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Reynolds A, Greenfield EA, Nepomnyaschy L. Disparate benefits of higher childhood socioeconomic status on cognition in young adulthood by intersectional social positions. ADVANCES IN LIFE COURSE RESEARCH 2024; 60:100608. [PMID: 38552532 PMCID: PMC11129928 DOI: 10.1016/j.alcr.2024.100608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 01/16/2024] [Accepted: 01/16/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVES Emerging evidence supports the protective effects of higher childhood socioeconomic status (cSES) on cognition over the life course. However, less understood is if higher cSES confers benefits equally across intersecting social positions. Guided by a situational intersectionality perspective and the theory of Minority Diminished Returns (MDR), this study examined the extent to which associations between cSES and cognition in young adulthood are jointly moderated by racialized identity and region of childhood residence. METHODS Using data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), we used multilevel modeling to test associations between cSES and delayed recall and working memory 14 years later when participants were ages 25-34. Further, we examined the influence of racialized identity and region of childhood residence on these associations. RESULTS Higher cSES was associated with higher delayed recall and working memory scores across social positions. However, the strength of the association between higher cSES and working memory differed across racialized subgroups and region of childhood residence. We found a statistically significant three-way interaction between cSES, race and region of childhood residence. Of particular important, a small yet statistically robust association was found in all groups, but was especially strong among White Southerners and especially weak among Black participants from the South. CONCLUSIONS This study contributes to a growing body of research indicating that the protective effects of higher cSES on cognition are not universal across subgroups of intersecting social positions, consistent with the theory of MDR. These findings provide evidence for the importance of considering the role of systemic racism across geographic contexts as part of initiatives to promote equity in life course cognitive aging and brain health.
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Affiliation(s)
- Addam Reynolds
- Andrus Gerontology Center, 3715 McClintock Ave, Los Angeles, CA 90089, USA; Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA.
| | - Emily A Greenfield
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Lenna Nepomnyaschy
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
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Schwartz GL, Wang G, Kim MH, Glymour MM, White JS, Collin D, Hamad R. Individual and regional differences in the effects of school racial segregation on Black students' health. SSM Popul Health 2024; 26:101681. [PMID: 38840850 PMCID: PMC11152755 DOI: 10.1016/j.ssmph.2024.101681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 04/03/2024] [Accepted: 05/19/2024] [Indexed: 06/07/2024] Open
Abstract
Background School racial segregation in the US has risen steadily since the 1990s, propelled by Supreme Court decisions rolling back the legacy of Brown v. Board. Quasi-experimental research has shown this resegregation harms Black students' health. However, whether individual or family characteristics (e.g., higher family incomes) are protective against segregation's health harms-or whether segregation is more damaging in regions of the US with fewer public sector investments-remains unclear. We leverage the quasi-random timing of school districts being released from Brown-era integration plans to examine heterogeneity in the association between resegregation and Black students' health. Methods & findings We took an instrumental variables approach, using the timing of integration order releases as an instrument for school segregation and analyzing a pre-specified list of theoretically-motivated modifiers in the Panel Study of Income Dynamics. In sensitivity analyses, we fit OLS models that directly adjusted for relevant covariates. Results suggest resegregation may have been particularly harmful in the South, where districts resegregated more quickly after order releases. We find little evidence that the effects of school segregation differed across family income, gender, or age. Conclusion The end of court-ordered integration threatens the health of Black communities-especially in the US South. Modestly higher incomes do not appear protective against school segregation's harms. Research using larger samples and alternative measures of school segregation-e.g., between districts, instead of within districts-may further our understanding of segregation's health effects, especially in Northern states.
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Affiliation(s)
- Gabriel L. Schwartz
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 490 Illinois Street, 7th Floor, San Francisco, CA, 94158, USA
- Urban Health Collaborative & Department of Health Management & Policy, Drexel University Dornsife School of Public Health, 3600 Market St, Philadelphia, PA, 19147, USA
| | - Guangyi Wang
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 490 Illinois Street, 7th Floor, San Francisco, CA, 94158, USA
| | - Min Hee Kim
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 490 Illinois Street, 7th Floor, San Francisco, CA, 94158, USA
| | - M. Maria Glymour
- Department of Epidemiology & Biostatistics, University of California San Francisco, 550 16th Street, 2nd Floor, San Francisco, CA, 94158, USA
- Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA
| | - Justin S. White
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 490 Illinois Street, 7th Floor, San Francisco, CA, 94158, USA
- Department of Health Law, Policy & Management, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA
| | - Daniel Collin
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 490 Illinois Street, 7th Floor, San Francisco, CA, 94158, USA
| | - Rita Hamad
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 490 Illinois Street, 7th Floor, San Francisco, CA, 94158, USA
- Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
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Gemmill A, Berger BO, Crane MA, Margerison CE. Mortality Rates Among U.S. Women of Reproductive Age, 1999-2019. Am J Prev Med 2022; 62:548-557. [PMID: 35135719 PMCID: PMC8940663 DOI: 10.1016/j.amepre.2021.10.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/21/2021] [Accepted: 10/03/2021] [Indexed: 11/01/2022]
Abstract
INTRODUCTION High and increasing levels of pregnancy-related mortality and morbidity in the U.S. indicate that the underlying health status of reproductive-aged women may be far from optimal, yet few studies have examined mortality trends and disparities exclusively among this population. METHODS All-cause and cause-specific mortality data for 1999-2019 were obtained from the Centers for Disease Control and Prevention WONDER Underlying Cause of Death database. Levels and trends in mortality between 1999 and 2019 for women aged 15-44 years stratified by age, race/ethnicity, and state were examined. Given the urgent need to address pregnancy-related health disparities, the correlation between all-cause and pregnancy-related mortality rates across states for the years 2015-2019 was also examined. RESULTS Age-adjusted, all-cause mortality rates among women aged 15-44 years improved between 2003 and 2011 but worsened between 2011 and 2019. The recent increase in mortality among this age group was not driven solely by increases in external causes of death. Patterns differed by age, race/ethnicity, and geography, with non-Hispanic American Indian and Alaskan Native women having 2.3 and non-Hispanic Black women having 1.4 times the risk of all-cause mortality in 2019 compared with that of non-Hispanic White women. Age-adjusted all-cause mortality rates and pregnancy-related mortality rates were strongly correlated at the state level (r=0.75). CONCLUSIONS Increasing mortality among reproductive-aged women has substantial implications for maternal, women's, and children's health. Given the high correlation between pregnancy-related mortality and all-cause mortality at the state level, addressing the structural factors that shape mortality risks may have the greatest likelihood of improving women's health outcomes across the life course.
