
Jennifer Karas MontezCase Western Reserve University | CWRU · Department of Sociology
Jennifer Karas Montez
PhD
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59
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Publications (59)
The contextual predictors of mortality in the United States are well documented, but the COVID-19 pandemic may have upended those associations. Informed by the social history of disease framework (SHDF), this study examined how the importance of county contexts on adult deaths from all causes, drug poisonings, and COVID-19-related causes fluctuated...
Objectives. To identify relationships between US states’ COVID-19 in-person activity limitation and economic support policies and drug overdose deaths among working-age adults in 2020.
Methods. We used county-level data on 140 435 drug overdoses among adults aged 25 to 64 years during January 2019 to December 2020 from the National Vital Statistics...
In the early months of the COVID-19 pandemic, states enacted multiple policies to reduce in-person interactions. Scholars have speculated that these policies may have contributed to adverse mental health outcomes. This study examines potential associations between states' COVID-19 physical distancing policies and working-age (18-64) adults' self-re...
In this paper, we test whether the Affordable Care Act Medicaid expansions are associated with maternal morbidity. The ACA expansions may have affected maternal morbidity by increasing pre‐conception access to health care, and by improving the quality of delivery care, through enhancing hospitals' financial positions. We use difference‐in‐differenc...
Unlabelled:
Policy Points The erosion of electoral democracy in the United States in recent decades may have contributed to the high and rising working-age mortality rates, which predate the COVID-19 pandemic. Eroding electoral democracy in a US state was associated with higher working-age mortality from homicide, suicide, and especially from drug...
The rise in working-age mortality rates in the United States in recent decades largely reflects stalled declines in cardiovascular disease (CVD) mortality alongside rising mortality from alcohol-induced causes, suicide, and drug poisoning; and it has been especially severe in some U.S. states. Building on recent work, this study examined whether U....
Introduction
Education level is positively associated with adult health in the United States. However, new research shows that the association is stronger in some U.S. states than others, and that states with stronger associations also tend to have poorer overall levels of health. Understanding why educational disparities in health are larger in so...
Introduction
The goal of this study was to estimate how state preemption laws that prohibit local authority to raise the minimum wage or mandate paid sick leave have contributed to working-age mortality from suicide, homicide, drug overdose, alcohol poisoning, and transport accidents.
Methods
County-by-quarter death counts by cause and sex for 199...
Demographers have consistently documented the importance of educational attainment for population-health. However, it is becoming increasingly clear that the relationship between educational attainment and health varies considerably across contexts. This study examines how the education-sleep association varies across U.S. states to glean insights...
In this paper, we test whether the association between income inequality and life expectancy is mediated and moderated by policy liberalism in US states for the years 2000-2014. Two-way fixed-effects models with autocorrelation-corrected standard errors show: (1) income inequality is negatively associated with policy liberalism and life expectancy;...
As laboratories of democracy, local governments are incubators for innovative policies with the potential to improve health and reduce health inequities. Local policy change is often grounded in a deep understanding of the health needs, goals, and lived experiences of communities and therefore has the potential to create lasting change in the struc...
Recent trends in U.S. health have been mixed, with improvements among some groups and geographic areas alongside declines among others. Medical sociologists have contributed to the understanding of those disparate trends, although important questions remain. In this article, we review trends since the 1980s in key indicators of U.S. health and weig...
Objectives. To estimate total life expectancy (TLE), disability-free life expectancy (DFLE), and disabled life expectancy (DLE) by US state for women and men aged 25 to 89 years and examine the cross-state patterns.
Methods. We used data from the 2013–2017 American Community Survey and the 2017 US Mortality Database to calculate state-specific TLE,...
Studies show that raising the minimum wage in a US state above the federal minimum wage can reduce infant mortality rates in those states. Some states have raised their minimum wage in recent decades, while many others did not, and have prohibited local authorities from doing so by enacting preemption laws. This study investigates how the recent em...
Contemporary challenges to healthy aging in communities across the United States are shaped by the complex, multilayered nature of the federal, state, and local contexts in which aging occurs. We introduce a framework for thinking in this multilevel way, as well as acknowledging the differences experienced by more and less socially advantaged group...
Policy Points
Explanations for the troubling trend in US life expectancy since the 1980s should be grounded in the dynamic changes in policies and political landscapes. Efforts to reverse this trend and put US life expectancy on par with other high‐income countries must address those factors.
Of prime importance are the shifts in the balance of pol...
