Black/white differences in the relationship between debt and risk of heart attack across cohorts.

Background: Numerous studies show that increasing levels of education, income, assets, and occupational status are linked to greater improvements in White adults' health than Black adults'. Research has yet to determine, however, whether there are racial differences in the relationship between health and debt and whether this relationship varies across cohorts. Methods: Using data from the 1992-2018 Health and Retirement Study, we use survival analyses to examine the link between debt and heart attack risk among the Prewar Cohort, born 1931-1941, and Baby Boomers, born 1948-1959. Results: Higher unsecured debt is associated with increased heart attack risk for Black adults, especially among Baby Boomers and during economic recessions. Higher mortgage debt is associated with lower risk of heart attack for White but not Black Baby Boomers. The relationship between debt and heart attack risk remains after controlling for health behaviors, depressive symptoms, and other economic resources that are concentrated among respondents with high levels of debt. Conclusion: Debt is predictive of heart attack risk, but the direction and strength of the relationship varies by type of debt, debtors' racial identity, and economic context.

Landfall After the Perfect Storm: Cohort Differences in the Relationship Between Debt and Risk of Heart Attack.

Analyses of the Health and Retirement Study (HRS) between 1992 and 2014 compare the relationship between different levels and forms of debt and heart attack risk trajectories across four cohorts. Although all cohorts experienced growing household debt, including the increase of both secured and unsecured debt, they nevertheless encountered different economic opportunity structures and crises at sensitive times in their life courses, with implications for heart attack risk trajectories. Results from frailty hazards models reveal that unsecured debt is associated with increased risk of heart attack across all cohorts. Higher levels of housing debt, however, predict higher rates of heart attack among only the earlier cohorts. Heart attack risk trajectories for Baby Boomers with high levels of housing debt are lower than those of same-aged peers with no housing debt. Thus, the relationship between debt and heart attack varies by level and form of debt across cohorts but distinguishes Baby Boomer cohorts based on their diverse exposures to volatile housing market conditions over the sensitive household formation period of the life course.

Childhood adversity, educational trajectories, and self-reported health in later life among U.S. women and men at the turn of the century.

A major objective of current life course research is to specify the processes linking early childhood conditions to subsequent life course statuses that span educational, occupational, familial, and health domains across the life span. This study confronts at least two persistent challenges to the rigorous specification of the relationships among these variables. The first is that the point-in-time measurement of education as "years of schooling" masks considerable heterogeneity in the timing and curricular tracks of schooling and obscures our understanding of how and when education matters for life-course inequality. The second challenge involves inter dependencies between aspects of life-course inequality, including educational achievement and health. The intertwining of these variables across the life course, and their usual conceptualization and measurement, limit the interpretation of their relationship and its generalizability across studies. We use data from three waves of the National Survey of Families and Households between 1987-1988 and 2001-2002 to explore trajectories of self-reported health, applying latent class cluster analysis (finite mixture models) to deal directly with these measurement and specification issues. Generally, we find mediating effects of education in mid-to late-life health demonstrating the pivotal role of education in life course processes. Women's childhood backgrounds are more heterogeneous and temporally complex educational careers affect their self-assessed health more than men's. Late degrees are linked to poor health trajectories among women, but not men. Also, marital history, number of births and health behaviors are associated in expected ways with women's and men's health trajectories at midlife.

Gender differences in the link between childhood socioeconomic conditions and heart attack risk in adulthood.

A growing body of evidence shows that childhood socioeconomic status (SES) is predictive of disease risk in later life, with those from the most disadvantaged backgrounds more likely to experience poor adult-health outcomes. Most of these studies, however are based on middle-aged male populations and pay insufficient attention to the pathways between childhood risks and specific adult disorders. This article examines gender differences in the link between childhood SES and heart attack risk trajectories and the mechanisms by which early environments affect future disease risk. By using methods that model both latent and path-specific influences, we identify heterogeneity in early life conditions and human, social, and health capital in adulthood that contribute to diverse heart attack risk trajectories between and among men and women as they age into their 60s and 70s. We find that key risk factors for heart attack operate differently for men and women. For men, childhood SES does not differentiate those at low, increasing, and high risk for heart attack. In contrast, women who grew up without a father and/or under adverse economic conditions are the most likely to experience elevated risk for heart attack, even after we adjust for the unequal distribution of working and living conditions, social relationships, access to health care, and adult lifestyle behaviors that influence health outcomes.

Processes of cumulative adversity: childhood disadvantage and increased risk of heart attack across the life course.

OBJECTIVES: This article examines how processes of cumulative adversity shape heart attack risk trajectories across the life course. METHODS: Our sample includes 9,760 Health and Retirement Study respondents born between 1931 and 1941. Using self-reported retrospective measures of respondents' early background, we first identify three latent classes with differential exposure to childhood disadvantage. Intervening covariates associated with educational attainment, employment status, income attainment, marital history, and health behaviors are added to capture sequential processes of adversity. Final latent-class cluster models estimate the cumulative impact of these covariates on three different heart attack risk trajectories between 1992 and 2002: high, increasing, and low. RESULTS: Early disadvantage and childhood illness have severe enduring effects and increase the risk for heart attack. Adult pathways, however, differentially influence trajectories of heart attack risk and mediate the effects of early disadvantage. DISCUSSION: Findings suggest that future research should consider how processes of cumulative adversity initiated in childhood influence health outcomes in older ages.

Diverse trajectories of cocaine use through early adulthood among rebellious and socially conforming youth.

This paper tests predictions of continuity and change in antisocial behavior over time as derived from population heterogeneity and life-course perspectives. These predictions are assessed with respect to a rarely studied form of delinquent/criminal behavior, cocaine use during the late-teenage and young adult years. We first examine the extent to which differential propensities toward antisocial behavior can be detected in a nationally representative sample of youth aged 14-16 in 1979. Based on self-reported delinquent and criminal activities in late adolescense, traditional cross-sectional latent-class analysis identifies three groups of antisocial/rebellious respondents and a group of non-offenders. We then follow these groups into early adulthood, examining age trajectories of cocaine usage between 1984 and 1998. Latent-class trajectory models identify clusters of respondents who show similar age trajectories of cocaine use over time and provide parameter estimates that predict membership in those clusters. In support of the population heterogeneity perspective, we find that antisocial/rebellious youth have higher probabilities of cocaine use throughout early adulthood than non-of-fending youth. There is, however, much variation in drug use patterns among the groups as they aged. In support of a life-course perspective, we find that social ties to schools, families, religion, and the labor market help differentiate youth who refrain from, maintain, or desist from using cocaine through early adulthood.

Later life education in the 1990s: increasing involvement and continuing disparity.

OBJECTIVES: We examine age differences in adults' participation in, perceived barriers to, and institutional support for educational activities provided by schools, businesses, and community organizations in the 1990s. METHODS: We conduct descriptive and logistic regression analyses on a sample of respondents aged 30 to 74 from the National Household Education Surveys. RESULTS: Adult education participation rates increased for all ages over the 1990s, but gains were proportionately largest among people in later phases of the life course. Although age was a weaker predictor of engaging in educational activities at the end of the 1990s than it was at the beginning of the decade, older adults continue to be less likely than younger ones to participate in education and training provided by businesses and schools. Some of this age discrepancy occurs because employers are more likely to provide financial support for training to younger employees. Older adults, however, are less likely than younger adults to perceive obstacles to their participation in education and training. DISCUSSION: Although age-graded roles of student, worker, and retiree are becoming increasingly blurred, Americans' pursuit of education at the end of the twentieth century was still guided by age-related role expectations.