The socioeconomic disadvantage experienced by disabled people is too often perceived as the natural, logical, or inevitable consequence of disability rather than resulting from policies and social structures that produce inequality. This dissertation aims to challenge this individualistic understanding of disability by examining how ableism and other systems of oppression are jointly embedded in institutions, policies, structures, and culture in ways that create and maintain disability-based inequalities in socioeconomic well-being, disproportionately harming multiply marginalized disabled communities. Using a variety of analytic techniques and drawing primarily on over a decade of data from the American Community Survey, this dissertation cuts across topics related to disability, inequality, and health policy, ultimately providing new insights into how structural ableism shapes disparities in Supplemental Poverty and unemployment between disabled and nondisabled people and at the intersection of disability and other axes of stratification. The first chapter provides rich, descriptive evidence of disparities in poverty and unemployment at the intersection of disability, gender, race-ethnicity, and age, highlighting intersectional injustices in which disabled Black, Indigenous, and Latine women across age iv groups experience heightened socioeconomic disadvantage. The second chapter documents the vast interstate variation in socioeconomic disparities between disabled and nondisabled people across U.S. states, suggesting that structural ableism operates through state contexts to shape geographic patterns in disability-based socioeconomic inequities. Linking the American Community Survey data with a variety of state-level policy and administrative data sources, the third chapter investigates whether and to what extent state-level policy contexts and specific policies related to Medicaid and Long-Term Services and Supports shape interstate variation in socioeconomic inequalities between disabled and nondisabled people. Taken together, the findings from the three chapters challenge the assumption that socioeconomic disadvantage among disabled people is natural or inevitable; rather, such disadvantage results from policies and structural contexts that create and maintain inequality. This work uncovers patterns of relational inequalities at national and state levels, providing essential context for the development of social and health policies and structural changes that promote disability and economic justice.

With no policy at the federal level, U.S. employers, counties, cities, and states have established a patchwork of paid sick leave (hereafter, PSL) policies that regularly force many workers in the United States to choose between their health and wages. Employees without PSL benefits are often penalized—for example, they may be forced to take unpaid days off from work or may even be fired—when they miss work to seek medical care or look after an ill loved one (National Partnership for Women and Families and National Association for the Advancement of Colored People [NAACP], 2017). These penalties can heighten workers’ feelings of job insecurity and negatively impact workers’ mental health and stress levels. Prior research demonstrates mental health's integral role in shaping our overall well-being. Poor mental health is associated with a host of adverse outcomes, including increased physical illness, lower probability of full-time employment, and reduced quality of life (Doherty and Gaughran, 2014; Doran and Kinchin, 2017). Although many researchers have considered the relationship between access to PSL benefits, physical health outcomes (Collins et al., 2020; DeRigne et al., 2016), and access to health services (DeRigne et al., 2017), fewer studies have examined PSL's relationship to mental health (Asfaw, 2023, DeRigne et al., 2019; Stoddard-Dare et al., 2018). Even fewer studies have used an intersectional racial capitalism lens to examine whether this relationship is conditional on race and gender (Alang et al., 2023). Existing evidence highlights racialized and gendered disparities in access to PSL (Harknett and Schneider, 2022; Williamson, 2023a) and mental well-being (Astbury, 2001; Williams and Mohammed, 2013). Understanding the roles that race, gender, and PSL play in mental health may provide critical insights into strategies for addressing disparities in the American workforce. Our research addresses the following questions: Is there a relationship between access to PSL benefits and psychological distress? If so, does this relationship vary by race and gender? Our study uses racial capitalism and intersectionality as conceptual lenses for examining these issues. Investigating how access to PSL benefits may be differentially related to mental health across genders, races, and ethnicities is paramount to understanding PSL’s impact on our diverse workforce.

