TY - JOUR T1 - The long-term mortality impact of combined job strain and family circumstances: A life course analysis of working American mothers JF - Social Science and Medicine Y1 - 2015 A1 - Erika L. Sabbath A1 - Mejía-Guevara, Iván A1 - Noelke, Clemens A1 - Lisa F Berkman KW - Adult children KW - Employment and Labor Force KW - Health Conditions and Status KW - Healthcare KW - Public Policy KW - Risk Taking AB - Background: Work stress and family composition have been separately linked with later-life mortality among working women, but it is not known how combinations of these exposures impact mortality, particularly when exposure is assessed cumulatively over the life course. We tested whether, among US women, lifelong work stress and lifelong family circumstances would jointly predict mortality risk. Procedures: We studied formerly working mothers in the US Health and Retirement Study (HRS) born 1924-1957 (n = 7352). We used sequence analysis to determine five prototypical trajectories of marriage and parenthood in our sample. Using detailed information on occupation and industry of each woman's longest-held job, we assigned each respondent a score for job control and job demands. We calculated age-standardized mortality rates by combined job demands, job control, and family status, then modeled hazard ratios for death based on family constellation, job control tertiles, and their combination. Results: Married women who had children later in life had the lowest mortality risks (93/1000). The highest-risk family clusters were characterized by spells of single motherhood (132/1000). Generally, we observed linear relationships between job control and mortality hazard within each family trajectory. But while mortality risk was high for all long-term single mothers, we did not observe a job control-mortality gradient in this group. The highest-mortality subgroup was previously married women who became single mothers later in life and had low job control (HR 1.91, 95 CI 1.38,2.63). Practical implications: Studies of associations between psychosocial work characteristics and health might consider heterogeneity of effects by family circumstances. Worksite interventions simultaneously considering both work and family characteristics may be most effective in reducing health risks. (C) 2015 Elsevier Ltd. All rights reserved. PB - 146 VL - 146 U4 - Social determinants of health/sequence analysis/Single motherhood/Job control/Work family conflict/Job stress/Job strain/mental health/risk factors/cardiovascular disease/public Policy/Working women/Health risk assessment/Occupational stress/Working mothers ER - TY - JOUR T1 - Mothering alone: cross-national comparisons of later-life disability and health among women who were single mothers JF - Journal of Epidemiology and Community Health Y1 - 2015 A1 - Lisa F Berkman A1 - Yuhui Zheng A1 - M. Maria Glymour A1 - Mauricio Avendano A1 - Axel Borsch-Supan A1 - Erika L. Sabbath KW - Adult children KW - Cross-National KW - Disabilities KW - Health Conditions and Status KW - Methodology AB - Background Single motherhood is associated with poorer health, but whether this association varies between countries is not known. We examine associations between single motherhood and poor later-life health in the USA, England and 13 European countries.Methods Data came from 25 125 women aged 50 who participated in the US Health and Retirement Study, the English Longitudinal Study of Ageing and Survey of Health, Ageing and Retirement in Europe. We tested whether single motherhood at ages 16 49 was associated with increased risk of limitations with activities of daily living (ADL), instrumental ADL and fair/poor self-rated health in later life.Results 33 of American mothers had experienced single motherhood before age 50, versus 22 in England, 38 in Scandinavia, 22 in Western Europe and 10 in Southern Europe. Single mothers had higher risk of poorer health and disability in later life than married mothers, but associations varied between countries. For example, risk ratios for ADL limitations were 1.51 (95 CI 1.29 to 1.98) in England, 1.50 (1.10 to 2.05) in Scandinavia and 1.27 (1.17 to 1.40) in the USA, versus 1.09 (0.80 to 1.47) in Western Europe, 1.13 (0.80 to 1.60) in Southern Europe and 0.93 (0.66 to 1.31) in Eastern Europe. Women who were single mothers before age 20, for 8 years, or resulting from divorce or non-marital childbearing, were at particular risk.Conclusions Single motherhood during early-adulthood or mid-adulthood is associated with poorer health in later life. Risks were greatest in England, the USA and Scandinavia. Selection and causation mechanisms might both explain between-country variation. PB - 69 VL - 69 UR - http://jech.bmj.com/content/early/2015/04/10/jech-2014-205149.abstract IS - 9 U4 - ELSA_/SHARE/cross Cultural Comparison/cross-national study/ADL/IADL/single motherhood/disability/disability ER - TY - JOUR T1 - Use of life course work-family profiles to predict mortality risk among US women JF - American journal of public health Y1 - 2015 A1 - Erika L. Sabbath A1 - Guevara, Ivan Mejia A1 - M. Maria Glymour A1 - Lisa F Berkman KW - Adult children KW - Event History/Life Cycle KW - Health Conditions and Status KW - Other KW - Women and Minorities AB - OBJECTIVES: We examined relationships between US women's exposure to midlife work-family demands and subsequent mortality risk. METHODS: We used data from women born 1935 to 1956 in the Health and Retirement Study to calculate employment, marital, and parenthood statuses for each age between 16 and 50 years. We used sequence analysis to identify 7 prototypical work-family trajectories. We calculated age-standardized mortality rates and hazard ratios (HRs) for mortality associated with work-family sequences, with adjustment for covariates and potentially explanatory later-life factors. RESULTS: Married women staying home with children briefly before reentering the workforce had the lowest mortality rates. In comparison, after adjustment for age, race/ethnicity, and education, HRs for mortality were 2.14 (95 confidence interval CI =1.58, 2.90) among single nonworking mothers, 1.48 (95 CI=1.06, 1.98) among single working mothers, and 1.36 (95 CI=1.02, 1.80) among married nonworking mothers. Adjustment for later-life behavioral and economic factors partially attenuated risks. CONCLUSIONS: Sequence analysis is a promising exposure assessment tool for life course research. This method permitted identification of certain lifetime work-family profiles associated with mortality risk before age 75 years. PB - 105 VL - 105 IS - 4 N1 - Times Cited: 0 0 U4 - mortality risk/mortality risk/WOMEN/midlife/work-family balance/life Course ER -