Sociologists have long struggled to explain the minority mental health paradox: that racial-ethnic minorities often report better mental health than non-Hispanic whites despite social environments that seem less conducive to well-being. Using data from the 2008–2013 Medical Expenditure Panel Survey (MEPS), this study provides a partial explanation for the paradox rooted in a very different disparity. Evidence from MEPS indicates that non-Hispanic whites consume more pharmaceuticals than racial-ethnic minorities for a wide variety of medical conditions. Moreover, non-Hispanic whites consume more pharmaceuticals that although effective in treating their focal indication, include depression or suicide as a side effect. In models that adjust for the use of such medications, the minority advantage in significant distress is reduced, in some instances to statistical nonsignificance. Although a significant black and Hispanic advantage in a continuous measure of distress remains, the magnitude of the difference is reduced considerably. The relationship between the use of medications with suicide as a side effect and significant distress is especially large, exceeding, for instance, the relationship between poverty and significant distress. For some minority groups, the less frequent use of such medications is driven by better health (as in the case of Asians), whereas for others, it reflects a treatment disparity (as in the case of blacks), although the consequences for the mental health paradox are the same. The implications of the results are discussed, especially with respect to the neglect of psychological side effects in the treatment of physical disease as well as the problem of multiple morbidities.

Exposure to conflict is associated with multiple impacts on youth populations in developing countries, predominantly in the areas of health and nutrition. Where many previous works have examined large-scale impacts of exposure to conflict on the civilian population, this study will analyze the effects of exposure to conflict specific to the experiences of children under the age of five. Where experiences of armed conflict are often indiscriminately destructive to individual well-being, West African conflicts have been characterized by disproportionately high levels of violence, with their most extreme consequences forced upon women and children. Research has suggested that accepted gender norms and levels of women’s agency may be strongly associated with children’s health responses to exposure to increased violence and conflict. To test this association this thesis assumes a critical analysis of reduced educational attainment and low marital age among women in relation to the effects of conflict on measures of childhood food security. Through the use of high-resolution conflict data from the Armed Conflict Location and Event Database (ACLED) and the Demographic and Health Survey (DHS), this thesis examines the effects of armed conflict on children under five years of age across seven West African nations. Along with previous works exploring the relationship between conflict and childhood nutrition, this study finds a negative, albeit small and statistically insignificant, impact on measures of weight-for-height (WFH). Surprisingly, there is a significant and positive response in children’s height-for-age (HFA) associated with exposure to conflict during one’s lifetime.

We contribute to literature exploring the socioecological impact of urban development as a multidimensional project, one in which changes to landscape features complement changes in demographic and administrative measures to co-constitute the socioecological impact of urbanity. We use a random coefficients modeling approach to examine U.S. relationships between the intensity of impervious surface within a county, population density in impervious areas, and carbon intensity of well-being (CIWB)—here constructed using industrial emissions. We then explore the moderating association that another component of social settlement patterns, household median income, has on the impervious surface–population density–CIWB nexus. Findings suggest that landscapes featuring greater development of impervious surface are associated with increased CIWB. Further exploration indicates that income acts to attenuate the association of urban space and CIWB. Ultimately, we argue that such attenuation indicates that more affluent areas are able to shift production-based processes associated with urban forms to less affluent areas.

In the U.S., women are entering motherhood at older ages, with the age at first birth rising from a mean of 21.4 in 1970 to 26.8 in 2017 (FP-18-25). Women who have first births at younger ages differ on a range of characteristics compared to women who become mothers at later ages, and maternal age is linked to children’s well-being (Gibson-Davis & Rackin, 2014; Brown, Stykes, & Manning, 2016; Rackin & Gibson-Davis, 2018). This profile uses the Current Population Survey’s 2018 June Fertility Supplement to identify mothers who had a first birth between 2015 and 2018. Education level, race/ethnicity, and union status of mothers are compared across three groups classified by age at first birth: younger mothers (less than 24 years old), mid-range age mothers (24 to 29 years old), and older mothers (30 years or older). Additional profiles using the June Fertility Supplement analyze trends in completed family size among women aged 40-44 by education and race/ethnicity (FP-20-04) and by union status (FP-20-03).

