Hurt on Both Sides: Political Differences in Health and Well-Being during the COVID-19 Pandemic.

Republicans and conservatives report better self-rated health and well-being compared to Democrats and liberals, yet they are more likely to reside in geographic areas with heavy COVID-19 morbidity and mortality. This harmed health on "both sides" of political divides, occurring in a time of rapid sociopolitical upheaval, warrants the revisiting of psychosocial mechanisms linked to political health differences. Drawing on national Gallup data (early 2021), we find that predicted differences in health or well-being vary substantially by ideology, party, voting behavior, and policy beliefs, with model fit depending on how politics are measured. Differences in self-rated health, psychological distress, happiness, trouble sleeping, and delayed health care tend to reveal worse outcomes for Democrats or liberals. Such differences often are reduced to insignificance by some combination of mastery, meritocratic beliefs, perceived social support, and COVID-19-related exposures and attitudes. Policy beliefs predict health differences most robustly across outcomes and mechanism adjustments.

The Long Arm of Childhood: Does It Vary According to Health Care System Quality?

Increasing evidence points to the salience of early life experiences in shaping health inequalities, but scant research has considered the role of institutional resources as buffers in this relationship. Health care systems in particular are an understudied yet important context for the generation of inequalities from childhood into adulthood. This research investigates associations between childhood disadvantage and adult morbidity and examines the role of health care system quality in this relationship. We also consider the role of adult socioeconomic status. We merge individual-level data on major disease (2014 European Social Survey) with nation-level health care indicators. Results across subjective and objective approaches to health care system quality are similar, indicating a reduced association between childhood socioeconomic status and adult disease in countries with higher quality health care. In total, our results reiterate the long-term influence of childhood disadvantage on health while suggesting health care's specific role as an institutional resource for ameliorating life course health inequalities.

Subjective dignity and self-reported health: Results from the United States before and during the Covid-19 pandemic.

Aims: To describe disparities in depressive symptoms and self-rated health with a novel, individual-level measure of subjective dignity administered before and during the COVID-19 pandemic. Methods: National survey data were collected across the United States by the Gallup Organization in Spring (2017) (n â€‹= â€‹1459) and again in Spring (2021) (n â€‹= â€‹1244). Subjective dignity is measured by self-reported perceptions of dignity in one's own life. Numerous demographic subgroups constructed across age, gender, race/ethnicity, education, income, urbanicity, labor force status, and political background are used to test for robustness of dignity-health associations within and across years. Results: All demographic subgroups studied reported numeric decreases in dignity from 2017 to 2021, with many of these decreases being both large and significant. With few group-year exceptions, subjective dignity relates to lower levels of depression and higher self-rated health, with dignity-depression associations significantly increasing from 2017 to 2021. Conclusions: Dignity, as a pluralistic moral concept, is purported to anchor legal, human rights, and cultural discourses on justice, equity, and social inclusion. This study provides timely, original evidence that subjective appraisals of dignity should be considered as a public health indicator, especially across periods of societal unrest or adversity. Given groupwise robustness of dignity-health associations as documented here, subgroup determinants and lay definitions of dignity may merit closer attention.

Work-Family Reconciliation and Children's Well-Being Disparities across OECD Countries.

Socioeconomic inequalities in health and well-being are large, beginning early in childhood and accumulating over the life course, but they also vary widely across rich developed nations. Despite this well-known cross-national variation, research has yet to examine why children's health disparities might be larger or smaller based on national policy contexts and macroeconomic conditions. Parental health and well-being suffer under high work-family or economic strain, which may directly impact children's health inequalities by family social class. These childhood health disadvantages, if not substantially improved, compound to even larger adult inequalities. To examine the role of national work-family reconciliation in children's health, we merge country-level policy data with 2006 and 2010 World Health Organization child-level data on mental and physical well-being and family economic disadvantage. Based on adjusted estimates, we find greatly narrowed disparities in children's self-rated health as work flexibility and vacation-sick leave mandates become more generous. However, cash transfer policies including family benefits spending and childcare costs were not associated with the size of children's health disparities. Taken together, our results suggest the distinctive value of better work-family accommodations, rather than any generic cash allowances, for lessening family-based inequalities in children's health and human capital development.