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Affiliation(s)
- Alison Gemmill
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
| | - Blair O Berger
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Matthew A Crane
- Johns Hopkins University School of Medicine, Baltimore, Maryland; USC Leonard D. Schaeffer Center for Health Policy & Economics, University of Southern California, Los Angeles, California; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Claire E Margerison
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan
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Xu W, Engelman M, Fletcher J. From convergence to divergence: Lifespan variation in US states, 1959-2017. SSM Popul Health 2021; 16:100987. [PMID: 34917746 PMCID: PMC8666353 DOI: 10.1016/j.ssmph.2021.100987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/15/2021] [Accepted: 11/29/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Large disparities in life expectancy exist across US states and the gaps have been widening in recent decades. Less is known about the lifespan variability - a measure that can provide important insights into mortality inequalities both between and within states. METHOD Using yearly lifetables from the United States Mortality Database, we explore geographic and temporal patterns in lifespan variation (unconditional and conditional on survival to age 10, 35 and 65) across US states between 1959 and 2017. We also examine the contribution of state differences in life expectancy to overall lifespan variation using standard decomposition techniques. RESULTS Despite overall convergence in lifespan variation across states over the last six decades, in more recent years there has been notable divergence. Gender-specific analyses show that lifespan variation was generally greater among males than among females; but this pattern reverses for mortality past age 65. Much of the state disparities in lifespan variation, unconditional and conditional on survival to age 10 and 35, were due to mortality differences under the age 65. Decomposition analysis shows that while within-state variability remains the primary driver of overall lifespan variation, the contribution of cross-state differences in life expectancy is growing. CONCLUSIONS Variation in longevity is greater within US States than between them, yet cross-states disparities in mortality are increasing. This likely reflects the long-term consequences of rising social, economic, and political stratification for health inequalities both within and across states.
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Affiliation(s)
- Wei Xu
- Center for Demography of Health and Aging, University of Wisconsin Madison, 1180 Observatory Drive, Madison, WI 53706, USA
| | - Michal Engelman
- Center for Demography of Health and Aging, University of Wisconsin Madison, 1180 Observatory Drive, Madison, WI 53706, USA
- Department of Sociology, University of Wisconsin Madison, 1180 Observatory Drive, Madison, WI 53706, USA
| | - Jason Fletcher
- Center for Demography of Health and Aging, University of Wisconsin Madison, 1180 Observatory Drive, Madison, WI 53706, USA
- Department of Sociology, University of Wisconsin Madison, 1180 Observatory Drive, Madison, WI 53706, USA
- La Follette School of Public Affairs, University of Wisconsin Madison, 1225 Observatory Drive, Madison, WI 53706, USA
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Gutin I, Hummer RA. Social Inequality and the Future of U.S. Life Expectancy. ANNUAL REVIEW OF SOCIOLOGY 2021; 47:501-520. [PMID: 34366549 PMCID: PMC8340572 DOI: 10.1146/annurev-soc-072320-100249] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Despite decades of progress, the future of life expectancy in the United States is uncertain due to widening socioeconomic disparities in mortality, continued disparities in mortality across racial/ethnic groups, and an increase in extrinsic causes of death. These trends prompt us to scrutinize life expectancy in a high-income but enormously unequal society like the United States, where social factors determine who is most able to maximize their biological lifespan. After reviewing evidence for biodemographic perspectives on life expectancy, the uneven diffusion of health-enhancing innovations throughout the population, and the changing nature of threats to population health, we argue that sociology is optimally positioned to lead discourse on the future of life expectancy. Given recent trends, sociologists should emphasize the importance of the social determinants of life expectancy, redirecting research focus away from extending extreme longevity and towards research on social inequality with the goal of improving population health for all.
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Affiliation(s)
- Iliya Gutin
- Department of Sociology and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27516
- Corresponding author:
| | - Robert A. Hummer
- Department of Sociology and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27516
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