Understanding the health decline of Americans in boomers to millennials.

Morbidity and mortality are on the rise among Americans from Boomers to Millennials. We investigate early-life diseases and the socioeconomic, psychosocial, and bio-behavioral factors behind this worsening health trend. Using data from the Panel Study of Income Dynamics Family and Individual Files 1968-2013, we find that the chronic disease index and poor subjective health have continuously increased for Baby Boomers and later cohorts. Early-life diseases, obesity, and shortening job tenure account for about half the health decline across cohorts. Weakening union protection, decreasing marriage, and declining religion only make minor contributions. All other factors, including early life nutrition and family background, adulthood socioeconomic status, physical activity, and smoking behaviors, make negative or non-significant contributions. These findings highlight that even though recent cohorts have better childhood nutrition, family socioeconomic environment,and higher levels of education and income, these advantages have been offset by elevated early-life disease exposure, obesity, and a precarious labor market. We discuss the findings in the context of Case and Deaton's "cumulative deprivation" thesis.

Rising childhood income inequality and declining Americans' health.

Morbidity and mortality are on the rise among Baby Boomers and younger cohorts. This study investigates whether this unfavorable health trend across birth cohorts 1925-1999 is related to rising income inequality Americans face during childhood. We use two nationally representative datasets: National Health and Nutrition Examination Surveys (NHANES) 1988-2018 and Panel Studies of Income Dynamics (PSID) 1968-2013, and two health outcomes: biomarkers of physiological dysregulation, and a chronic disease index. Childhood income inequality is measured by the average of the Gini index at the national level each birth cohort is exposed to between birth and age 18, where the Gini index from 1925 to 2016 is computed based on Internal Revenue Service income data. By merging childhood income inequality to individual level data from NHANES or PSID based on birth cohort, we find childhood income inequality is positively associated with the risk of physiological dysregulation in adulthood for all gender and racial groups in the NHANES data. It is also significantly related to the risk of chronic disease in the PSID data. This association is robust to controls for individual level childhood health and family background, adulthood socioeconomic and marital status, and contemporary macro socioeconomic factors. More importantly, childhood income inequality exposure explains a substantial amount of variation in these two health outcomes across cohorts, a pattern not observed for other early life exposures that display negative temporal trends similar to those for childhood income inequality. This study provides important evidence that income inequality experienced during childhood may have a long-lasting negative consequence for adult health, which partially explains the adverse health trends experienced by Baby Boomers and younger cohorts in the United States.

Divergent Trends in the Effects of Early-Life Factors on Adult Health.

Life course theories have shaped social and health scientists' understanding of the origins and pathways of health, aging, and mortality. However, few studies have examined how these origins might have changed across cohorts. This study investigates the impact of birth, childhood, and adolescence factors on adult health across birth cohorts born in the second half of the 20th century in the United States. Data come from the Panel Study of Income Dynamics Family and Individual Files 1968-2013 and the Childbirth and Adoption History File 1985-2013. Multilevel growth models are used to capture the growth trajectories of two adult health outcomes: self-rated health and health summary index. We find the association between three pre-adulthood factors (birth weight, mother's education, childhood family income-to-needs ratio) and health outcomes weakens in more recent cohorts, while the association strengthens for the other two early life factors (early-life disease index and parental smoking status before age 17). These findings demonstrate the complexity of the social-to-biological embodiment across the life course, and suggest that the effects of early-life factors on adult health can increase or decrease across cohorts due to macro social, economic, policy, technological, and medical changes. They also illuminate the long-term debate on the period and cohort effects in shaping the health trend, and suggest that the cohort effect is multidimensional and is weaker or stronger depending on the dimension of early life examined.

Job satisfaction developmental trajectories and health: A life course perspective.