Higher exposure, lower vulnerability? The curious case of education, gender discrimination, and Women's health.

Workplace gender discrimination persists in American society and women's experiences of discrimination are linked to diminished mental and physical well-being. While higher socioeconomic status (SES) decreases exposure to a number of work-related stressors, research suggests higher SES may also be associated with increased rates of perceived gender discrimination at work. We conceptualize educational attainment as a "metamechanism" that shapes women's work lives, family lives, as well as their ideologies. We argue that these factors in turn structure women's exposure and vulnerability to gender discrimination. We assess the influence of educational attainment on women's perceptions of workplace discrimination, as well as its health consequences, by analyzing national data from the 2002-2014 General Social Surveys. Our analyses show that women with high levels of education are more likely than women with lower levels of education to work full-time and in well-compensated, male-dominated occupations, and it is in these contexts where women are most likely to perceive gender discrimination. While educational attainment is associated with increased reports of workplace gender discrimination, it also sometimes provides women with resources that buffer its negative health consequences. For women with lower levels of education, perceived gender discrimination is associated with worse mental health, lower quality sleep, less happiness, and lower job satisfaction, but these particular health tolls diminish or disappear at higher levels of education. Our results shed light on the multi-level processes through which gender and education work together to structure health outcomes.

Looking homeward with the life course: Early origins of adult dwelling satisfaction?

The long-term influence of childhood economic and social exposures on adult health and well-being is well-known. Most childhood circumstances transpire in or near the home, yet research has largely neglected how early exposures shape people's experience of their residential context in adulthood. To help address this gap, we use retrospective longitudinal data from the Midlife Development in the United States (MIDUS) study. Drawing on a life course framework, we test the potential mediating roles of adult social, economic, and mental health processes. Results suggest that childhood parental warmth and maltreatment have an enduring influence on people's satisfaction with their adult home, while there is little indication that childhood economic conditions shape adult dwelling satisfaction. Analyses of average controlled direct effects suggest that the effects of childhood parental warmth are mediated slightly by adult socioeconomic attainment and psychological adjustment but especially by supportive family relationships during adulthood. This pattern is consistent with an attachment-based interpretation of the importance of childhood conditions for adult relationships as well as home satisfaction. Taken together, our results suggest that parent-child bonds cast a long shadow over how people experience their residential context decades later, through a diffuse, multifaceted set of intervening pathways.

Does the Association Between Age and Major Illness Vary by Healthcare System Quality?

This study builds on research into global aging, by offering a multiple-indicator test of whether national healthcare system quality modifies the association between age and major illness. Recent individual-level data on morbidity among respondents aged 50 or older (16 countries; 2014 European Social Survey) are merged with nation-level healthcare indicators. Healthcare system quality is assessed using a subjective, evaluation-based approach and an objective, attributable-mortality approach. Lagged nation-level economic and health indicators are controlled to help isolate healthcare system effects. Results across subjective and objective approaches to healthcare system quality are strikingly consistent. While older individuals showed approximately a 10% reduction in probability of major illness when residing in countries with higher healthcare quality, associations between age and morbidity indices combining number and severity of illness showed greater modification by healthcare quality, with reductions around 18%. Taken together, results are suggestive of healthcare's protective role in reducing age-related illness and disability.

Strapped for Time or Stressed Out? Predictors of Work Interruption and Unmet Need for Workplace Support Among Informal Elder Caregivers.