The health-care sector is in many ways the most consequential part of the United States economy. It is a fundamental part of people’s lives, supporting their health and well-being. Moreover, it matters because of its economic size and budgetary implications. The health-care sector now employs 11 percent of American workers (Bureau of Labor Statistics [BLS] 1980– 2019b and authors’ calculations) and accounts for 24 percent of government spending (Centers for Medicare & Medicaid Services [CMS] 1987–2018; Bureau of Economic Analysis 1987–2018; authors’ calculations).1 Health insurance is the largest component (26 percent) of nonwage compensation (BLS 2019b) and health care is one of the largest categories of consumer spending (8.1 percent of consumer expenditures; BLS 2019a).

As the COVID-19 pandemic took deeper hold in the United States in March 2020, fears of exposure to the novel coronavirus caused many people to restrict activities outside their homes. To reduce the spread of the coronavirus and maintain sufficient hospital capacity to meet the potential need, governors and local officials instituted states of emergency. These declarations required that people remain at home, only going out for groceries and prescriptions, doctor’s appointments, exercise, and other essential activities; defined the essential businesses that could remain open; and ordered nonessential businesses to shut down most operations that could not be done remotely or through telework.

Social media permeates many aspects of our lives, including how we connect with others, where we get our news and how we spend our time. Yet, we know little about the economic effects for users. In 2017, we ran a large field experiment with over 1765 individuals to document the value of Facebook to users and its causal effect on news, well-being and daily activities. Participants reveal how much they value one week of Facebook usage and are then randomly assigned to a validated Facebook restriction or normal use. One week of Facebook is worth $67. Those who are off Facebook for one week reduce news consumption, are less likely to recognize politically-skewed news stories, report being less depressed and engage in healthier activities. These results are strongest for men. Our results further suggest that, after the restriction, Facebook’s value increases, consistent with information loss or that using Facebook may be addictive.

Importance Millions of low-income children in the United States reside in substandard or unaffordable housing. Relieving these burdens may be associated with changes in asthma outcomes. Objectives To examine whether participation in the US Department of Housing and Urban Development’s (HUD) rental assistance programs is associated with childhood asthma outcomes and to examine whether associations varied by program type (public housing, multifamily housing, or housing choice vouchers). Design, Setting, and Participants This survey study used data from the nationally representative National Health Interview Survey linked to administrative housing assistance records from January 1, 1999, to December 31, 2014. A total of 2992 children aged 0 to 17 years who were currently receiving rental assistance or would enter a rental assistance program within 2 years of survey interview were included. Data analysis was performed from January 15, 2018, to August 31, 2019. Exposures Participation in rental assistance provided by HUD. Main Outcomes and Measures Ever been diagnosed with asthma, 12-month history of asthma attack, and 12-month history of visiting an emergency department for the treatment of asthma among program participants vs those waiting to enter a program. Overall participation was examined, and participation in public or multifamily housing was compared with participation in housing choice vouchers. Results This study included 2992 children who were currently participating in a HUD program or would enter a program within 2 years. Among children with an asthma attack in the past year, participation in a rental assistance program was associated with a reduced use of emergency departments for asthma of 18.2 percentage points (95% CI, −29.7 to −6.6 percentage points). Associations were only found after entrance into a program, suggesting that they were not confounded by time-varying factors. Statistically significant results were found for participation in public or multifamily housing (percentage point change, −36.6; 95% CI, −54.8 to −18.4) but not housing choice vouchers (percentage point change, −7.2; 95% CI, −24.6 to 10.3). No statistically significant evidence of changes in asthma attacks was found (percentage point change, −2.7; 95% CI, −12.3 to 7.0 percentage points). Results for asthma diagnosis were smaller and only significant at the 10% level (−4.3; 95% CI, −8.8 to 0.2 percentage points). Conclusions and Relevance Among children with a recent asthma attack, rental assistance was associated with less emergency department use. These results may have important implications for the well-being of low-income families and health care system costs.

