Essays on health, the process of aging, and family context

It is well-established that there is a large degree of stratification in health and well-being by socioeconomic status (SES), however the mechanisms are not well understood. I examine two factors thought to contribute to differences in health by socioeconomic status--early childhood morbidity and health behaviors. In Chapter 2, I examine whether morbidity in early and later childhood is associated with risk factors for cardiovascular disease among Guatemalan adults who experienced high levels of morbidity in childhood. I find that most types of childhood morbidity are associated with poorer adult health, independent of other measured factors, consistent with most research on this topic. However, diarrhea! disease in later childhood was associated with lower levels of some risk factors, as measured by triglycerides and plasma glucose, similar to emerging research on the importance of early life immunity. In Chapters 3 and 4, I focus on health behaviors and analyze the predictors of changes in smoking and physical activity in middle age, two health behaviors which are important for preventing and managing chronic illness and maintaining health. For these chapters, I use the Health and Retirement Study (HRS), a panel study of health and aging in the United States. In Chapter 3, I focus on differences by educational attainment in healthy behavior changes and adherence to these changes once initiated. I find that while the more-educated are the least likely to smoke in middle age and the most likely to quit overall, there are no differences by education in smoking cessation after diagnosis or adherence to smoking cessation. For physical activity, there are strong differences by educational attainment in starting physical activity overall, starting after diagnosis, and adherence. Future research should try to better understand the barriers to physical activity among those with low education. Lastly, in Chapter 4, I focus on health behaviors and health behavior changes by partnership status, partner's characteristics, and partnership transitions. Understanding the family context of healthy lifestyle changes is important to understand social patterns in health.

health Behavior

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