OBJECTIVE: We evaluate whether strong associations between unmet need and work interruption observed among informal elder caregivers are explained by caregiver personal characteristics, caregiving situations, or diminished caregiver well-being. METHOD: We analyze a proprietary survey of informal elder caregivers conducted by a single large U.S. employer ( N = 642 caregivers). RESULTS: Unmet need was about twice as common among those experiencing mild (29.79%) or severe interruption (35.00%) relative to those who did not interrupt work (16.87%). Although caregiver characteristics and aspects of caregiving situation show links to either unmet need or work interruption specifically, the association between unmet need and work interruption was not explained by these factors, or by caregiver well-being. DISCUSSION: Needs-related work interruptions may arise by other workplace processes, such as organizational culture, that should be measured and tested explicitly by future research.

A Discordance Weighting Approach Estimating Occupational and Income Returns to Education.

Schooling differences between identical twins are often utilized as a natural experiment to estimate returns to education. Despite longstanding doubts about the truly random nature of within-twin-pair schooling discordance, such discordance has not yet been understood comprehensively, in terms of diverse between- and within-family peer, academic, familial, social, and health exposures. Here, a predictive analysis using national U.S. midlife twin data shows that within-pair schooling differences are endogenous to a variety of childhood exposures. Using discordance propensities, returns to education under a true natural experiment are simulated. Results for midlife occupation and income reveal differences in estimated returns to education that are statistically insignificant, suggesting that twin-based estimates of causal effects are robust. Moreover, identical and fraternal twins show similar levels of discordance endogeneity and similar responses to propensity weighting, suggesting that the identical twins may not provide demonstrably better leverage in the causal identification of educational returns.

Informal Care Networks in the Context of Multimorbidity: Size, Composition, and Associations With Recipient Psychological Well-Being.

OBJECTIVE: We evaluate how the size and composition of care networks change with increasing morbidity count (i.e., multimorbidity) and how larger care networks relate to recipient psychological well-being. METHOD: Using the National Health and Aging Trends study (NHATS; N = 7,026), we conduct multivariate regressions to analyze size and compositional differences in care networks by morbidity count and recipient gender, and to examine differences in recipient psychological well-being linked to care network size. RESULTS: Women report larger and more diverse care networks than men. These gender differences strengthen with increasing morbidity count. Larger care networks are associated with diminished psychological well-being among care recipients, especially as morbidity increases. DISCUSSION: These findings reveal how increasing morbidity translates differently to care network size and diversity for men and women. They also suggest that having multiple caregivers may undermine the psychological well-being of care recipients who face complex health challenges.

Does educational attainment shape reactions to genetic risk for Alzheimer's disease? Results from a national survey experiment.

While higher education is associated with healthy lifestyles and health literacy, it remains unclear whether education shapes reactions to varying levels of genetic risk for Alzheimer's disease (AD). In this study, participants (N = 701) in the National Genetic Risk Survey Experiment (NGRISE) received a hypothetical genetic risk assessment for AD (ranging from 20 to 80% lifetime risk) and then completed items on their cognitive (perceived threat to health), emotional (general negative affect), and anticipated behavioral (seek information, improve health behaviors, engage in public or private civic action) reactions to this risk. Individuals with a college education showed reactions to increasing genetic risk approximately twice or several times as strong relative to those of individuals with lower (high school, HS) education. In fact, behavioral reactions do not significantly increase with AD risk among those with HS education. Some educational differences in risk response widen at older ages.

Adult health returns to education by key childhood social and economic indicators: Results from representative European data.

In the United States, associations between attained education and adult health typically are larger for those from disadvantaged childhood backgrounds. However, it remains unclear how specific key childhood indicators contribute to these adult health patterns, especially outside the United States. Drawing on the 2014 European Social Survey (20 countries; N=31544), we investigate the key childhood and adolescent indicators of parental education, childhood financial strain, and any serious household conflict growing up, given how these early exposures are known to correlate strongly with both educational attainment and adult health. In regressions with country fixed effects, we find across Europe that higher levels of education are more strongly linked to lessened adult depressive symptoms when childhood disadvantage is present in terms of lower levels of parental education or higher childhood financial strain specifically. However, adjusted predictions reveal that childhood financial strain contributes to this heterogeneity in educational returns far more strongly than parental education. For self-rated health, only childhood financial strain enhances estimated educational health benefits when considering all key childhood social and economic factors jointly. Similarly, childhood financial strain in particular enhances educational protection against overall rates of disease in adulthood. Overall, our findings support prior work on United States data revealing higher educational health returns given childhood disadvantage. At the same time, our findings across three distinct adult health indicators suggest the particular importance of childhood financial strain to understanding heterogeneity in educational health returns.