Since the 1990s, immigrants have been increasingly moving to rural areas of the U.S., yet we know little about the economic well-being of these immigrants as compared to their more urban peers. To fill this knowledge gap, we draw on both segmented assimilation and industrial restructuring approaches and use microdata data from the American Community Survey (ACS) 2019 5-year estimates (n = 10,536,645) to examine the household income of U.S.-born and foreign-born heads of households by metropolitan status, as well as the roles of race/ethnicity and regional location in conditioning the impact of nativity status on household income. Similar to Census reports on the urban–rural wealth gap (Shrider et al. in Income and poverty in the United States: 2020. United States Census Bureau. Washington, DC. https://www.census.gov/library/publications/2021/demo/p60-273.html , 2021), OLS regression results indicate that rural respondents tend to report significantly less income than their nonrural peers, however, there is significant variation by nativity status, racial/ethnic background, and regional location. On average, foreign-born respondents, racial/ethnic minorities, and respondents located in the South report lower household incomes than their peers. Racial/ethnic background has a greater influence on household income than does nativity status, however, especially in rural areas. Race/ethnicity also moderates the effects of nativity status, although somewhat differently depending on metropolitan location and region. Predicted estimates of household income by nativity and race/ethnicity show that, regardless of race/ethnicity, foreign-born individuals in urban areas tend to have household incomes that are slightly lower than or similar to those of their same-race U.S.-born peers, with the exception of Black immigrants, those who report having two or more races, and respondents who belong to the Other Race category who tend to have higher incomes. In rural areas, however, substantively meaningful nativity differentials in income are only apparent for Black respondents.

Objectives: To descriptively document birth cohort differences in sleeping patterns, self-reported age-specific sleep duration, and insomnia symptoms among adults aged 50+ from the National Health Interview Survey (NHIS) and the Health and Retirement Study (HRS). Methods: We analyzed respondents aged 50+ (born 1920–1969) from the 2006–2018 NHIS (n = 162,400) and HRS (n = 28,918). We fit multinomial models among the NHIS sample predicting age-specific optimal sleep duration (optimal for age vs short for age, and optimal for age vs long for age). For the HRS sample, we fit growth curve models predicting age-based insomnia symptom trajectories. The models for both samples adjusted for age, gender, race/ethnicity, and educational attainment. Results: Results regarding sleep duration in the NHIS, suggested that cohorts born in the 1950s and 1960s had significantly higher odds of reporting short sleep duration than cohorts before them. Results from the HRS similarly illustrated that cohorts born in the 1950s and 1960s had significantly higher levels of insomnia symptoms than those born before them. The worsening sleep among cohorts entering midlife was consistent regardless of alternative cohort specification, when age groups or periods were analyzed, and when more extensive covariates were modeled. Discussion: We observe a pronounced decline in healthy sleeping patterns among American cohorts in midlife, with consistent and striking results across data sets, methods, and measures. These findings have important implications for the well-being and longevity of Americans who have entered midlife in the 21st century.

This study examines whether an immigrant health advantage exists among US Whites, a group often used as a reference category in research on racial and ethnic health disparities. Using recent data from the National Health Interview Survey (2019–2022), I disaggregate non-Hispanic White adults (n = 41,752) by nativity status and use logistic regression models to assess differences in six measures of mental and physical health. The analysis includes self-reported conditions (depression, anxiety, fair/poor self-rated health) and diagnosed conditions that require interaction with the healthcare system (hypertension, diabetes, and chronic obstructive pulmonary disease, COPD). Foreign-born Whites have a significantly lower prevalence of each health outcome relative to US-born Whites. The immigrant health advantage remains significant for depression, anxiety, fair/poor health (i.e., self-reported conditions) and diagnosed hypertension, after adjusting for sociodemographic and healthcare characteristics. In contrast, the inclusion of these explanatory factors reduces the nativity gap in diagnosed diabetes and COPD to non-significance. Overall, the results indicate important variation in health among Whites that is missed in studies that focus on US-born Whites, alone. Scholars must continue to monitor the health of White immigrants, who are projected to grow to 20% of the US immigrant population in the years to come.