Policy Points
• Changes in US state policies since the 1970s, particularly after 2010, have played an important role in the stagnation and recent decline in US life expectancy.
• Some US state policies appear to be key levers for improving life expectancy, such as policies on tobacco, labor, immigration, civil rights, and the environment.
• US lif...
The United States currently ranks last among high-income countries for life expectancy. Since 2014, U.S. life expectancy has declined. By now, these alarming trends are well known to researchers, the public, and policymakers. Nevertheless, there is no consensus among researchers on the causes of the trends, and there has been no serious and effecti...
Policy Points Preemption is a legal doctrine whereby a higher level of government may limit or even eliminate the power of a lower level of government to regulate a certain issue. Some state legislatures are using preemption with increasing regularity to thwart local policies that have the potential to reduce health inequities. Despite recent trend...
The positive association between educational attainment and adult health (“the gradient”) is stronger in some areas of the United States than in others. Explanations for the geographic pattern have not been rigorously investigated. Grounded in a contextual and life-course perspective, the aim of this study is to assess childhood circumstances (e.g....
Despite numerous studies on educational disparities in U.S. adult health, explanations for the disparities and their growth over time remain incomplete. We argue that this knowledge gap partly reflects an individualist paradigm in U.S. studies of educational disparities in health. These studies have largely focused on proximal explanations (e.g., i...
Adult mortality varies greatly by educational attainment. Explanations have focused on actions and choices made by individuals, neglecting contextual factors such as economic and policy environments. This study takes an important step toward explaining educational disparities in U.S. adult mortality and their growth since the mid-1980s by examining...
To understand the education–mortality association among U.S. adults, recent studies have documented its national functional form. However, the functional form of education–mortality relationship may vary across geographic contexts. The four U.S. Census regions differ considerably in their social and economic policies, employment opportunities, inco...
Objectives:
To examine how disparities in adult disability by educational attainment vary across US states.
Methods:
We used the nationally representative data of more than 6 million adults aged 45 to 89 years in the 2010-2014 American Community Survey. We defined disability as difficulty with activities of daily living. We categorized education...
Growing disparities in adult mortality across U.S. states point to the importance of assessing disparities in other domains of health. Here, we estimate state-level differences in disability, and draw on the WHO socio-ecological framework to assess the role of ecological factors in explaining these differences. Our study is based on data from 5.5 m...
Functional limitations and disability declined in the US during the 1980s and 1990s, but reports of early 21st century trends are mixed. Whether educational inequalities in functioning increased or decreased is also poorly understood. Given the importance of disability for productivity, independent living, and health care costs, these trends are cr...
Inequalities in women's mortality between U.S. states are large and growing. It is unknown whether they reflect differences between states in their population characteristics, contextual characteristics, or both. This study systematically examines the large inequalities in women's mortality between U.S. states using a multilevel approach. It focuse...
Objectives
The general educational development (GED) diploma is intended to be equivalent to a high school (HS) credential; however, recent evidence finds that GED recipients have worse health than HS graduates. This study aims to explain the health disadvantage, focusing on three domains: noncognitive skills, health behaviors, and economic factors...
Objective: Adverse events in childhood can indelibly influence adult health. While evidence for this association has mounted, a fundamental set of questions about how to operationalize adverse events has been understudied. Method: We used data from the National Survey of Midlife Development in the United States to examine how quantity, timing, and...
We appreciate Dowd and Hamoudi's comments regarding our editorial. Their commentary reflects the critical thinking and productive dialogue that we had hoped to generate. (Am J Public Health. Published online ahead of print November 13, 2014: e1. doi:10.2105/AJPH.2014.302339).
Several recent studies report that life expectancy has declined (or that mortality rates have increased) among low-educated women in recent decades.(1-7) For instance, between 1990 and 2000, life expectancy at age 25 years declined by nearly one year among White women with zero to 12 years of education while it increased by one year among White wom...
Policy debates about raising the full retirement age often neglect socioeconomic health disparities among U.S. workers. In response to this gap, we analyzed educational differentials in health among middle-age and older adults and translated the findings into age equivalents.Method.We used the nationally representative 1997-2010 National Health Int...
Mounting evidence finds that adult health reflects socioeconomic circumstances (SES) in early life and adulthood. However, it is unclear how the health consequences of SES in early life and adulthood accumulate—for example, additively, synergistically. This study tests four hypotheses about how the health effects of early-life SES (measured by pare...
