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November 24, 2009
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Noreen Goldman's Research Health and WellbeingBy examining social gradients in health measures for Hispanics and whites in the U.S., Noreen Goldman and colleagues identified an unusual pattern among Hispanics-- relatively weak education differentials for a number of health outcomes and health behaviors. An extension of this research revealed that much of the mortality advantage of Hispanics stemmed from better than expected mortality among lower SES Hispanics. These studies led to the development of a collaborative project by Noreen Goldman, Anne Pebley (University of California-Los Angeles), and Rebeca Wong (University of Texas) to investigate the extent to which these SES gradients are unique to Hispanic groups and to identify the mechanisms that underlie these patterns. This project involves examining SES differentials in health in Mexico and the potential role of acculturation and assimilation in producing these atypical health gradients in the United States.
Several studies related to this project were recently completed or are underway. Goldman, Duncan Thomas (Duke University), Graciela Teruel (Ibero-American University, Mexico) and Luis Rubalcava (CIDE, Mexico) analyzed data from the 2002 and 2005 waves of the Mexican Family Life Survey (MxFLS) to examine whether there is any evidence to support the "healthy migrant hypothesis"--i.e., whether immigrants from Mexico to the U.S. during the inter-survey period are positively selected by education and health status. The results, published in the American Journal of Public Health, suggest very modest health-related selection.
Rachel Kimbro (Rice University), graduate student Sharon Bzostek, Goldman, and Germán Rodríguez examined education differentials in a broad range of health measures and across diverse racial and ethnic groups based on the NHIS. In a paper in Health Affairs, they demonstrate that education is a more powerful determinant of health for some groups than others, and that the education gradients in health for foreign-born groups are generally more modest than those for the corresponding native-born populations.
Noreen Goldman, Maxine Weinstein (Georgetown University), and Dana Glei (University of California- Berkeley) are continuing to collaborate with colleagues at the Bureau of Health Promotion, Department of Health in Taiwan, on the Social Environment and Biomarkers of Aging Study (SEBAS). This data collection effort, supported by the National Institute on Aging, was designed to provide insights into the role of physiological processes in the complex relationships among stressful experience, the social environment, and physical and mental health. The first wave of the survey, fielded in 2000, includes home-based interviews, collection of blood and urine samples, and physicians' health exams from about 1,000 middle-aged and elderly respondents. Respondents are a random sub-sample from an ongoing national survey that has collected periodic interviews between 1989 and 2003 in Taiwan. SEBAS II, which was fielded between August 2006 and January 2007, has obtained a second set of measurements for biomarkers collected in 2000 as well as several new physiological measures, including (1) inflammatory markers, such as C-reactive protein and fibrinogen; (2) health assessments in the home--blood pressure, grip strength, lung function, timed walks, and chair stands; and (3) additional questions in the household interview on pain, perceived stress, stressful and traumatic events, and sleep.
During the past year, Goldman, Weinstein and Glei have been preparing data from SEBAS II for public use. A summary paper of the Taiwan project to date was published in the National Academy of Sciences volume, Biosocial Surveys. In addition, numerous projects based on SEBAS I have been ongoing. For example, Glei, Goldman and Weinstein explored the extent to which chronic stressors predicted physiological dysregulation in the cardiovascular, immune, and neuroendocrine systems and the role of individual and environmental characteristics in mediating that relationship. In a paper in Psychosomatic Medicine, they concluded that, although the relationship between life challenges and physiological dysregulation was generally weak, the combination of low social position, weak social networks, and poor coping ability was associated with greater physiological consequences. In a recently published paper, Goldman and colleagues used survival data from Taiwan to demonstrate that an array of biomedical measurements that are not typically measured in clinical exams (measures of immune and neuroendocrine function) are at least as predictive as clinical measures (e.g., blood pressure, cholesterol, glucose levels) of the risks of dying in a three-year period. In an ongoing update of this analysis, they demonstrate that a set of disease progression markers and non-clinical measures each provide more discriminatory power in predicting six-year mortality than standard cardiovascular and metabolic risk factors. An analysis of sex differences in mortality suggests that the majority of excess male mortality results from the fact that Taiwanese men are more likely to smoke than women; several markers of disease progression and inflammation explain a modest amount of the sex difference in mortality.
Goldman and postdoctoral fellow Amy Collins examined whether findings from previous studies demonstrating that subjective measures of relative social position are significant predictors of health are biased. Their results, published in Social Science and Medicine, underscore that the associations are substantially attenuated when estimated from longitudinal data with controls for health status at baseline. Together with Germán Rodríguez, Collins and Goldman analyzed the relationship between measures of positive wellbeing and subsequent disability. Their findings demonstrate that life satisfaction and perceptions of future happiness are associated with the development of fewer mobility limitations during follow-up, but only for those participants who had no mobility limitations at baseline. The results suggest a protective relationship between psychological wellbeing and physical decline in later life.View All Research on Health and Wellbeing
Migration and DevelopmentNoreen Goldman has been examining whether relatively low mortality for Mexican immigrants to the U.S. (the "Hispanic paradox") and modest or nonexistent education differentials in health among Mexican Americans result from migration patterns. Analysis of survey data from Mexico reveals that, contrary to the "healthy migrant hypothesis," there is little evidence that Mexicans who migrate to the U.S. are substantially healthier than those who remain in Mexico. In addition, although higher socioeconomic status is associated with better health for most populations, the magnitude and direction of the association between education and two health-related measures (smoking and obesity) in Mexico vary by gender and place of residence and appear to be related to the stage of economic development. These patterns are likely to be one factor contributing to the relatively modest social disparities in health that we identified among Mexican immigrants.View All Research on Migration and Development
Source: OPR Annual Reports.
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