How socioeconomic status shapes health: Essays on the biological and social determinants of human welfare at older ages

Economic and epidemiological research has long established that socioeconomic status (SES) and the core characteristics that define it--education, earnings, and occupation--are strongly associated with health and mortality. However, the actual pathway these interventions and life circumstances take to affect health is not well known, and more research is needed to identify how socioeconomic-related health disparities develop and "get underneath the skin." This dissertation considers the influence of early- and late-life occupational stressors in tandem with genetic inheritances and other elements of SES to better understand how biological and social determinants cumulate over the life span and affect the health of greying populations. The first chapter explores whether characteristics of the physical and psychosocial work environment shape the health gradient in the years leading up to retirement. Dynamic panel and instrumental variable (IV) methods are used in combination with a rich data set that combines demographic information from the Health and Retirement Study (HRS), expert ratings on job characteristics from the Occupational Information Network (O*NET), and W-2 earnings records to draw more robust connections between workplace demands and health at older ages. Results indicate physical demands, environmental hazards, and conditions of the psychosocial work environment are all associated with health outcomes after age 50. In particular, there is a strong relationship between the degree of control and influence exercised on the job and improved self-reported health status, blood pressure, musculoskeletal conditions, cognitive function, and depression. The second two chapters use IV methods that exploit an exogenous shock to occupation at a young age--the Vietnam-era draft lotteries--to investigate genotype-by-environment interactions. Instrumented veteran status is interacted with polygenic scores for smoking initiation and educational attainment to test for genetic moderation (i.e. heterogeneous treatment effects) of veteran status on health behaviors, educational attainment, earnings, and labor force participation at older ages. Results reveal conscription both amplified polygenic risk for smoking and moderated the socioeconomic attainment of veterans, indicating genetic inheritances further mediate the gestation of health disparities across the life course.

Copyright - Copyright ProQuest, UMI Dissertations Publishing 2015 Last updated - 2015-08-28 First page - n/a

0501:Economics