Studies of the early-life origins of adult physical functioning and mortality have found that childhood health and socioeconomic context are important predictors, often irrespective of adult experiences. However, these studies have generally assessed functioning and mortality as distinct processes and used cross-sectional prevalence estimates that...
Objectives:
We investigated trends in the educational gradient of US adult mortality, which has increased at the national level since the mid-1980s, within US regions.
Methods:
We used data from the 1986-2006 National Health Interview Survey Linked Mortality File on non-Hispanic White and Black adults aged 45 to 84 years (n = 498,517). We examin...
This study compares trends in work–family context by education level from 1976 to 2011 among U.S. women. The major aim is to assess whether differences in work–family context by education level widened, narrowed, or persisted. We used data from the 1976–2011 March Current Population Surveys on women aged 25–64 (n = 1,597,914). We compare trends in...
Over the past half century the gap in mortality across education levels has grown in the United States, and since the mid-1980s, the growth has been especially pronounced among white women. The reasons for the growth among white women are unclear. The authors investigated three explanations-social-psychological factors, economic circumstances, and...
Objectives:
To elucidate why the inverse association between education level and mortality risk (the gradient) has increased markedly among White women since the mid-1980s, we identified causes of death for which the gradient increased.
Methods:
We used data from the 1986 to 2006 National Health Interview Survey Linked Mortality File on non-Hisp...
Recent studies of old-age mortality trends assess whether longevity improvements over time are linked to increasing compression of mortality at advanced ages. The historical backdrop of these studies is the long-term improvement in a population's socioeconomic resources that fueled longevity gains. We extend this line of inquiry by examining whethe...
A vast literature has documented the inverse association between educational attainment and U.S. adult mortality risk but given little attention to identifying the optimal functional form of the association. A theoretical explanation of the association hinges on our ability to describe it empirically. Using the 1979-1998 National Longitudinal Morta...
The educational gradient of U.S. adult mortality became steeper between 1960 and the mid 1980s, but whether it continued to steepen is less clear given a dearth of attention to these trends since that time. This study provides new evidence on trends in the education-mortality gradient from 1986 to 2006 by race, gender, and age among non-Hispanic wh...
largely a consequence of historical gender differences in labor force attachment in the United States, many women rely on their spouse for health insurance coverage, particularly during late middle age. Prior research finds that this creates a window of vulnerability for women during late middle age who may lose their (older) spouse's employment-ba...
Although the idea that early life conditions shape mortality is not new, there has been a resurgence of studies on the topic
in the last two decades. In our review of this work, we weigh the evidence for the major causal mechanisms, i.e., biological
imprint and pathway processes, thought to underlie the associations between childhood conditions and...
Social relationships--both quantity and quality--affect mental health, health behavior, physical health, and mortality risk. Sociologists have played a central role in establishing the link between social relationships and health outcomes, identifying explanations for this link, and discovering social variation (e.g., by gender and race) at the pop...
Objectives. The employment-based health insurance system of the United States means that those individuals who are disadvantaged in the labor market are also disadvantaged in terms of health insurance coverage. The Mexican-origin population has historically been disadvantaged in both domains. We examine the extent to which low rates of health insur...
In the United States, a woman health insurance coverage is largely determined by her employment and marital roles. This research evaluates competing hypotheses regarding how the combination of employment and marital roles shapes insurance coverage among Mexican-origin, non-Hispanic white, and African American women. We use data from the 2004 and 20...
It is often documented that the educational gradient of mortality is steeper for men than for women; yet, the explanation remains a matter of debate. We examine gender differences in the gradients within the context of marriage to determine whether overall differences reflect gender differences in health behaviors or a greater influence of men's ed...
The educational gradient of U.S. adult mortality became steeper between 1960 and the mid-1980s, but whether it continued to steepen is less clear given a dearth of attention to these trends since then. This study provides new evidence on trends in the education-mortality gradient from 1986 through 2006 by race, gender, and age among non-Hispanic Wh...
Previous research on the relationship between diet and acculturation among Hispanics has produced inconsistent results. This study examined the association between diet, country of birth, and a language acculturation scale among Mexican-American women.
The study used a cross-sectional design with data from the 2000 National Health Interview Survey...
Diabetes is the sixth leading cause of death from disease, shortens the average life span by up to 15 years, and is the main cause of new blindness, kidney failure, and amputations in the United States. Interviews with 2 practitioners and 8 individuals with diabetes illustrate how individuals embody their illness. Interviewed persons with diabetes...