Decarbonizing our building stock is a critical step in reducing emissions and slowing the effects of climate change. Residential decarbonization involves replacing all gas appliances, including stoves, dryers, water heaters, and HVAC systems with electric systems and increasing the energy efficiency of homes by upgrading windows, doors, air sealing, and insulation. The federal government and the state of California have made historic large-scale investments to encourage homeowners to retrofit their homes. Creating labor standards to mandate wage floors and benefits levels in the industry can ensure that residential decarbonization investments improve job quality rather than reinforcing labor practices that undermine workers’ well-being. Climate advocates want building decarbonization investments to go as far and fast as possible toward reaching climate goals. Some have expressed concerns that attaching labor standards could raise the costs of residential decarbonization work significantly, reducing the number of projects that can be completed with available funds and slowing down the timeframe for reducing emissions. This paper explores the potential economic impacts of adopting labor standards for the residential decarbonization industry in the 9-county Bay Area. Our study compares the status quo in the industry to two different labor standards that could be adopted: (1) prevailing wages and benefits and (2) setting a wage floor of 180 to 250 percent of the state minimum wage, depending on a worker’s trade, and requiring that employers provide health insurance and retirement plans. For each of these potential labor standards, we estimate the potential impact on worker earnings, operating costs for employers, project prices for consumers and public agencies, the size of the local economy, and local government revenues and expenditures.

Importance Since 1999, over 1 million people have died of a drug overdose in the US. However, little is known about the bereaved, meaning their family, friends, and acquaintances, and their views on the importance of addiction as a policy priority. Objectives To quantify the scope of the drug overdose crisis in terms of personal overdose loss (ie, knowing someone who died of a drug overdose) and to assess the policy implications of this loss. Design, Setting, and Participants This cross-sectional study used data from a nationally representative survey of US adults (age ≥18 years), the fourth wave of the COVID-19 and Life Stressors Impact on Mental Health and Well-Being (CLIMB) study, which was conducted from March to April 2023. Main Outcomes and Measures Respondents reported whether they knew someone who died of a drug overdose and the nature of their relationship with the decedent(s). They also reported their political party affiliation and rated the importance of addiction as a policy issue. Logistic regression models estimated the associations between sociodemographic characteristics and political party affiliation and the probability of experiencing a personal overdose loss and between the experience of overdose loss and the perceived salience of addiction as a policy issue. Survey weights adjusted for sampling design and nonresponse. Results Of the 7802 panelists invited to participate, 2479 completed the survey (31.8% response rate); 153 were excluded because they did not know whether they knew someone who died of a drug overdose, resulting in a final analytic sample of 2326 (51.4% female; mean [SD] age, 48.12 [0.48] years). Of these respondents, 32.0% (95% CI, 28.8%-34.3%) reported any personal overdose loss, translating to 82.7 million US adults. A total of 18.9% (95% CI, 17.1%-20.8%) of all respondents, translating to 48.9 million US adults, reported having a family member or close friend die of drug overdose. Personal overdose loss was more prevalent among groups with lower income (<$30 000: 39.9%; ≥$100 000: 26.0%). The experience of overdose loss did not differ across political party groups (Democrat: 29.0%; Republican: 33.0%; independent or none: 34.2%). Experiencing overdose loss was associated with a greater odds of viewing addiction as an extremely or very important policy issue (adjusted odds ratio, 1.37; 95% CI, 1.09-1.72) after adjustment for sociodemographic and geographic characteristics and political party affiliation. Conclusions and Relevance This cross-sectional study found that 32% of US adults reported knowing someone who died of a drug overdose and that personal overdose loss was associated with greater odds of endorsing addiction as an important policy issue. The findings suggest that mobilization of this group may be an avenue to facilitate greater policy change.

Health insurance coverage for both children and their parents can facilitate access to affordable health care, protect families' economic security, enhance families' overall well-being, and promote children's healthy development During the COVID-19 public health emergency (PHE), numerous federal and state policies were enacted to protect access to affordable health insurance coverage, including a continuous coverage requirement in Medicaid that maintained enrollment for all enrollees between March 2020 and March 2024 and enhanced Marketplace subsidies beginning in 2021. 1 Prior research has shown that uninsurance fell during this period for both children and nonelderly adults (Lee et al. 2022; Haley et al. 2022; McMorrow et al. 2022). 2 Access to affordable health care is particularly critical in the perinatal period and during early childhood, given high and inequitable risks of infant mortality and maternal morbidity and mortality and the important physical, cognitive, and socio-development occurring in children under age 3 (Center on the Developing Child 2010; Declercq and Zephyrin 2021; Ely and Driscoll 2023; Gunja, Gumas, and Williams 2023; Lipkin and Macias 2020). We focus on coverage among children under age 3 and their custodial parents, hereafter referred to as young children and their parents.