Chronic Disease at Midlife: Do Parent-child Bonds Modify the Effect of Childhood SES?

Childhood socioeconomic status (SES) often is associated with physical health even decades later. However, parent-child emotional bonds during childhood may modify the importance of childhood SES to emergent health inequalities across the life course. Drawing on national data on middle-aged adults (1995 and 2005 National Survey of Midlife Development in the United States; MIDUS; Ns = 2,746 and 1,632), I find that compromised parent-child bonds eliminate the association between childhood SES and midlife disease. Longitudinal models of incident disease across one decade show that childhood abuse in particular continues to undermine the health protection associated with childhood SES. When childhood SES is moderate to high, compromised parent-child bonds lead to no predicted health benefits from childhood SES. In total, these findings direct attention to parent-child bonds as social-psychological levers for the transmission of class-based health advantages.

Desire for weight loss, weight-related social contact, and body mass outcomes.

OBJECTIVE: This study evaluated whether desiring to lose weight is associated with subsequent changes in social contact with individuals perceived to be thinner or heavier. METHODS: Longitudinal data were used to examine associations between desiring to lose weight at baseline and social contact with thinner and heavier individuals across a 1-year follow-up period (N = 9,335, 2013-2014 Gallup National Panel). How baseline social contact is linked to body mass outcomes among those desiring to lose weight (N = 7,134) was also examined. RESULTS: Over time, individuals desiring to lose weight interacted more frequently (+69 interactions/year, on average) and were more likely to possess social ties (tie probability +0.12) with heavier individuals while lessening their interactions (-51 interactions/year) and decreasing their likelihood of ties (tie probability -0.048) with thinner individuals. On the other hand, increasing contacts and interactions with thinner individuals, and declining contacts and interactions with heavier individuals, were linked to actual weight loss. CONCLUSIONS: Using national longitudinal data, an important mismatch was demonstrated between the social contacts created by individuals desiring weight loss and the contextual factors possibly useful for weight loss. This may help to explain why weight loss is often unsuccessful.

Parenthood and Happiness: Effects of Work-Family Reconciliation Policies in 22 OECD Countries.

The recent proliferation of studies examining cross-national variation in the association between parenthood and happiness reveal accumulating evidence of lower levels of happiness among parents than nonparents in most advanced industrialized societies. Conceptualizing parenting as a stressor buffered by institutional support, we hypothesize that parental status differences in happiness are smaller in countries providing more resources and support to families. Our analyses of the European Social Surveys (ESS) and International Social Survey Programme (ISSP) reveal considerable variation in the parenthood gap in happiness across countries, with the U.S. showing the largest disadvantage of parenthood. We also find that more generous family policies, particularly paid time off and childcare subsidies, are associated with smaller disparities in happiness between parents and non-parents. Moreover, the policies that augment parental happiness do not reduce the happiness of nonparents. Our results shed light on macro-level causes of emotional processes, with important implications for public policy.

Health returns to education by family socioeconomic origins, 1980-2008: Testing the importance of gender, cohort, and age.