Understanding the health consequence of job dissatisfaction becomes increasingly important because job insecurity, stress and dissatisfaction have significantly increased in the United States in the last decade. Despite the extensive work in this area, prior studies nonetheless may underestimate the harmful effect of job dissatisfaction due to the cross-sectional nature of their data and sample selection bias. This study applies a life-course approach to more comprehensively examine the relationship between job satisfaction and health. Using data from the NLSY 1979 cohort, we estimate group based job satisfaction trajectories of respondents starting at age 25 and ending at age 39. Four job satisfaction trajectory groups are identified, a consistently high satisfaction group, a downward group, an upward group, and a lowest satisfaction group. We examine the effects of these trajectories on several physical and mental health outcomes of respondents in their early forties. We find membership in the lowest job satisfaction trajectory group to be negatively associated with all five mental health outcomes, supporting the accumulation of risks life course model. Those in the upward job satisfaction trajectory group have similar health outcomes to those in the high job satisfaction trajectory group, supporting the social mobility life course model. Overall, we find the relationship between job satisfaction trajectories and health to be stronger for mental health compared to physical health.

Ecological Networks and Neighborhood Social Organization.

Drawing on the social disorganization tradition and the social ecological perspective of Jane Jacobs, the authors hypothesize that neighborhoods composed of residents who intersect in space more frequently as a result of routine activities will exhibit higher levels of collective efficacy, intergenerational closure, and social network interaction and exchange. They develop this approach employing the concept of ecological networks-two-mode networks that indirectly link residents through spatial overlap in routine activities. Using data from the Los Angeles Family and Neighborhood Survey, they find evidence that econetwork extensity (the average proportion of households in the neighborhood to which a given household is tied through any location) and intensity (the degree to which household dyads are characterized by ties through multiple locations) are positively related to changes in social organization between 2000-2001 and 2006-2008. These findings demonstrate the relevance of econetwork characteristics-heretofore neglected in research on urban neighborhoods-for consequential dimensions of neighborhood social organization.

The Body Mass Index-Mortality Link across the Life Course: Two Selection Biases and Their Effects.

In this study, we investigated two selection biases that may affect the obesity-mortality link over the life course: mortality selection and healthy participant effects. If these selection mechanisms are stronger among obese adults than among non-obese adults, they may contribute to the weakening obesity-mortality link over the life course. We used data from the National Health and Nutrition Examination Survey 1988-2010 with linked mortality files from 1988-2011. We employed weighted Cox models to test and adjust for these two selection biases. We also used complementary log-log models, adjusted for a normal distribution of frailty, to test for mortality selection effects; accelerated failure-time models to mitigate the mortality selection effect; and ordinary least squares regression to test for healthy participant effects. The link between class II/III obesity and mortality weakens at older ages. We did not find evidence for significant mortality selection or healthy participant effects. Also, even if the healthy participant effects were stronger among obese adults, they are not strong enough to produce a weakening association between obesity and morbidity at higher ages at the time of the survey. Therefore, neither of these selection biases explains the diminishing effect of class II/III obesity on mortality over the life course.

From Heterogeneity to Concentration: Latino Immigrant Neighborhoods and Collective Efficacy Perceptions in Los Angeles and Chicago.

Latino immigrant presence in urban neighborhoods has been linked with reduced neighborhood cohesion in social disorganization-based ethnic heterogeneity hypotheses and enhanced cohesion in immigration revitalization approaches. Using the 2000-2002 Los Angeles Family and Neighborhood Survey and the 1994-1995 Project on Human Development in Chicago Neighborhoods Community Survey, we explore the association between Latino immigrant concentration and both levels of, and agreement about, neighborhood collective efficacy. Findings from multilevel models with heteroskedastic variance indicate that Latino immigrant concentration exhibits a nonlinear association with collective efficacy. At low levels, increases in Latino immigrant concentration diminish collective efficacy, consistent with a heterogeneity hypothesis. The negative association between Latino immigrant concentration and collective efficacy declines in magnitude as immigrant concentration increases and, particularly in LA, becomes positive beyond a threshold, consistent with an immigration revitalization effect. We also find an inverse nonlinear pattern of association with the variance of collective efficacy. At low levels, increasing Latino immigrant concentration increases the variance of collective efficacy (reflecting more disagreement), but beyond a threshold, this association becomes negative (reflecting increasing agreement). This pattern is observed in both LA and Chicago. The prevalence of social interaction and reciprocated exchange within neighborhoods explains a modest proportion of the Latino immigrant concentration effect on mean levels of collective efficacy in Chicago, but does little to explain effects on the mean in LA or effects on the variance in either LA or Chicago. These findings offer insight into the complex role Latino immigrant presence plays in shaping neighborhood social climate.