Keynote Palloni

Amateur

Download

Post to :

URL :

Related Presentations :

Add to Flag Embed

Uploaded from authorPOINT

Views: 40

Category: News & Reports..

Presentation Description

No description available.

Comments

Presentation Transcript

Health and Mortality Differentials among adults: does selection matter? :

Health and Mortality Differentials among adults: does selection matter? Alberto Palloni Carolina Milesi Robert White Alyn Turner Center for Demography and Ecology University of Wisconsin-Madison

Some history: why did I end up here?:

Some history: why did I end up here? Mortality and health differentials over the life course The role of social classes The argument of selection Stages of research: Early health and adult social class---stratification Early health and adult mortality/health differentials What if selection occurs? Are social classes ignorable if selection is relevant?

Empirical regularities:

Empirical regularities Increasing income and wealth inequality in the US: sustained from 1985 onward, steeper after 1995 Persistently high intergenerational correlation of earnings, income and wealth ρ = βcp * (σp /σc ) [.30-.60] Stalling social mobility: increased stickiness Persistent adult health and mortality differentials everywhere

Adult SES health/mortality gradients:

Adult SES health/mortality gradients Magnitude: They are large Over time: increasing By age: increase until age 50-55 then (tend to) decrease Continuous: not accounted for by extremes Pervasive: causes of death, health status, self-reported conditions Fairly global (or almost) regardless of prevailing health care system

Age equivalence of mortality rates for high and low education groups:

Age equivalence of mortality rates for high and low education groups

Age equivalence of mortality rates for high and low education groups:

Age equivalence of mortality rates for high and low education groups

Age equivalence of mortality rates for high and low education groups:

Age equivalence of mortality rates for high and low education groups

Age equivalence of mortality rates for high and low education groups:

Age equivalence of mortality rates for high and low education groups

Age equivalence of mortality rates for high and low education groups:

Age equivalence of mortality rates for high and low education groups

Proportion with poor self-reported health by education and age, 1975 :

Proportion with poor self-reported health by education and age, 1975 Source: NHIS, 1975

Proportion with poor self-reported health by education and age, 2000 :

Proportion with poor self-reported health by education and age, 2000 Source: NHIS, 2000

Evidence is strong, water tight:

Evidence is strong, water tight Education differentials Income (permanent) Wealth: Studies with PSID Studies with HRS Studies with NLSM (couples) Occupation (prestige/social class)

The origins of social class differentials in health and mortality:

The origins of social class differentials in health and mortality Social class traits Health

Selection processes:

Selection processes Direct or 'drift' Reverse causality Heterogeneity Indirect ‘health selection proper’

Indirect Selection:

Indirect Selection Health inequalities by SES early in life translate into health inequalities by SES late in life. This requires that: Health inequalities early in life be a significant determinant of adult social stratification Either that early health directly affect adut health OR that there be paths linking early health with conditions (exposure to risks) that are class related

Need a unified theory:

Need a unified theory How does early health affect stratification? Social stratification theory Labor economics and wage determination How does early health affect adult health? Early effects theory (Barker-type hypotheses) Life cycle trajectories (Kuh, Ben-Shlomo, Smith, Wadsworth)

Conditions of possibility:

Conditions of possibility Allocation of health in early childhood is non-random (class dependent) There must be a relation between early childhood health and acquisition of traits that determine social stratification There must be a relation between early health and later exposure to risk (direct or indirect)

A new problem: relations involved in “selection”:

A new problem: relations involved in 'selection' Social class of origin (genes/environments) Traits, antecedent health status Adult health status Social class of destination

What is social class?:

What is social class?

What is child health status?:

What is child health status?

“Emotional development during the first five years offers a window into the psychological growth of young children” (National Research Council, 2003) :

'Emotional development during the first five years offers a window into the psychological growth of young children' (National Research Council, 2003)

“Early social experiences, especially those with primary attachment figures, can have profound consequences for both biobehavioral and physiological functioning throughout the life span” (Suomi, 1999):

'Early social experiences, especially those with primary attachment figures, can have profound consequences for both biobehavioral and physiological functioning throughout the life span' (Suomi, 1999)

What is adult health status?:

What is adult health status?

Two tasks:

Two tasks Early health status affects adult social class positions Early health status matters for intergenerational transmission of inequalities Early health status is responsible for effects that account for some or all of adult SES health gradients

The data:

The data British Cohort Survey 1958 Only males Use information from 0 up to 41-42 Do not do multiple imputation to resolve attrition We go from circa 8,000 to 1,000 cases Disproportionate attrition among low class

Procedures:

Procedures Formulate and estimated structural equation model: Limited: one factor models Limited: ignore attrition and non response Use estimates to decompose paths Use estimates to simulate life course

Task 1: intergenerational transmission of inequalities:

Task 1: intergenerational transmission of inequalities

What pays out there?:

What pays out there? Years of education? Credentials? Cognitive performance? Labor market experience? Personalities? Parents’ wallets? Luck?

“It is common knowledge outside academic journals that motivation, tenacity, trustworthiness, and perseverance are important traits for success in life” (Heckman and Rubinstein, 2001):

'It is common knowledge outside academic journals that motivation, tenacity, trustworthiness, and perseverance are important traits for success in life' (Heckman and Rubinstein, 2001)

Slide30:

Path diagram of relations between early child health conditions and earnings Cognitive Skills Non- Cognitive Skills Social Class Early Health Parental Social Class 1 2 1 2 1 2  4 3 1 2 Parental Health Educational Attainment

Representation of relations: BCS58:

Representation of relations: BCS58 Cognitive skills age 11 Non- cognitive skills age 11 Social class age 30 Chronic conditions age 7 Parental social class Parental health Educational attainment age 16 Low birth weight Chronic conditions age 16 SR Health 30 Social class age 40 SR Health 40

Slide32:

Main results Social class age 41/42 Chronic conditions age 7 Parental social class Parental health Educational attainment age 16 Low birth weight Chronic conditions age 16 Cognitive skills age 11 Non- cognitive skills age 11

Slide33:

Slide34:

Slide35:

Slide36:

Slide37:

Main results Cognitive skills age 11 Social class age 41/42 Chronic conditions age 7 Parental social class Parental health Educational attainment age 16 Low birth weight Chronic conditions age 16 Non- cognitive skills age 11

Main inference:

Main inference The effects of early health on social class are important but they only work through cognitive skills and non-cognitive traits. None are direct.

Decomposition of effects:

Decomposition of effects Close to 50 percent of the correlation between parental and offspring social class works through early childhood health indicators (birthweight, chronic conditions at ages 7 and 11)

Decomposition of effects of parental social class on sons’ social class:

Decomposition of effects of parental social class on sons’ social class

Decomposition of effects of parental social class on sons’ social class:

Decomposition of effects of parental social class on sons’ social class

Decomposition of effects of parental social class on sons’ social class:

Decomposition of effects of parental social class on sons’ social class

Decomposition of effects of parental social class on sons’ social class:

Decomposition of effects of parental social class on sons’ social class

Monte Carlo matrix exercise:

Monte Carlo matrix exercise Use structural equation model to produce mobility matrices Each iteration generates a random matrix (with random entries) From each matrix several measures of mobility can be extracted

Slide45:

Probability of staying in LOWEST class

Slide46:

Probability of staying in HIGHEST class