Recent studies find that health returns to education are elevated among those who come from disadvantaged families. These findings suggest that education may be a health resource that compensates or "substitutes" for lower parental socioeconomic status. Alternatively, some studies find support for a cumulative (dis)advantage perspective, such that educational health returns are higher among those who already were advantaged, widening initial health (dis)advantages across the life course. However, it remains unclear whether these findings are dependent on gender or cohort, and this is a fundamental oversight given marked differences between men and women in educational and health inequalities across the twentieth century. Drawing on national US data (1980-2002 General Social Survey with 2008 National Death Index Link), I indeed find that the presence or strength of resource substitution or cumulative (dis)advantage depends upon health measure as well as gender and cohort. For self-rated health, cumulative (dis)advantage explains educational health disparities, but among men only. Cumulative (dis)advantage in avoiding fair or poor health is partly explained by cohort and age variation in health returns to education, and cumulative (dis)advantage in excellent health is more robust in earlier cohorts and at older ages. For mortality, resource substitution is instead supported, but for women only. Among those from disadvantaged families, educational mortality buffering increases with cohort but diminishes with age. Taken together, these findings confirm prior research showing that adult health inequalities linked to education depend on family background, and extend this work by demonstrating that the nature and extent of these dynamics differ considerably depending on the health outcome being assessed and on an individual's historical context, life course stage, and gender.

Early-life characteristics and educational disparities in smoking.

Health inequalities pose an important public health challenge in European countries, for which increased social mobility has been suggested as a cause. We sought to describe how the relationship between health inequalities and social mobility varies among welfare regime types in the European region. Data from six rounds of the European Social Survey was analyzed using multilevel statistical techniques,stratified by welfare regime type, including 237,535 individuals from 136 countries. Social mobility among individuals was defined according to the discrepancy between parental and offspring educational attainment. For each welfare regime type, the association between social mobility and self-rated health was examined using odds ratios and risk differences, controlling for parental education. Upwardly mobile individuals had between 23 and 44% lower odds of reporting bad or very bad self-rated health when compared to those who remained stable. On an absolute scale, former USSR countries showed the biggest and only significant differences for upward movement,while Scandinavian countries showed the smallest. Downward social mobility tended to be associated with worse health, but the results were less consistent. Upward social mobility is associated with better health in all European welfare regime types. However, in Scandinavian countries the association of upward mobility was smaller, suggesting that the Nordic model is more effective in mitigating the impact of social mobility on health and/or of health on mobility [corrected].

How do we assign ourselves social status? A cross-cultural test of the cognitive averaging principle.

Subjective social status (SSS), or one's perceived social standing, is linked robustly to mental and physical health and is thought to be determined in part by a cognitive average of one's past, present and expected socioeconomic status. However, this averaging principle awaits a formal test. Further, cultures differ with regard to how they perceive and discount time. In this study, I draw upon cross-sectional data from the United States and Japan (2005 MIDUS non-Hispanic whites and 2008 MIDJA), which measured subjective status in terms of one's perceived standing within a personally defined community. I compare equal and unequal cognitive averaging models for their goodness of fit relative to a traditional present-based model. Socioeconomic status is assessed broadly, in terms of past, present and expected overall work and financial situations. In the United States, averaging models do not fit the data consistently better than a present-based model of SSS. However, in Japan, averaging models do fit SSS consistently better. These fit conclusions are robust to controlling for negative affect.

Optimizing the perceived benefits and health outcomes of writing about traumatic life events.

Expressive writing, which involves disclosing one's deepest thoughts and feelings about a stressful life event by using a first-person perspective, has been linked to gains in health and well-being, though effect sizes range widely. Assuming a third-person perspective is a natural and effective way of coping with highly distressing events. Therefore, the current study examined whether a distanced, third-person approach to expressive writing might be more beneficial than a traditional, first-person intervention for high baseline levels of event-linked intrusive thinking. Randomly assigned participants wrote expressively about traumatic life events by using a first-person or third-person-singular perspective. Linguistic analyses showed that assuming a first-person perspective is linked to higher levels of in-text cognitive engagement, whereas a third-person perspective is linked to lower cognitive engagement. However, in a context of higher levels of intrusive thinking, third-person expressive writing, relative to a traditional first-person approach, yielded (1) greater perceived benefits and positive, long-lasting effects as well as (2) fewer days of activity restriction due to illness. Although more research is needed, these results suggest that third-person expressive writing may be an especially fitting technique for recovering from traumatic or highly stressful life events.