Health Selection and the Process of Social Stratification: The Effect of Childhood Health on Socioeconomic Attainment

School of Social and Family Dynamics, Center for Population Dynamics, Arizona State University, PO Box 4802, Tempe, AZ 85287, USA.
Journal of Health and Social Behavior (Impact Factor: 2.72). 01/2007; 47(4):339-54. DOI: 10.1177/002214650604700403
Source: PubMed


This study investigates whether childhood health acts as a mechanism through which socioeconomic status is transferred across generations. The study uses data from the Panel Study of Income Dynamics to track siblings and to estimate fixed-effects models that account for unobserved heterogeneity at the family level. The results demonstrate that disadvantaged social background is associated with poor childhood health. Subsequently, poor health in childhood has significant, direct, and large adverse effects on educational attainment and wealth accumulation. In addition, childhood health appears to have indirect effects on occupational standing, earnings, and wealth via educational attainment and adult health status. The results further show that socioeconomic health gradients are best understood as being embedded within larger processes of social stratification.

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    • "For example , aspects of the physical work environment may mediate social causation effects [17] , while lack of support for young adults struggling with labour market entry or progression because of poor mental health may mediate health selection effects. Our results highlight the importance of taking a life-course perspective, recognising how social factors may accumulate and impact on life-chances as well as health, forming chains of risk [11, 31, 57,969798 , and acknowledging ado- lescence [95] and early adulthood as very important stages in this process and therefore also as critical periods for intervention. "
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    ABSTRACT: Background: Evidence is inconsistent as to whether or not there are health inequalities in adolescence according to socio-economic position (SEP) and whether or when they emerge in early adulthood. Despite the large health inequalities literature, few studies have simultaneously compared the relative importance of 'health selection' versus 'social causation' at this life-stage. This study followed a cohort through the youth-adult transition to: (1) determine whether, and if so, when, health inequalities became evident according to both class of origin and current SEP; (2) compare the importance of health selection and social causation mechanisms; and (3) investigate whether these phenomena vary by gender. Methods: Data are from a West-of-Scotland cohort, surveyed five times between age 15 (in 1987, N=1,515, response=85%) and 36. Self-reported physical and mental health were obtained at each survey. SEP was based on parental occupational class at 15, a combination of own education or occupational status at 18 and own occupational class (with an additional non-employment category) at older ages. In respect of when inequalities emerged, we used the relative index of inequality to examine associations between both parental and own current SEP and health at each age. In respect of mechanisms, path models, including SEP and health at each age, investigated both inter and intra-generational paths from SEP to health ('causation') and from health to SEP ('selection'). Analyses were conducted separately for physical and mental health, and stratified by gender. Results: Associations between both physical and mental health and parental SEP were non-significant at every age. Inequalities according to own SEP emerged for physical health at 24 and for mental health at 30. There was no evidence of selection based on physical health, but some evidence of associations between mental health in early adulthood and later SEP (intra-generational selection). Paths indicated intra-generational (males) and inter-generational (females) social causation of physical health inequalities, and intra-generational (males and females) and inter-generational (females) social causation of mental health inequalities. Conclusions: The results suggest complex and reciprocal relationships between SEP and health and highlight adolescence and early adulthood as a sensitive period for this process, impacting on future life-chances and health.
    Full-text · Article · Dec 2015 · BMC Public Health
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    • "Two competing hypotheses have been developed to explain marriage advantages in health. The first, marriage selection, posits that selection factors, such as greater socioeconomic status or better health, place individuals at higher risk of being married and of exhibiting health advantages (Goldman, 1993; Haas, 2006, 2008). Accounting for the endogeneity of marriage is therefore necessary to produce an unbiased estimate of the effect of marriage on health. "
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    ABSTRACT: Marriage is a social tie associated with health advantages for adults and their children, as lower rates of preterm birth and low birth weight are observed among married women. In this study the author tested 2 competing hypotheses explaining this marriage advantage—marriage protection versus marriage selection—using a sample of recent births to single, cohabiting, and married women from the National Survey of Family Growth, 2006–2010. Propensity score matching and fixed effects regression results demonstrated support for marriage selection, as a rich set of early life selection factors account for all of the cohabiting–married disparity and part of the single–married disparity. Subsequent analyses demonstrated that prenatal smoking mediates the adjusted single–married disparity in birth weight, lending some support for the marriage protection perspective. The study's findings sharpen our understanding of why and how marriage matters for child well-being and provide insight into pre-conception and prenatal factors describing intergenerational transmissions of inequality via birth weight.
    Full-text · Article · Oct 2015 · Journal of Marriage and Family
    • "Evidence suggests that childhood health and socioeconomic status (SES) have long-term effects that extend into adulthood (Brandt et al. 2012). Drawing on the social determinants of health perspective, a US study found that socioeconomic disparities in childhood are related to childhood health and education which, in turn, relate to occupational attainment and adult health, highlighting the interrelatedness of health and SES across the life course (Haas 2006). These findings are consistent with contemporary life course approaches that argue a person's developmental trajectory is influenced by both proximal and early life circumstances and resources (Pavalko and Caputo 2013). "

    No preview · Article · Aug 2015 · Journal of Population Ageing
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