Examining the Association between Racialized Economic Threat and White Suicide in the United States, 2000–2016

Suicide is steadily rising. Many blamed worsening economic conditions for this trend. Sociological theory established clear pathways between joblessness and suicide focused on status threat, shame, and consequent disruption of social relationships. However, recent empirical research provides little support for a link between unemployment and suicide. I attempt to reconcile this contradiction by focusing on white suicide and white employment-to-population ratio. Whiteness is not just a default category but a pervasive ideology that amplifies the effects of status loss. The white employment-to-population ratio represents a form of racialized economic threat and accounts for discouraged workers who have exited the labor force. I use longitudinal hybrid models with U.S. state-level data, 2000 to 2016, and find that decreasing employment is associated with increasing suicide among the white population and white men. I discuss this study’s contributions to the literature on suicide and joblessness and the emerging scholarship on whiteness and health.

Sandwiched Grandparents and Biological Health Risks in China

This study examined the cross-sectional associations between intergenerational caregiving and health risks among sandwiched Chinese grandparents who provide care to grandchildren, great-grandparents, or both. Drawing on biomarker data from the 2011 wave of the China Health and Retirement Longitudinal Study (N range = 2,189–3,035), we measured age-related biological health risks of hypertension, diabetes, inflammation, and allostatic load. We found that health risks did not necessarily increase with the intensity of intergenerational caregiving. Providing care to grandchildren and great-grandparents simultaneously was not as detrimental to health as reported in earlier studies from the United States. Sandwiched grandparents could benefit from providing care to grandchildren or great-grandparents only. These unexpected findings might be related to the cultural mandates of filial piety and family solidarity in China. Grandfathers and grandmothers experienced different associations between varying types of intergenerational caregiving and health risks.

Dualized Labor Market and Polarized Health: A Longitudinal Perspective on the Association between Precarious Employment and Mental and Physical Health in Germany

This study analyzes the longitudinal association between precarious employment and physical and mental health in a dualized labor market by disaggregating between-employee and within-employee effects and considering mobility in precariousness of employment. Analyses were based on the German Socio-Economic Panel from 2002 to 2018 considering all employees ages 18 to 67 years (n = 38,551). Precariousness of employment was measured as an additive index considering working poverty, nonstandard working time arrangements, perceived job insecurity, and low social rights. Health outcomes were mental and physical health. Random effects models were used and controlled for sociodemographic and socioeconomic variables. Results indicated that the association between precariousness of employment and mental and physical health is mainly based on between-employee differences and that prolonged precariousness of employment or upward or downward mobility are associated with poor health. We found evidence of polarization in health by precariousness of employment within a dualized labor market.

Surveillance, Self-Governance, and Mortality: The Impact of Prescription Drug Monitoring Programs on U.S. Overdose Mortality, 2000–2016

Policy mechanisms shaping population health take numerous forms, from behavioral prohibitions to mandates for action to surveillance. Rising drug overdoses undermined the state’s ability to promote population-level health. Using the case of prescription drug monitoring programs (PDMPs), we contend that PDMP implementation highlights state biopower operating via mechanisms of surveillance, whereby prescribers, pharmacists, and patients perceive agency despite choices being constrained. We consider whether such surveillance mechanisms are sufficient or if prescriber/dispenser access or requirements for use are necessary for population health impact. We test whether PDMPs reduced overdose mortality while considering that surveillance may require time to reach effectiveness. PDMPs reduced opioid overdose mortality 2 years postimplementation and sustained effects, with similar effects for prescription opioids, benzodiazepines, and psychostimulants. Access or mandates for action do not reduce mortality beyond surveillance. Overall, PDMP effects on overdose mortality are likely due to self-regulation under surveillance rather than mandated action.

Structural Racism and Quantitative Causal Inference: A Life Course Mediation Framework for Decomposing Racial Health Disparities

Quantitative studies of racial health disparities often use static measures of self-reported race and conventional regression estimators, which critics argue is inconsistent with social-constructivist theories of race, racialization, and racism. We demonstrate an alternative counterfactual approach to explain how multiple racialized systems dynamically shape health over time, examining racial inequities in cardiometabolic risk in the National Longitudinal Study of Adolescent to Adult Health. This framework accounts for the dynamics of time-varying confounding and mediation that is required in operationalizing a “race” variable as part of a social process ( racism) rather than a separable, individual characteristic. We decompose the observed disparity into three types of effects: a controlled direct effect (“unobserved racism”), proportions attributable to interaction (“racial discrimination”), and pure indirect effects (“emergent discrimination”). We discuss the limitations of counterfactual approaches while highlighting how they can be combined with critical theories to quantify how interlocking systems produce racial health inequities.

Crossover Effects of Education on Health within Married Couples

Although empirical work has shown that personal and spousal education are both related to health, the nature of these associations has been harder to establish. People select into marriages on the basis of observed and hard-to-observe characteristics, complicating the job of the researcher who wishes to make causal inferences. In this article, we implement a within-sibling-pair design that exploits variation within pairs in spousal education to generate estimates of spousal crossover effects. Results—based on a long-term study of siblings and their spouses—suggest that spousal education is positively related to health, but to a greater degree for women than men. Sensitivity analyses show that these patterns are unlikely to derive from measured differences between individuals or unmeasured characteristics that sort them into unions. These results are consistent with network-based theories of social capital, which view education as a resource that can be mobilized by network ties to enhance health.

The Nexus of Physical and Psychological Pain: Consequences for Mortality and Implications for Medical Sociology

Although physical pain lies at the intersection of biology and social conditions, a sociology of pain is still in its infancy. We seek to show how physical and psychological pain are jointly parts of a common expression of despair, particularly in relation to mortality. Using the 2002–2014 National Health Interview Survey Linked Mortality Files (N = 228,098), we explore sociodemographic differences in the intersection of physical and psychological pain (referred to as the “pain–distress nexus”) and its relationship to mortality among adults ages 25 to 64. Results from regression and event history models reveal that differences are large for the combination of the two, pointing to an overlooked aspect of health disparities. The combination of both high distress and high pain is most prevalent and most strongly predictive of mortality among socioeconomically disadvantaged, non-Hispanic whites. These patterns have several implications that medical sociology is well positioned to address.

Parental Death and Mid-adulthood Depressive Symptoms: The Importance of Life Course Stage and Parent’s Gender

Traditional theories of grief suggest that individuals experience short-term increases in depressive symptoms following the death of a parent. However, growing evidence indicates that effects of parental bereavement may persist. Situating the short- and long-term effects of parental death within the life course perspective, we assess the combined influence of time since loss and life course stage at bereavement on mental health for maternal and paternal death. Using data from the National Longitudinal Study of Adolescent to Adult Health (N = 11,877) to examine biological parental death from childhood to mid-adulthood, we find that those who experience recent maternal or paternal death have heightened depressive symptoms. Furthermore, those who experience maternal death in childhood or paternal death in young adulthood exhibit long-term consequences for mental health. Our findings underscore the theoretical importance of early life course stages and parent’s gender when determining whether depressive symptoms persist following parental bereavement.