Objective: The objective if this study was to directly assess the contamination and fragmentation of parents' leisure quality with direct measures of experienced well-being. Background: Parents report less leisure than those without children, and the nature of their leisure differs in ways that are assumed to reflect lower quality—contaminated by the presence of children or fragmented by care work or other demands. Previous research on this question has not been able to assess leisure quality directly. Method: Using the 2010, 2012, and 2013 American Time Use Survey's Well-Being Module (N = 5,433 parents; N = 7,066 activities) and random intercept models to account for multilevel data, the authors investigated mothers' and fathers' reports of well-being across multiple dimensions in leisure activities and directly assessed their experiences in leisure activities (a) with children present or (b) interrupted by care work or other demands. Results: Contrary to expectations from prior work, there was no evidence that leisure was of lower quality with children, and leisure interruptions had little bearing on parents' well-being. Well-being was especially high in “family time” with both children and other adults. Conclusion: Leisure time with children, considered of lower quality in prior accounts, was not experienced more negatively by parents. These findings suggest a reconsideration of how we think about and measure the quality of leisure time.

The Great Recession was the worst economic downturn in the U.S. since the Great Depression of the 1930s. This research focusses on children in five income-quintile groups before, during, and following the Great Recession by analyzing changing disparities across these groups using a new Index of Parental Employment Insecurity, nine additional well-being indicators, and the overall Child Well-Being Index. The new Index of Parental Employment Insecurity captures employment insecurity more fully than the official U.S. monthly unemployment rate by using a comprehensive approach spanning 15-month periods (combining January-to-December measures for a calendar year with measures for March of the following year), based not only on two traditional unemployment indicators, but also two indicators of “hidden unemployment” and two indicators of “underemployment”. The other nine well-being indicators, also with children or youth as the unit of analysis, are median family income, health insurance coverage, Prekindergarten enrollment, three health indicators – very good or excellent health, obesity, and activity limitations – two indicators reflecting family experience – one-parent families and residential mobility – and idle or disconnected youth. For each of the 10 indicators in 1994, children in the lowest-income, lower-middle-income, and middle-income families had lower levels of well-being, often much lower, than children in the highest-income families. These had gaps narrowed, as of 2014, for all three of the lowest-income groups by about two-thirds for health insurance coverage and by about two-fifths for Prekindergarten enrollment. Compared to the highest-income group, however, the gaps had widened for the middle-income group for most indicators, the direction of changes in gaps was mixed for the lower-middle-income group, and the gaps had narrowed, usually by about one-fourth, for the lowest-income group, leaving gaps for the lowest-income group for seven of the ten indicators in 2014 that were at least three-fourths as large as they had been in 1994. In addition, median family income for the highest-income group grew by $32,500 reaching $173,600 in 2014, and the corresponding disparities expanded for the middle-income, lower-middle-income, and lowest-income groups, respectively, to $113,300, $139,400, and $160,800.

In rural, suburban, and urban counties throughout North Carolina, serious housing challenges undermine economic success and resident well-being. The urgency of these issues both preceded and is exacerbated by the economic and health risks caused by the COVID-19 pandemic. No county has enough affordable housing to meet the needs of its residents with the lowest incomes, leading to strained household budgets and elevated rental market risks. Building on pre-2020 population projections from the state demographer, we project a net growth of approximately 866,000 households statewide, with substantial growth in urban counties and more populous suburban counties; moderate growth in higher-cost rural counties, rural recreation economies, and less-populous suburban counties; and more modest growth in the more affordable rural counties. Unless stakeholders across the state work together toward a healthier housing market, current gaps in the low-cost housing supply, added household demand, and increased arrears related to the pandemic will combine to exacerbate affordability challenges for households while undermining the viability of the rental and homeownership markets.

In the U.S., women are entering motherhood at older ages, with the age at first birth rising from a mean of 21.4 in 1970 to 26.8 in 2017 (FP-18-25). Women who have first births at younger ages differ on a range of characteristics compared to women who become mothers at later ages, and maternal age is linked to children’s well-being (Gibson-Davis & Rackin, 2014; Brown, Stykes, & Manning, 2016; Rackin & Gibson-Davis, 2018). This profile uses the Current Population Survey’s 2018 June Fertility Supplement to identify mothers who had a first birth between 2015 and 2018. Education level, race/ethnicity, and union status of mothers are compared across three groups classified by age at first birth: younger mothers (less than 24 years old), mid-range age mothers (24 to 29 years old), and older mothers (30 years or older). Additional profiles using the June Fertility Supplement analyze trends in completed family size among women aged 40-44 by education and race/ethnicity (FP-20-04) and by union status (FP-20-03).