African Economic Development Solutions (AEDS) works throughout the Twin Cities metropolitan area to create wealth, lift immigrant communities out of poverty, and contribute to and benefit from the region’s vibrant economy. Over the past several decades, the proportion of African-born residents living in the Twin Cities has increased by 72% (Ruggles et al., 2007-2011; 2017-2021). The majority of African-born adults are working (78%) and more than half (56%) have attended at least some college. As Minnesota welcomes more immigrant communities, organizations like AEDS can play an important role in supporting and building the economic success of those who arrive. Business ownership is an important part of the United States economy and has multiple advantages for business owners in the form of independence, flexible lifestyle, learning opportunities, creative freedom and personal satisfaction, and financial rewards (Exploring Business, 2016). In addition, the ability to earn income, own a house, and build and sustain wealth is critical to the health and well-being of all Twin Cities residents, as well as the overall economy.

Farmers face unique challenges and opportunities in saving for and maintaining income during retirement relative to other Americans. Farm households have higher income than the average American household but may decide to invest in their farm rather than save for retirement. We use information from the Agricultural Resource Management Survey, the Survey of Consumer Finances, and the Current Population Survey to answer three questions pertaining to the retirement preparedness of farm households. First, what is the composition of income and assets for farm households? Second, how do retirement income and assets for farm households compare to those of all U.S. households and nonfarm self-employed households? Third, do retirement income and assets vary across subpopulations of retirement-age farmers? Our results suggest that, on average, older farm households received smaller shares of their income from retirement sources and had smaller retirement assets than older U.S. households. However, farm households had higher levels of total income and assets with most assets being concentrated in the farm operation. Farm assets may be relatively illiquid compared to retirement assets making it more difficult to rely on them for income during retirement. Among older farm households, those with low-sales farm businesses and Hispanic and non-White operators may be particularly unprepared for retirement relative to other farm households. Our results have implications for farm household well-being as operators’ average age rises. They highlight the similar and distinct challenges farmers face in saving for and maintaining income in retirement relative to other workers.

Introduction: 22q11.2 deletion syndrome (22q11DS) and 22q duplication syndrome present a wide range of medical challenges. The health and well-being of pediatric patients with 22q11DS may be influenced by socioeconomic factors, which can significantly shape their healthcare experiences, access to services, and overall quality of life. The objective of this study is to identify what factors are correlated with no-show clinic visits for children with 22q11DS. Methods: A retrospective chart review was performed on pediatric patients in a 22q patient registry of a tertiary care facility that includes patients with 22q11DS and 22q duplication syndrome. Demographic data, sex assigned at birth, appointment attendance, comorbid conditions, and patient specific outcomes were collected for analysis. The patient’s home address was cross-referenced with the GeoMarker database to define corresponding specific socioeconomic contextual variables. Results: 236 patients were included in the study including 198 patients (83.9%) with 22q11DS and 38 patients (16.1%) with 22q duplication syndrome. Collectively, these patients were scheduled for a total of 9,734 clinic visits and 2,347 visits with the 22q multidisciplinary clinic (22q MDC). The overall mean rate of no-show clinic visits for the 22q MDC was 7.7% ± 10.9 and the median was 0% (IQR = 8.4%). Factors associated with clinic no-show included lower median household income (OR (95% CI) 1.43 (1.25-1.64), p < .001), lower fraction of population with high school diploma (OR (95% CI) 2.33 (2.04-2.67), p < .001) higher fraction of population below the poverty line (OR (95% CI) 1.52 (1.32- 1.73), p < .001) and higher fraction of population that required assisted income (OR (95% CI) 1.38 (1.21-1.58), p < .001). Interestingly, farther distance from the tertiary care facility was associated with lower no-show rate (OR (95% CI) 0.71 (0.60-0.85), p < .001). Conclusion: These findings highlight the potential influence of socioeconomic factors on no-show clinic appointments in pediatric patients with 22q11DS. These factors can be used to help identify patients at risk of no-show clinic appointments and be used to develop targeted interventions aimed at improving clinic attendance and ultimately elevating patient outcomes.

