Few studies of disparities consider logistical hurdles faced by adults with obesity in obtaining needed healthcare. This study compared adults with obesity to adults without obesity on self-reported practical aspects of receiving healthcare including ease of seeing a doctor and wait times for appointments. Serious psychological distress and chronic health conditions are prevalent in adults with obesity. Because serious psychological distress and number of chronic health conditions can act as confounders in any observed differences between the adults with and without obesity in their use of healthcare, we have examined these differences independent of serious psychological distress and chronic health conditions. Adults 18 to 64 years sampled from the 2006–2015 National Health Interview Survey (NHIS) (n = 74,598) were examined on five self-reported indicators: does not need a doctor, waited too long in the doctor’s office, and to get an appointment, year since having seen a doctor, and saw a doctor ten times or more in the last 12 months. Multivariable models adjusted for serious psychological distress, chronic health conditions, gender, age, race/ethnicity, income, health coverage, and survey year demonstrated that adults with obesity were more likely to wait too long to get an appointment, and in the waiting room. Adults with obesity report not needing doctors despite seeing doctors frequently. Greater attention is needed to understand barriers to health care utilization in adults with obesity.
Racial segregation has long characterized urban life in the U.S., with research consistently showing that minority groups occupy different social spaces than whites. While past scholarship has focused largely on residential contexts, a considerable portion of individuals’ days is spent outside of the home and existing research misses the potential for cross-group contact in non-residential contexts. In this paper, we assess the levels and patterns of segregation in the environments where people spend their workday, for white, black, Hispanic, and Asian workers. Using commuting data from the Census Transportation Planning Package, we construct measures of racial composition in “workhoods” and compare metropolitan-level segregation in places of work and home. Results indicate that workhood segregation is substantially lower than residential segregation. Black-white segregation in work settings is, for example, half the level of black-white segregation in residential settings. Multivariate analyses also reveal that workhood segregation, for all groups, is higher in metropolitan areas with greater residential segregation. For Hispanic workers, areas with larger immigrant populations have higher workhood segregation, and for blacks, workhood segregation is lower in metropolitan areas with large military populations. Our findings also consistently show that black and Hispanic workhood segregation is lower in areas where minority groups are more occupationally disadvantaged.
Recent research from the gender revolution perspective suggests that men’s increasing involvement in the family domain accounts for the positive association between fertility and female labor force participation in developed Western countries. However, little relevant evidence exists on their Asian counterparts, where lowest-low fertility, low levels of women’s employment, and traditional family values prevail. Using the 2007, 2008, and 2010 waves of the Korean Longitudinal Survey of Women and Families (N = 10,263 couple-waves), we examine how parenthood transitions affect wives’ and husbands’ provisions of household labor and how their employment status moderates this relationship. Focusing on comparisons between first and additional children, we estimate couple fixed-effects regressions. The dependent variables are the time that each spouse spends on household labor and the husband’s share of the couple’s total time spent on this labor. The key independent variables are the number of children and the number interacted with each spouse’s employment status. The results show that household labor was gendered even prior to the birth of the first child. Inequality in household labor increased significantly further with first children, but not with additional children. This increase persisted regardless of women’s employment status, thereby implying that first children might exacerbate the double burden on employed women. Policy lessons are drawn regarding how to raise fertility and female labor force participation in Korea and other countries where women have difficulty reconciling work and family life.
While cohabitation has been increasing and a growing context to have and raise children, there has been little attention to one of the key determinants of fertility and effective contraceptive use. Drawing data from the 2013–2015 National Survey of Family Growth (N = 2285), we provide a contemporary portrait of contraceptive use among cohabiting American women. Specifically, we were guided by two main goals. First, we compared cohabiting and married women’s contraceptive use patterns and the variation by race and ethnicity. Second, we focused solely on cohabiting unions; and examined the racial and ethnic variation among cohabiting women. We found that cohabiting women are more likely to use effective methods of contraception than married women. Nonetheless, our findings point to the fact that white cohabiting women are driving the higher patterns of contraceptive use among cohabiting women. Indeed, a further examination of the variation among women in cohabiting relationships shows that black cohabitors are less likely to use effective contraception in cohabiting relationships, compared to whites. Our findings contribute to understanding the reproductive behaviors among a growing set of couples, cohabitors.