Objective: This study examines the association between psychological distress and Alzheimer’s disease mortality among US adults aged ≥45. Methods: We analyzed the Kessler 6-item psychological distress scale as a risk factor for Alzheimer’s mortality using the pooled 1997–2014 National Health Interview Survey (NHIS)- National Death Index (NDI) database (N = 265,089). Cox regression was used to model mortality as a function of psychological distress and sociodemographic and behavioral covariates. Results: The Alzheimer’s mortality risk was 97% higher (HR = 1.97; 95% confidence interval [CI] = 1.37, 2.84) in adults with serious psychological distress compared with those without psychological distress, controlling for sociodemographic covariates. The relative mortality risk remained statistically significant (HR = 1.49; 95% CI = 1.04, 2.13) after additional adjustment for smoking, alcohol consumption, health status, activity limitation, and body mass index. Discussion: US adults had significantly higher risks of Alzheimer’s disease mortality at higher psychological distress levels. These findings underscore the significance of addressing psychological well-being as a strategy for reducing Alzheimer’s disease mortality.

What is financial health? It is the ability to control your short-term finances and make choices to enjoy your life, such as supporting a family member or going back to school. A financially healthy individual can also absorb financial setbacks and meet their financial goals (Consumer Financial Protection Bureau [CFPB], 2015). Financial stability, however, comes first: in the short term, this means having money left over at the end of the month, manageable debt, a small pot of savings, and a trusted network to help bridge financial gaps (Siwicki, 2019). For many low- and moderate- income Detroiters, the necessary ingredients for financial health and financial stability are out of reach. Indeed, just over half of Detroit residents are either financially insecure (32%) or in financial trouble (24%) (DMACS, 2019). Due to low and volatile incomes and disproportionately high costs, tens of thousands of Detroit households cannot maintain consistently positive cash flow, which makes it challenging to build . . .

Global economic wellbeing and food security have improved considerably over the past 50 years but scholars are concerned that climate change will exacerbate recent trends towards deterioration, particularly for the world’s most vulnerable populations (Burke et al. 2015). Among the most vulnerable are those living in tropical low- and middle-income countries, where baseline temperatures are high and community resources are often few (Mora et al. 2017; Frame et al. 2017; IPCC 2014). In these areas, population health and well-being are already threatened by rising global temperatures and increasingly variable rainfall patterns (Mora et al. 2017; Challinor et al. 2014; Spears et al. 2018), which in turn puts children’s food security and nutritional health at particular risk. Appropriate nutrition in children under five years old is recognized as central to development at the individual, national, and international level (Horton 2013), as chronic malnutrition in early childhood has been shown to cause irreparable damage to immune systems and cognitive and physical development (Black 2013, Shively 2017, Alderman 2006). Understanding the complex interactions between climate, nutrition, and social vulnerability in regions facing nutritional shortfalls is the key to developing appropriate policy and mitigation measures as the climate continues to change (Frame et al. 2017). This study is designed to assess the impact of temperature and precipitation anomalies from the last four decades on child nutritional health in South Asia (Bangladesh, India, Pakistan, and Nepal), with consideration towards particular social vulnerability among demographic groups.

Green space has been associated with better health and well-being. However, most studies have been cross-sectional with limited long-term exposure data. Further, research is limited in what type of green space is beneficial for health. We conducted a longitudinal study to assess sensitive periods (birth, childhood or adulthood) of exposure to different types of green space in association with adult blood pressure and body mass index (BMI). Using longitudinal data from the New England Family Study (1960–2000) and multilevel regression analysis, we examined associations between time-varying markers of residential exposure to green space, and adult BMI, systolic (SBP) and diastolic blood pressure (DBP) (N = 517). We created three exposure metrics: distance, average area, and green space count in the neighborhood throughout the life-course. In adjusted models, living one mile farther away from a green space at birth was associated with a 5.6 mmHg higher adult SBP (95%CI: 0.7, 10.5), and 3.5 mmHg higher DBP (95%CI: 0.3, 6.8). One more green space in the neighborhood at birth was also associated with lower DBP (−0.2 mmHg, 95%CI: −0.4, −0.02) in adulthood. Finally, average area of green space was not associated with SBP, DBP nor BMI. Analysis by type of green space suggested that parks may be more relevant than playgrounds, cemeteries or golf courses. Our study suggests that the perinatal period may be a critical time-period where living closer to green spaces may lower hypertension risk in adulthood, but not obesity.