The material well-being of veterans and their families is an important, policy-relevant topic. I research this topic through two crucial measures. In Chapters 1 and 2, I focus on wages, and in Chapter 3, I focus on poverty. In Chapter 1, I estimate the effect of veteran status on unconditional quantiles of wages for males across the period 1979-2017. I show there are important changes to the veteran wage differential over time across the entire wage distribution. In earlier periods, veterans enjoyed wage premiums across the entire wage distribution. Beginning in the early 1990s, wage premiums systematically declined across the wage distribution and largely became slight wage penalties across the wage distribution. Starting around 1997 and going forward, a pattern emerged showing that veterans at the low end of the wage distribution experience wage premiums of around 2% to 4%, whereas veterans at the upper end of the wage distribution experience wage penalties of around 4%. I then conduct wage decompositions of these differentials at both the beginning and end of the period of study. The results show that veterans in more recent times have had their wage premiums reduced or are now earning wage penalties compared to nonveterans. The primary reason for this is that more recent veterans have less favorable compositional differences as compared to nonveterans, especially in the upper-end of the wage distribution. Whereas veterans in the past maintained an advantage in characteristics the labor market valued throughout the wage distribution. In Chapter 2, I examine the effect of potential non-random selection into employment on the female veteran-nonveteran median wage gap over the period 2006-2021. I find no evidence iii that selection is contaminating estimates of the female veteran-nonveteran median wage gap over this period. In Chapter 3, I estimate both the effect of veteran status on households’ likelihood of poverty and deep poverty and the effect of service-connected disability on veteran households’ likelihood of poverty and deep poverty. I construct two measures of service-connected disability. First, I construct an indicator for whether a veteran household has any service- connected disability. Next, I construct a categorical measure of the severity of service-connected disability. The latter allows me to test whether service-connected disability has heterogeneous effects depending on its severity. I estimate these effects over the period 2009-2019. The results are consistent with prior literature, indicating that veteran households have a much lower likelihood of poverty as compared to nonveteran households in all periods. Generally, veteran households enjoy a 1.7 to 3.3 percentage point lower likelihood of poverty depending on the year. This advantage does not transfer to the likelihood of deep poverty. Among impoverished households, veteran households generally maintain around a 2 percentage point higher likelihood of being in deep poverty. Veteran households with the presence of service-connected disability have a lower likelihood of poverty by 2 to 2.5 percentage points as compared to veteran households with no service-connected disability, depending on the year. A different pattern emerges for deep poverty. Among impoverished veteran households, those with the presence of service-connected disability have around a 4 percentage point higher likelihood of poverty. This effect is consistent across the period of study. I also find evidence for heterogeneity in the effect of service-connected disability on the likelihood of poverty and deep poverty. There is a strong pattern whereby as the severity of service-connected disability increases, the likelihood of poverty among veteran households declines. The most severe category of service-connected iv disability is associated with a consistent reduction in poverty by around 3 to 4 percentage points (depending on the year) as compared to veteran households with no service-connected disability or a rating of 0%. Veteran households in the second most severe category analogously experience around a 2 to 3 percentage point reduction in poverty. Veteran households in the second lowest severity category analogously experience around a 1 to 2 percentage point reduction in poverty.

This study aims to investigate the impact of financial inclusion and household decision-making on child health outcomes in Nigeria. Specifically, it explores how financial inclusion—measured through mobile phone usage for financial transactions, bank account ownership, and mobile digital payment methods—interacts with women's decision-making power regarding earnings and household purchases to influence child health. Using data from the 2018 IPUMS-NDHS dataset, the analysis considers both rural and urban divides to assess disparities in financial inclusion and its effects on child mortality. The study employs logistic regression analysis to examine the relationship between financial inclusion, household decision-making, and child health. The findings reveal that households with mobile phones for financial transactions have significantly lower odds of child mortality, while bank account ownership has no significant effect. Regional disparities are apparent, with women in rural areas more likely to face financial exclusion and associated negative health outcomes for their children. Additionally, the study finds that women who have decision-making power over household purchases are less likely to experience child mortality in their households. In conclusion, the study emphasizes the need for financial empowerment of women as a critical strategy to improve family well-being and reduce child mortality. Expanding access to mobile financial platforms and enhancing women's decision-making authority are recommended to promote better health outcomes for children in Nigeria.

