Self-Rated Health Trajectories among Married Americans: Do Disparities Persist over 20 Years?

Terceira A Berdahl,Julia Mcquillan

doi:10.1155/2018/1208598

Abstract

The purpose of this study is to understand self-rated health (SRH) trajectories by social location (race/ethnicity by gender by social class) among married individuals in the United States. We estimate multilevel models of SRH using six observations from 1980 to 2000 from a nationally representative panel of married individuals initially aged 25–55 (Marital Instability Over the Life Course Study). Results indicate that gender, race/ethnicity, and social class are associated with initial SRH disparities. Women are less healthy than men; people of color are less healthy than whites; lower educated individuals are less healthy than higher educated individuals. Women's health declined slower than men's but did not differ by race/ethnicity or education. Results from complex intersectional models show that white men with any college had the highest initial SRH. Only women with any college had significantly slower declines in SRH compared to white men with any college. For married individuals of all ages, most initial SRH disparities persist over twenty years. Intersecting statuses show that education provides uneven health benefits across racial/ethnic and gender subgroups.

Highlights

IntroductionA growing number of researchers are calling for more nuanced analyses of health inequality to acknowledge diverse outcomes of individuals who occupy different positions in social structural hierarchies [1,2,3]
We advance understanding of health disparities by answering two important questions: In the United States, are there health disparities among people who are married that are created by disadvantaged social locations due to the intersections of gender, race, and education? If yes, do disparities persist over decades? To answer these questions, we examined self-rated health trajectories of a random sample of individuals who were married in 1980 and followed over twenty years
Average self-rated health ranges from a low of 1.85 among nonwhite women with less than a high school degree to a high of 2.55 among white men with any college education (Table 2)

Summary

Introduction

A growing number of researchers are calling for more nuanced analyses of health inequality to acknowledge diverse outcomes of individuals who occupy different positions in social structural hierarchies [1,2,3]. One useful approach is the intersectionality paradigm [4,5,6], which emphasizes how social structures intersect to create the axis of advantage and disadvantage in multiplicative rather than only in separate or additive ways. To assess particular policies or laws, it can be appropriate to study only one axis of inequality; but to gain a more comprehensive understanding of overall changes in health with aging, comparing subgroups created by assessing multiple axes of stratification simultaneously (e.g., social class, race/ethnicity, and gender) is fruitful [10,11,12]

Results

Discussion

Conclusion