The literature on neighborhoods and child obesity links contextual conditions to risk, assuming that if place matters, it matters in a similar way for everyone in those places. We explore the extent to which distinctive neighborhood types give rise to social patterning that produces variation in the odds of child obesity. We leverage geocoded electronic medical records for a diverse sample of over 135,000 children aged 2 to 12 and latent profile modeling to characterize places into distinctive neighborhood contexts. Multilevel models with cross-level interactions between neighborhood type and family socioeconomic standing (SES) reveal that children with different SES, but living in the same neighborhoods, have different odds of obesity. Specifically, we find lower-SES children benefit, but to a lesser degree, from neighborhood advantages and higher-SES children are negatively influenced, to a larger degree, by neighborhood disadvantages. The resulting narrowing of the gap in obesity by neighborhood disadvantage helps clarify how place matters for children’s odds of obesity and suggests that efforts to improve access to community advantages as well as efforts to address community disadvantages are important to curbing obesity and improving the health of all children.
Social surveys prospectively linked with death records provide invaluable opportunities for the study of the relationship between social and economic circumstances and mortality. Although survey-linked mortality files play a prominent role in U.S. health disparities research, it is unclear how well mortality estimates from these datasets align with one another and whether they are comparable with U.S. vital statistics data. We conduct the first study that systematically compares mortality estimates from several widely used survey-linked mortality files and U.S. vital statistics data. Our results show that mortality rates and life expectancies from the National Health Interview Survey Linked Mortality Files, Health and Retirement Study, Americans’ Changing Lives study, and U.S. vital statistics data are similar. Mortality rates are slightly lower and life expectancies are slightly higher in these linked datasets relative to vital statistics data. Compared with vital statistics and other survey-linked datasets, General Social Survey-National Death Index life expectancy estimates are much lower at younger adult ages and much higher at older adult ages. Cox proportional hazard models regressing all-cause mortality risk on age, gender, race, educational attainment, and marital status conceal the issues with the General Social Survey-National Death Index that are observed in our comparison of absolute measures of mortality risk. We provide recommendations for researchers who use survey-linked mortality files.
Researchers typically identify health disparities using self-reported race/ethnicity, a measure identifying individuals’ social and cultural affiliations. In this study, we use data from Waves 1, 3, and 4 of Add Health to examine health disparities by interviewer-ascribed skin color, a measure capturing the perceptions of race/ethnicity ascribed to individuals by others. Individuals with darker-skin tones may face greater exposure to serious stressors such as perceived discrimination, poverty, and economic hardship which can accumulate over the lifecourse and increase the likelihood of poor health. We found significant gradients in Body Mass Index (BMI), obesity, self-reported health, and depressive symptoms by interviewer-ascribed skin color but results differed by gender. Associations of BMI, obesity, and fair/poor health among women were only partially mediated by discrimination, self-reported stress, or low socioeconomic status and persisted after controlling for race/ethnicity. Among men, initial associations between skin color and both fair/poor health and depressive symptoms did not persist after controlling for race/ethnicity. This study demonstrates the value of considering stratification by skin color and gender in conjunction with race/ethnicity.
Despite a growing literature documenting deleterious intergenerational consequences of incarceration, relatively little is known about how exposure to paternal incarceration is associated with risk behaviors in adolescence. In this article, we use data from the Fragile Families and Child Wellbeing Study (N = 3405)—a cohort of urban children born around the turn of the twenty-first century and followed for 15 years—to examine the relationship between paternal incarceration and one indicator of adolescent risk behavior, early sexual onset. Results from adjusted logistic regression models show that paternal incarceration is associated with a greater likelihood of initiating sexual activity before age 15, in part resulting from externalizing problems that follow paternal incarceration. We also find that these associations are concentrated among boys living with their fathers prior to his incarceration. Given that paternal incarceration is a stressor concentrated among already vulnerable children, paternal incarceration may exacerbate inequalities in adolescent sexual risk behavior.
