 2,752). We present novel estimates using within–identical twin and biometric models. Our findings show that one year of additional schooling is associated with about one-half year later age at first birth in ordinary least squares (OLS) models. This estimate reduced to only a 1.5-month later age at first birth for the within–identical twin model controlling for all shared family background factors (genetic and family environmental). Biometric analyses reveal that it is mainly influences of the family environment—not genetic factors—that cause spurious associations between education and age at first birth. Last, using data from the Office for National Statistics, we demonstrate that only 1.9 months of the 2.74 years of fertility postponement for birth cohorts 1944–1967 could be attributed to educational expansion based on these estimates. We conclude that the rise in educational attainment alone cannot explain differences in fertility timing between cohorts.     

Malthus in the Bedroom: Birth Spacing as Birth Control in Pre-Transition England

We use duration models on a well-known historical data set of more than 15,000 families and 60,000 births in England for the period 1540–1850 to show that the sampled families adjusted the timing of their births in accordance with the economic conditions as well as their stock of dependent children. The effects were larger among the lower socioeconomic ranks. Our findings on the existence of parity-dependent as well as parity-independent birth spacing in England are consistent with the growing evidence that marital birth control was present in pre-transitional populations.     

Racial and Ethnic Disparities in Health Insurance Coverage: Dynamics of Gaining and Losing Coverage Over the Life-Course

Health insurance coverage varies substantially between racial and ethnic groups in the United States. Compared to non-Hispanic whites, African Americans and people of Hispanic origin had persistently lower insurance coverage rates at all ages. This article describes age- and group-specific dynamics of insurance gain and loss that contribute to inequalities found in traditional cross-sectional studies. It uses the longitudinal 2008 Panel of the Survey of Income and Program Participation (N = 114,345) to describe age-specific patterns of disparity prior to the Affordable Care Act (ACA). A formal decomposition on increment–decrement life tables of insurance gain and loss shows that coverage disparities are predominately driven by minority groups’ greater propensity to lose the insurance that they already have. Uninsured African Americans were faster to gain insurance compared to non-Hispanic whites, but their high rates of insurance loss more than negated this advantage. Disparities from greater rates of loss among minority groups emerge rapidly at the end of childhood and persist throughout adulthood. This is especially true for African Americans and Hispanics, and their relative disadvantages again heighten in their 40s and 50s.     

Life Course Changes in Smoking by Gender and Education: A Cohort Comparison Across France and the United States

Widening of educational disparities and a narrowing female advantage in mortality stem in good part from disparities in smoking. The changes in smoking and mortality disparities across cohorts and countries have been explained by an epidemic model of cigarette use but are also related to life course changes. To better describe and understand changing disparities over the life course, we compare age patterns of smoking in three cohorts and two nations (France and the US) using smoking history measures from the 2010 French health barometer (N = 20,940) and the 2010 US National Health Interview Survey Sample Adult File (N = 20,444). The results demonstrate statistically significant widening of gender and educational differences from adolescence to early and middle adulthood, thus accentuating the disparities already emerging during adolescence. In addition, the widening disparities over the life course have been changing across cohorts: age differences in educational disparities have grown in recent cohorts (especially in France), while age differences in gender disparities have narrowed. The findings highlight the multiple sources of inequality in smoking and health in high-income nations.     

Childbearing Behavior Before and After the 1994 Population Policies in Ghana

Due to the high population growth rate in the mid-20th century, the government of Ghana introduced population policies to reduce the growth rate. Encouraging girls’ education and increasing contraceptive use were the two main policy measures to reduce population growth. In order to get a clear picture of the childbearing dynamics of Ghanaian women in response to the population policy of 1994, we analyzed individual reproductive histories from 1969 to 2003 using 2003 Ghana Demographic Health survey data to disentangle patterns by parity, calendar period, and educational groups. Exponential hazard regression models were used to estimate the relative risk of births. We find some evidence of a critical juncture in fertility trends, particularly for the fifth child. In addition, higher parity transition rates continuously declined for women with secondary or higher education and these educational levels were achieved by a higher share of the population after the policy was implemented. The 1994 population policy was successful if only by virtue of the increasing number of women with secondary or higher education. Belonging to this group is not only associated with lower fertility, but this suppressing effect strengthened in the years following the policy implementation. We also suspect that the increasing similarity between women with no education and with primary education reflects the diffusion of contraceptive knowledge and norms related to childbearing. The educational reform and contraceptive initiatives did result in increased education and contraceptive awareness and are therefore beneficial programs.     

Maternal Household Decision-Making Autonomy and Adolescent Education in Honduras

Maternal decision-making autonomy has been linked to positive outcomes for children’s health and well-being early in life in low- and middle-income countries throughout the world. However, there is a dearth of research examining if and how maternal autonomy continues to influence children’s outcomes into adolescence and whether it impacts other domains of children’s lives beyond health, such as their education. The goal of this study was to determine whether high maternal decision-making was associated with school enrollment for secondary school-aged youth in Honduras. Further, we aimed to assess whether the relationships between maternal autonomy and school enrollment varied by adolescents’ environmental contexts and individual characteristics such as gender. Our analytical sample included 6579 adolescents ages 12–16 living with their mothers from the Honduran Demographic and Health Survey (DHS) 2011–2012. We used stepwise logistic regression models to investigate the association between maternal household decision-making autonomy and adolescents’ school enrollment. Our findings suggest that adolescents, especially girls, benefit from their mothers’ high decision-making autonomy. Findings suggest that maternal decision-making autonomy promotes adolescents’ school enrollment above and beyond other maternal, household, and regional influences.     

Discrimination,Sleep, and Stress Reactivity: Pathways to African American-White Cardiometabolic Risk Inequities

This review provides a model explicating two related physiologic and behavioral pathways through which the chronic daily stress of the expectation and experience of discrimination exposure can shape life course cardiometabolic risk trajectories: sleep and stress reactivity. We argue that these two pathways work together jointly to shape African American-White disparities in cardiometabolic morbidities. The body’s ongoing anticipation of experiencing racism-related stressors disrupts sleep, a behavior highly responsive to stress reactivity, which is also elevated during stressful conditions. The constant feedback between sleep disruption and the body’s stress response can lead to higher allostatic load and disproportionate exposure to stress-related illness among African Americans earlier in their life course.