Background: Theimpact of happiness and life satisfaction on cardiovascular disease (CVD) mortality is not well-studied. Using a longitudinal dataset, we examined the association between levels of happiness/life satisfaction and CVD mortality in the United States. Methods: We analyzed the 2001 National Health Interview Survey (NHIS) prospectively linked to 2001-2014 mortality records in the National Death Index (NDI) (N=30,933). Cox proportional hazards regression was used to model survival time as a function of happiness, life satisfaction, and sociodemographic and behavioral characteristics. Results: In Cox models with 14 years of mortality follow-up, CVD mortality risk was 59% higher (hazard ratio [HR]=1.59; 95% CI=1.26,2.02) in adults with little or no happiness, controlling for age, and 30% higher (HR=1.30; 95% CI=1.01,1.67) in adults with little/no happiness, controlling for sociodemographic, behavioral and health characteristics, when compared with adults reporting happiness most or all of the time. Mortality risk was 81% higher (HR=1.81; 95% CI=1.40,2.34) in adults who were very dissatisfied with their life, controlling for age, and 39% higher (HR=1.39; 95% CI=1.05,1.82) in adults who were very dissatisfied, controlling for all covariates, when compared with adults who were very satisfied. Conclusions and Implications for Translation: Adults with lower happiness and life satisfaction levels had significantly higher CVD mortality risks than those with higher happiness and life satisfaction levels. Subjective well-being is an important determinant of CVD mortality.

We show that health and productivity around retirement age, and earnings over the life cycle, vary with exposure to economic conditions in early life. Using state-year-level variation from the most severe and prolonged economic downturn in American history-the Great Depression-combined with restricted micro-data from the Health and Retirement Study, we find that changes in macroeconomic indicators before age 6 are associated with changes in economic well-being, earnings, metabolic syndrome, and physical limitations decades later. We also document large declines in long-term mortality. Results are not driven by endogenous fertility responses throughout the 1930s. Our results help inform the design of retirement and healthcare systems and the long-term costs of business cycles.

Past research consistently suggests that singles are stigmatized, but do they constitute a stigmatized group? The current research provides deeper insight into the stigmatization of single people by understanding their ‘group-y’ nature, and how group identification and perception map onto discrimination and prejudice. Study 1 examined the extent to which singles identify as part of a group. Participants were assigned a novel minimal group identity and then completed measures of group identification for four group memberships (e.g., minimal group, relationship status, sexual orientation, nationality). As hypothesized, singles' identification with other singles was lower compared to their identification with other identities—as well as compared to partnered people's group identification. Contrary to our hypothesis, singles did not perceive less discrimination towards singles relative to other aspects of their identity. Study 2 examined the extent to which singles are perceived as a group and the extent to which their group-y-ness vs. perceived responsibility for their group membership explains the acceptability of prejudice towards them. Participants completed measures of entitativity and perceived responsibility for similar out-group identities as in Study 1 (e.g., single people vs. people in romantic relationships). As hypothesized, singles were rated lower in entitativity than people in romantic relationships and other groups. Prejudice towards singles was also more acceptable than prejudice towards national and sexual orientation groups. Accordingly, perceived responsibility was a stronger predictor of the acceptability of prejudice towards singles than their entitativity. We discuss the importance of group-based theoretical perspectives for understanding the current and future stigmatization and well-being of singles.

Over 1.5 million new jobs need to be filled by 2026 for medical assistants, nursing aides, and home care aides, many of which will work in the long-term services and supports (LTSS) sector. Using 16 years of data from the American Time Use Survey, we examined the financial vulnerability of high-skill and low-skill LTSS workers in comparison with other health care workers, while providing insight into their well-being by measuring time spent on work and nonwork activities. We found that, regardless of skill status, working in LTSS was associated with lower wages and an increased likelihood of experiencing poverty compared with other health care workers. Results from time diary data indicated that the LTSS workforce spent a greater share of their time working and commuting to work. Low-skill LTSS workers were hardest hit, spending more time on paid and unpaid activities, such as household and child care responsibilities.