While there has been much empirical investigation into how social support networks improve mental health in post-disaster communities, network density—the extent members within a network are acquainted—remains under-researched. This study examines correlations between support network density and support reciprocity satisfaction in an elderly sample (N = 221), and the influence on post-disaster depression and trauma symptomology in a fishing community south of the Fukushima nuclear plant within 1 year of the March 11, 2011 Japan earthquake. The Brief Inventory of Social Support Exchange Network (BISSEN) taps support network density, support source by relational category, tangible and emotional type, and providing or receiving direction of social support. Density measurement convergent validity was established from questionnaire responses. After confirming network density construct and criteria validity, and extracting components reciprocal support relationship satisfaction, correlation between these two variables was moderate at r = 0.34. However, reciprocity satisfaction moderately explained mental health variance, but results were not significant for density nor interaction between predictors. These results question the assumption that support network density and support reciprocity can be validly incorporated into a construct of “social capital” necessarily promoting mental health.
Sea-Level Rise (SLR) Projections from the National Oceanic and Atmospheric Administration (NOAA) and the U.S. Army Corp of Engineers (USACE) indicate increasing, and imminent, risk to coastal communities from tidal flooding and hurricane storm surge. Building on recent research related to the potential demographic impacts of such changes (Hauer et al. 2016, in Nat Clim Chang 3:802–806, 2017; Neumann et al. 2015; Curtis and Schneider in Popul Environ 33:28–54, 2011), localized flooding projections in the Miami Beach area (Wdowinski et al. in Ocean Coast Manag 126:1–8, 2016) and projected economic losses associated with this rise in projected SLR (Fu et al. Ocean Coast Manag 133:11–17, 2016); this research investigates the accrued current cost, in terms of real-estate dollars lost, due to recurrent tidal flooding and projected increases of flooding in Miami-Dade County. Most directly related to this line of research, Keenan et al. (2018) have recently produced results indicating that Climate Gentrification is taking place in Miami, FL with higher elevations in flood prone areas appreciating at a higher rate. In that vein of thinking, we seek to answer a question posed by such research: What is the actual accrued loss to sea-level rise over the recent past? To answer this question, we replicate well-documented estimation methods by combining publicly available sea-level rise projections, tide gauge trends, and property lot elevation data to identify areas regularly at risk of flooding. Combining recent patterns of flooding inundation with future forecasts, we find that properties projected to be inundated with tidal flooding in 2032 have lost $3.08 each year on each square foot of living area, and properties near roads that will be inundated with tidal flooding in 2032 have lost $3.71 each year on each square foot of living area. These effects total over $465 million in lost real-estate market value between 2005 and 2016 in the Miami-Dade area.
In a rural African context, the saying, “it takes a village to raise a child,” suggests that community characteristics are substantially important in children’s lives as they transit to adulthood. Are these contextual factors also related to youth migration? Demographers are uncertain about how community characteristics improve our understanding of an individual’s propensity to migrate, beyond individual and household factors. In many low- and middle-income country settings, youth become migrants for the first time in their lives to provide access to resources that their families need. We employ discrete-time event history models from 2003 to 2011 Agincourt Health and socio-Demographic Surveillance System in rural South Africa to test whether markers of development in a village are associated with the likelihood of youth and young adults migrating, distinguishing between becoming temporary and permanent migrants during this critical life cycle phase. We find that village characteristics indeed differentially predict migration, but not nearly as substantially as might be expected.
Pregnant women are likely to be sensitive to daily fluctuations in nutritional intake. To see if income constraints at the end of the month limit food consumption and trigger health problems, we examine how the date that benefits are issued for the Supplemental Nutrition Assistance Program (SNAP) changes the probability that a woman will go to the Emergency Room (ER) for pregnancy-related conditions using administrative data from SNAP and Medicaid from Missouri for 2010–2013. SNAP benefits in Missouri are distributed from the 1st through the 22nd day of the month based on the birth month and the first letter of the last name of the head of the household, making timing of SNAP issuance exogenous. We estimate probit models of the calendar month and SNAP benefit month on the probability of a pregnancy-related ER visit for women age 17–45, or the sample at risk of being pregnant. We also examine the relationship between SNAP benefit levels and ER visits. We found that women who received SNAP benefits in the second or third week of the calendar month were less likely to receive pregnancy-related care through the ER in the week following benefit receipt. Results suggest that SNAP benefits might be related to patterns of pregnancy-related medical care accessed through the ER. Since SNAP issuance date is within state control in the United States, states may want to consider the health effects of their choice.