The COVID-19 pandemic has exposed individuals to various risks, including job loss, income reduction, deteriorating well-being, and severe health complications and death. In Brazil and the U.S., as well as in other countries, the initial response to the pandemic was marked by governmental underestimation, leading to inadequate public health measures to curb the spread of the virus. Although progressively mitigated, this approach played a crucial role in the impacts on local populations. Therefore, the principal aim of this paper is to evaluate the impact of COVID-19 and, indirectly, of the policies adopted by the U.S. and the Brazilian governments to prevent pandemic diffusion on income distribution. Utilizing available microdata and employing novel econometric methods (RIF-regression for inequality measures) this study shows that growth in COVID-19 prevalence significantly exacerbates economic disparities. Furthermore, the impact of COVID-19 on inequality has increased over time, suggesting that this negative impact has been intensifying. In the U.S., results indicate that working from home, the inability to work, and barriers to job-seeking significantly increase inequalities. Although further data are necessary to validate the hypothesis, this preliminary evidence suggests that the pandemic has significantly contributed to increased inequality in these two countries already characterized by increasing polarization and significant social disparities.

Rural areas have experienced dramatic economic and demographic change over the past half-century. Since the 1970s, globalization trends have moved manufacturing industries away from rural areas and sometimes outsourced their labor to other countries, while agricultural industries have increasingly used technological advances that have lessened the need for workers (Flora et al. 2015). Industrial restructuring patterns that became notable in the 1990’s also moved many “newer” jobs in specialized and high-paying industries away from rural areas (Center on Rural Innovation 2022; Muro 2020). Concurrently, these trends have led to shrinking economic opportunities within much of rural America and high levels of out-migration among native-born rural residents (Flora et al. 2015). Despite these trends, an increase in foreign-born in-migration to these areas started in the 1990s and continues today (e.g., Farmer and Moon 2009; Lichter and Johnson 2009). More recently, the COVID-19 pandemic created widespread disruptions to employment in the U.S., but little attention has been given to how these disruptions have affected rural areas or the immigrant workers who live there. This two-article dissertation uses American Community Survey data to provide a descriptive picture of industrial prevalence by nativity status in both urban and rural areas five years before COVID-19, and Current Population Survey data to investigate the onset of COVID- 19 and its implications for rural workers (U.S.- and foreign-born) participating in Retail and Hospitality industries and Professional industries. In addition to providing a novel analysis of rural immigrant labor by industry, I find evidence of regional shifts in rural workers’ participation in retail and hospitality work by nativity status during the COVID-19 years. Moreover, this research highlights the enduring importance of race/ethnicity for rural labor opportunities. These findings extend the literature on rural immigrant well-being by examining labor and industry trends across spatial contexts and build on existing industrial restructuring and segmented assimilation theories.

Our report focuses on the current state of the American middle class. First, we examine changes in the financial well-being of the middle class and other income tiers since 1970. This is based on data from the Annual Social and Economic Supplements (ASEC) of the Current Population Survey (CPS), conducted from 1971 to 2023. Then, we report on the attributes of people who were more or less likely to be middle class in 2022. Our focus is on their race and ethnicity, age, gender, marital and veteran status, place of birth, ancestry, education, occupation, industry, and metropolitan area of residence. These estimates are derived from American Community Survey (ACS) data and differ slightly from the CPS-based estimates. In part, that is because incomes can be adjusted for the local area cost of living only with the ACS data. (Refer to the methodology for details on these two data sources.) This analysis and an accompanying report on the Asian American middle class are part of a series on the status of America’s racial and ethnic groups in the U.S. middle class and other income tiers. Forthcoming analyses will focus on White, Black, Hispanic, American Indian or Alaska Native, Native Hawaiian or Pacific Islander and multiracial Americans, including subgroups within these populations. These reports are, in part, updates of previous work by the Center. But they offer much greater detail on the demographic attributes of the American middle class.

