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Socioeconomic status (SES) and health research often ignores heterogeneity related to individual social mobility. While trends in social mobility are well-documented, the health consequences of social mobility, including causal mechanisms and confounders, remain poorly understood. To address this gap in the literature, this dissertation examines SES and social mobility status variation in three interrelated set of health outcomes after accounting for multiple sources of confounding bias including adolescent health status, cognitive skills, height, personality, and physical attractiveness using longitudinal data from the Add Health study (n=13,937). In chapter 2, I consider how SES and mobility affect stress exposures, social resources, and personal resources. I examine variation in four measure of stress exposures (including stressful life events and economic hardship), eight measures of social resources (including perceived social isolation and number of friends), and four measures of personal resources (including sense of mastery and optimism). I use diagonal reference models to explore variation in these stress process outcomes across immobile persons and to compare socially mobile persons to the immobile in their origins and their destinations. I find that higher SES immobile persons report more favorable stress process profiles than lower SES immobile persons. I also find that socially mobile persons stress process outcomes often, but do not always, resemble the immobile in their new destination SES position. In chapter 3, I examine how SES and mobility affect risky health behaviors. I examine variation in 8 measures of health behaviors including fast food and sugary beverage consumption, preventive physical and dental healthcare use, physical activity, and tobacco, alcohol, and marijuana use. Diagonal reference models are used to explore differences in these measures of risky health behaviors across immobile persons and to compare socially mobile persons to their immobile counterparts. I find that higher SES immobile persons report fewer risky health behavior than lower SES persons and that the health behaviors of socially mobile persons are more often similar to the immobile in their new higher SES positions. In chapter 4, I explore how SES and mobility affect multidimensional health status. I explore variation in depressive symptoms, self-rated health, cardiovascular disease risk, and metabolic syndrome. I use diagonal reference models to compare health status across SES immobile persons and to compare the socially mobile to the immobile in their origins and their destinations. I find that higher SES immobile persons report more favorable health status than their immobile counterparts and that socially mobile persons health status is either similar or intermediate that of their immobile counterparts. Taken together, these findings indicate the importance of considering origin and social mobility status when examining SES differences in health. Furthermore, this work highlights the importance of mobility effects research that utilizes a causal framework to explore the health consequences of SES immobility/mobility. By accounting for endogeneity in the SES-health relationship related to adolescent health status, height, personality, physical attractiveness, and cognitive skills, researchers can help identify intervenable mechanisms linking SES to health to inform public policy and improve health equity. |
