@article {8807, title = {Educational and Gender Differences in Health Behavior Changes After a Gateway Diagnosis.}, journal = {J Aging Health}, volume = {30}, year = {2018}, month = {2018 03}, pages = {342-364}, abstract = {

OBJECTIVE: Hypertension represents a gateway diagnosis to more serious health problems that occur as people age. We examine educational differences in three health behavior changes people often make after receiving this diagnosis in middle or older age, and test whether these educational differences depend on (a) the complexity of the health behavior change and (b) gender.

METHOD: We use data from the Health and Retirement Study and conduct logistic regression analysis to examine the likelihood of modifying health behaviors post diagnosis.

RESULTS: We find educational differences in three behavior changes-antihypertensive medication use, smoking cessation, and physical activity initiation-after a hypertension diagnosis. These educational differences in health behaviors were stronger among women compared with men.

DISCUSSION: Upon receiving a hypertension diagnosis, education is a more important predictor of behavior changes for women compared with men, which may help explain gender differences in the socioeconomic gradient in health in the United States.

}, keywords = {Aged, Attitude to Health, Educational Status, Exercise, Female, Health Behavior, Humans, Hypertension, Male, Middle Aged, Retirement, Sex Factors, Smoking cessation, United States}, issn = {1552-6887}, doi = {10.1177/0898264316678756}, url = {http://jah.sagepub.com/cgi/doi/10.1177/0898264316678756}, author = {Elaine M Hernandez and Rachel Margolis and Robert A Hummer} } @article {7866, title = {Educational Differences in Healthy Behavior Changes and Adherence Among Middle-aged Americans}, journal = {Journal of health and social behavior}, volume = {54}, year = {2013}, note = {Times Cited: 0}, pages = {353-68}, publisher = {54}, abstract = {Although the better-educated are more likely to practice healthy behaviors when measured at one point in time, there is no clear evidence regarding whether more educated people are more likely to initiate healthy behavior changes in the face of new chronic conditions and whether they are better able to adhere to these healthy changes, once made. I use data from the Health and Retirement Study (HRS) (1992-2010) to examine smoking cessation and starting physical activity by educational attainment over an 18-year period among 16,606 respondents ages 50 to 75. The more-educated are the least likely to smoke and most likely to be physically active in middle age. They are also most likely to make healthy changes overall and better adhere to them. Education also shapes behavior change after a new diagnosis, which likely contributes to socioeconomic status differences in chronic disease management and health outcomes.}, keywords = {Demographics, Health Conditions and Status}, doi = {10.1177/0022146513489312}, author = {Rachel Margolis} } @mastersthesis {5991, title = {Essays on health, the process of aging, and family context}, volume = {Ph.D.}, year = {2011}, pages = {219}, school = {University of Pennsylvania}, address = {Philadelphia, PA}, abstract = {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{\textquoteright}s characteristics, and partnership transitions. Understanding the family context of healthy lifestyle changes is important to understand social patterns in health.}, keywords = {Adult children, Demographics, Health Conditions and Status, Other}, url = {https://repository.upenn.edu/dissertations/AAI3475918/}, author = {Rachel Margolis} }