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Do U.S. states' socioeconomic and policy contexts shape adult disability?

ABSTRACT: 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 million adults aged 25-94 years in the 2010-2014 waves of the American Community Survey. Disability is defined as difficulty with mobility, independent living, self-care, vision, hearing, or cognition. We first provide estimates of age-standardized and age-specific disability prevalence by state. We then estimate multilevel models to assess how states' socioeconomic and policy contexts shape the probability of having a disability. Age-standardized disability prevalence differs markedly by state, from 12.9% in North Dakota and Minnesota to 23.5% in West Virginia. Disability was lower in states with stronger economic output, more income equality, longer histories of tax credits for low-income workers, and higher cigarette taxes (for middle-age women), net of individuals' socio-demographic characteristics. States' socioeconomic and policy contexts appear particularly important for older adults. Findings underscore the importance of socio-ecological influences on disability.

SUBMITTER: Montez JK

PROVIDER: S-EPMC5388855 | biostudies-literature | 2017 Apr

REPOSITORIES: biostudies-literature

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Do U.S. states' socioeconomic and policy contexts shape adult disability?

Montez Jennifer Karas JK Hayward Mark D MD Wolf Douglas A DA

Social science & medicine (1982) 20170213

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 million adults aged 25-94 years in the 2010-2014 waves of the American Community Survey. Disability is defined as difficulty with mobility, independent ...[more]

PMID: 28219027

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Project description:The large inflow of asylum-seekers in recent years has heralded a diversification in adopted asylum policies across European societies. Although a growing body of research has addressed these versatile approaches and their implications for the European integration project, insight into the social basis of these restrictive or open asylum policies remains underdeveloped. Hence, the current study provides detailed insight into public preferences for asylum policies and offers a new understanding of how these attitudes are affected by diverging socio-economic realities across Europe. In addition, this paper considers the role of individual factors that coincide with publicly adopted frames in contemporary asylum debates. In particular, to explain how contextual differences reflect on opinion climates, the impacts of the policy, economic, and migratory context are studied. On the individual-level, we focus on threat perception and human values, which represent humanitarian, economic, and cultural frames. To explore these relations, data on 20 countries from the European Social Survey Round 8 (2016) are analyzed through a multilevel structural equation modeling approach. Results indicate that, on the contextual-level, only unemployment rates have a significant impact and, rather surprisingly, lower unemployment rates provoke a more negative opinion climate. Yet, this relationship seems to be largely driven by some specific countries that are characterized by large unemployment rates and relatively positive opinion climates simultaneously. The migratory and policy context, on the other hand, do not influence attitudes toward asylum policy. This indicates that it is not necessarily the countries facing the largest inflow of asylum-seekers or issuing the most positive decisions on asylum applications that have the most restrictive opinion climates. As shown by the important roles of human values and threat perceptions, which represent widely adopted frames, public discourses seem much more important in explaining attitudes toward asylum policy across Europe.

Dataset Information

Do U.S. states' socioeconomic and policy contexts shape adult disability?

Publications

Do U.S. states' socioeconomic and policy contexts shape adult disability?

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