Chinese women have reached a high level of labor force participation before China’s deepening economic reform starting from the early 1990s, while women’s deteriorating position in the labor market has been documented in recent literature. However, few studies connect the relationship between the presence of children at different ages and women’s labor market outcomes. Capitalizing on longitudinal data, this study uses a person-fixed-effects model to investigate the relationship between motherhood stages and women’s economic outcomes in urban China. It takes into consideration the impact of children at various ages, as well as the impact of growth in local economies. We find that very young children inhibit mothers’ employment, but the presence of school-aged children is positively correlated with mothers’ income. Our analysis further suggests that, with the development of local economies, the negative association of very young children and women’s labor activity is exacerbated, while the positive relationship between school-aged children and mothers’ income is weakened. Our findings also contribute to the literature on labor market institutions, gender-role ideologies, and the impact on women’s economic outcomes as they balance work with childrearing obligations.
Many previous studies identified factors influencing hurricane evacuation decisions by testing the protective action decision model (PADM). This study further examines factors that affect the trust in authority’s recommendation and evacuation decision-making in a proposed Kyne–Donner Model. The model provides an understanding of the predictive factors influencing evacuation decision-making through the mediating factor of trust in authority’s recommendation. This study takes advantage of the structural equation modeling method to simultaneously test multi-stages of the model. There are factors, namely, age, gender, education, household size, decision maker, risk area, house materials, hurricane evacuation experience, information seeking frequency, information seeking behavior, and information sources which influence trust in authority’s recommendation which, together with hurricane evacuation impediments, influence the hurricane evacuation decision. The study’s findings are consistent with the PADM and demonstrate the importance of trust in authority’s recommendation and hurricane evacuation decision-making.
Australia is a major immigration country and immigrants currently represent around 28% of the total population. The aim of this research is to understand the long-term consequences of this immigration and, particularly, how migrants respond to opportunities within the country after arriving through the process of subsequent (internal) migration. The focus is on major immigrant groups in Australia, including persons born in the United Kingdom, New Zealand, China and India, and how their patterns differ from persons born in Australia. To conduct this analysis, we have gathered data for a 35-year period based on quinquennial census data. We also obtained birthplace-specific mortality data for constructing multiregional life tables for the immigrant populations. Subsequent migration is important for understanding population redistribution, and the relative attractiveness of destinations within host countries. Our results highlight the importance of subsequent migration and the diversity of migration behaviours amongst different immigrant groups in the context of overall declines in internal migration since 1981.
A critical development goal involves reducing subsistence farming and encouraging entrepreneurship and formal sector employment. A growing number of studies examine cross-national variation in the rates of subsistence farming, marginal self-employment, formal employment, and prosperous entrepreneurship by level of development. However, despite significant regional disparities in development within most low-to-middle-income countries, little is known about how development at the local level is associated with labor market patterns. Using a pooled cross section containing four waves of data from the Mexican Census (1990–2015), this study investigates the relationship between social development and municipal workforce composition. In the 1980s, Mexico initiated an ambitious and multipronged development agenda intended to reduce extreme regional disparities in educational attainment, housing quality, access to utilities, and poverty. This study measures social development using a multi-dimensional measure that captures educational attainment, housing quality, access to utilities, and poverty. Laborers are separated into employed, own-account workers, and employers, with each category divided into agricultural and non-agricultural. In a second set of analyses, non-agricultural own-account workers are categorized as high and low growth potential and non-agricultural wage workers are separated into informal and formal sector. Results from fixed effects regression models indicate that local development significantly reduces the rate of own-account agricultural work and increases non-agricultural wage labor and employer self-employment. As less developed areas advance, the largest initial increase in non-agricultural work is in the informal sector. But, in more developed communities, social development increasingly predicts growth in formal sector employment and more selective entry into non-agricultural own-account work. The findings suggest that investment in community-level social development has the potential to reduce subsistence self-employment, encourage formal sector work, and promote entrepreneurship. Yet, the greatest gains occur in communities that already have mid to high levels of social development.