By concentrating large populations in compact geographical regions, cities have emerged as potent catalysts for socioeconomic development and progress. For cities to thrive and prosper, it is imperative that they provide alluring living and working environments, establishing an atmosphere conducive to growth, innovation, and overall well-being. Among the essential factors that directly influence the potential productivity and prosperity of these environments is the availability of clean, uncontaminated air that enables individuals to thrive both physically and mentally. In order to shed light on the impact of urban pollution on the growth of urban output and employment, a comprehensive comparative statics model has been meticulously developed.

This paper delves into the nuanced impact of the COVID-19 pandemic on time use activities in the United States, particularly examining gender and parental status differences. Drawing on data from the 2018–2022 American Time Use Survey, the study analyzes trends in six distinct time use categories: unpaid care work, leisure, employed activities, personal care, childcare, and household activities. The research sheds light on the evolving dynamics within households during the pandemic, emphasizing the potential implications for economic stratification and societal well-being. The COVID-19 pandemic completely disrupted established time use patterns, forcing a reconsideration of ‘traditional’ gender roles and caregiving responsibilities in certain countries. While early studies hinted at a temporary shift toward more equitable distribution of household activities, particularly childcare, this paper scrutinizes these trends over a more extended period. Despite the short-lived increases in fathers’ involvement in childcare during the pandemic, the study finds that the caregiving burden remained disproportionately on mothers and women. Notably, the analysis reveals persistent gender disparities in unpaid care work, with women and mothers spending a disproportionate amount of time on household activities, housework, and caring for children. This unequal distribution of caregiving responsibilities limits a women’s ability to engage in paid work activities, contributing to economic stratification and constraining their financial resources. While some activities demonstrated slight reductions in gender gaps, the overall picture suggests that the pandemic may not bring about lasting changes in how time is allocated within households.

Background: Transportation and health are undeniably related topics. Transportation choices impact our physical and mental health, affecting our activity levels and access to different opportunities. In recent years, research on the transportation and health domain has mainly focused on urban settings, while the rural population has been overlooked. Research is needed to explore the complex relationships across transportation-related health determinants in the rural context and support policies prioritizing health in these areas. Methods: A conceptual framework is proposed based on an extensive literature review to identify the factors representing the transportation and health relationships in the rural U.S. Confirmatory factor analyses are employed to identify the variables representing each transportation-related health determinant. A structural equation model (SEM) is then estimated to quantify the relationships between these determinants in the rural U.S. For this endeavor, we collected individual data from an online survey and available secondary spatial data. A policy approach, the ABC PATH, is also proposed to support community health through transportation changes. Results: We find strong and significant associations across all transportation-related health determinants, particularly with physical activity. Decreasing car usage and providing alternative transportation options can increase health and well-being. The proposed ABC PATH policy approach comprehensively promotes a healthy lifestyle and identifies potential interventions, with particular attention to vulnerable groups. Conclusions: This paper presents a conceptual framework and quantifies the complex interrelationships between transportation and health in rural areas. The policy implications suggest that decision-makers must identify all-inclusive solutions and promote active lifestyles, considering the interlinked connections of the transportation-related determinants examined herein.

Background: This study assessed the associations between children’s experiences of discrimination based on race/ethnicity and sexual orientation/gender identity and their parents’ anxiety, depressive symptoms, and self-rated health. Methods: Our sample included 3910 parents with at least one child between 12 and 17 years of age. Data were pooled from the 2021 and 2022 waves of the National Health Interview Survey. Path analysis with maximum likelihood (ML) estimation and bootstrapping were used to examine the indirect pathways from child-experienced discrimination to parental self-rated health through parental anxiety and depressive symptoms. Results: Child-experienced discrimination based on race/ethnicity was associated with worse parental self-rated health via pathways through higher parental anxiety (p = 0.003) and depressive symptoms (p < 0.001). Child-experienced discrimination based on sexual orientation/gender identity was also associated with worse parental self-rated health via pathways through higher parental anxiety (p = 0.002) and depressive symptoms (p = 0.001). Conclusions: The results show a strong association between children’s experiences of discrimination and parental self-rated health through pathways of poor parental mental health. Findings demonstrate the need to reduce discrimination directed at children and to facilitate mental health support for parents of children experiencing discrimination to improve family well-being.