Transportation infrastructures play an essential role in influencing population and employment change. While railroads, highways, and airports were constructed in different time periods, now they complement each other in terms of providing accessibility. This study uses county-level data to examine the impacts of the three forms of transportation infrastructure on population and employment change in the continental United States from 1970 to 2010. The findings suggest that transportation infrastructures play evolving but complementary roles in affecting population and employment change during the study period: railroads act as a distributive factor, highways take a facilitator role, and airports behave like growth poles. Diversification of the roles indicates that transportation infrastructures have evolved from a pure growth factor to an essential multifaceted development element of human society.
Post natural disaster immigration has potential to significantly impact labor markets, possibly affecting local workers’ employment opportunities and thereby community recovery. However, research is limited. This study examines the impacts of the 2010 and 2011 Canterbury earthquakes on demographic composition and occupational structure in the Greater Christchurch construction industry using customized data from New Zealand Census of Populations and Dwellings conducted in 2006 and 2013. Replication of the discrete dependent variable regression methods used by Sisk and Bankston III (Popul Res Policy Rev 33(3):309–334, 2014) enables comparison with outcomes in New Orleans post-Hurricane Katrina. The increased presence of migrant construction workers did not reduce employment of New Zealand-born workers, both non-immigrant and immigrant participation in the construction industry increased post-earthquakes. After the earthquakes, there was increased worker participation at the lowest-skill end of the occupational structure, but there were few significant changes in occupational distributions of non-immigrant and immigrant workers. Non-immigrant workers still dominated all occupational levels post-earthquakes. Construction workers’ education levels were higher post-earthquakes, particularly among migrant workers. Overall, migrant workers in the Greater Christchurch construction industry were more diverse, better educated, and participated at higher occupational levels than migrants assisting in the New Orleans rebuild, possibly due to differences in immigration policies.
Teens’ attitudes about adolescent childbearing predict childbearing in the short term. If these attitudes reflect persistent goals and values, they may also be linked to later outcomes. To test long-term linkages, we analyze the association of adolescent fertility attitudes with actual and prospective fertility in adulthood using Waves I (1994–1995) and IV (2007–2008) of the National Longitudinal Study of Adolescent to Adult Health and focusing on men (N = 4275) and women (N = 4418) without a teen birth. For women, we find that more negative teen attitudes predict lower hazards of a first birth up to around age 30 but that teens’ attitudes are unrelated to planned childlessness among those who have not yet had children. Men’s adolescent attitudes are unrelated to actual fertility or prospective intentions. For both men and women, more advantaged individuals are less likely to have had a child by around age 30; socioeconomic advantage is also related to postponement of childbearing rather than planned childlessness, though more so for women than men. We interpret the findings as evidence that, for girls, teens’ attitudes toward adolescent childbearing capture an internalization of social schema about childbearing, childrearing, and sequencing with other life outcomes but do not reflect overall preferences about having children. More work is needed to understand the psychosocial factors that influence men’s fertility.
Previous research has found a strong link between educational attainment and health, where the highly educated live longer and healthier lives than those with lower levels of education. Because such research has relied on samples of the non-institutionalized population, previous research has not explored the association between education and specific chronic and infectious health conditions among the currently incarcerated. Analyzing the relationship between education and health conditions among the incarcerated, who tend to be less healthy and for whom many of the intermediate mechanisms between education and health are held relatively constant in prison, may yield new insights. Using the 2002–2004 National Health Interview Study (N = 74,881), the 2004 Survey of Inmates in State and Federal Correctional Facilities (N = 17,553), and interaction terms from logistic regression models, I compared the strength of the association between educational attainment and the presence of chronic and infectious health conditions among the incarcerated and non-incarcerated populations. These models indicated generally stronger negative associations between educational attainment and chronic conditions among the non-incarcerated, while the negative relationship between education and hepatitis was stronger for the incarcerated. These results suggest that while education may play a lesser role for chronic conditions for the incarcerated, it can still important for avoiding risky health behaviors.