Current Projects

Geographical Variation in the Long-Arm of Childhood

A growing sociological literature examines health disparities across geographical contexts  to understand structural determinants of health and health disparities.  Studies of educational disparities across states by Jennifer Karas Montez and colleagues have found significant variation in the size of disparities for both mortality and morbidity. These studies of geographical disparities have so far only examined predictors and outcomes in adulthood, though a large literature on the early origins of disease finds evidence for the importance of the relationship between childhood socioeconomic status (SES) and adult health.

Understand these differences across states is the first step toward more closely examining the childhood contexts that increase or decrease adult health disparities. Using several years of data from the Panel Study of Income Dynamics, I compare the likelihood of reporting poor health across states for adults based on their childhood SES (operationalized as parental educational attainment). I also analyze possible potential factors in this relationship including state level measures of welfare state generosity and income inequality.

The Long-Term Health Effects of Welfare Reform

Coauthors: Kelli Komro and Melvin Livingston, III

Research on childhood poverty’s effects on health across the life course traditionally focuses on the effect of individual-level measures of childhood socioeconomic status on adult health. While there is some movement to consider early-life contextual factors on life course health, analyses of structural impacts are rare. Interventions on the structural level can have a stronger and larger impact compared to individualized interventions, especially when the success of the intervention depends heavily on contextual factors. This study builds on the life course and health literature, but applies a policy framework as an approach to understand structural impacts on health across the life course. ​

Specifically, we investigate the effect of childhood exposure to welfare reform on adult health. We examine welfare reform as the policy exposure because it represents different types of welfare programming that vary in generosity and administrative burdens. We use data from several years of the Panel Study on Income Dynamics and a quasi-experimental design to investigate the study's two research questions: 1) what are the long-term effects on adult self-rated health and psychological distress from childhood exposure to welfare reform? And 2) do these effects differ by race/ethnicity?

TANF and Infant and Maternal Mortality

Coauthors: Susan Mumford, Kelli Komro and Melvin Livingston, III

The United States has higher infant and maternal mortality rates compared to peer countries, and both rates have recently increased, presenting an urgent public health crisis. Upstream risk factors for infant and maternal mortality include poverty, access to health care, unstable housing, and structural racism. Financial stress is particularly common among pregnant people with 60% of pregnant people reporting that they experienced healthcare unaffordability during pregnancy or immediately after, and 54% reporting general financial stress during or immediately after pregnancy. Safety-net programs are one potential solution for high infant and maternal mortality rates because of their ability to decrease financial stress and increase access to resources before, during, and after pregnancy. Temporary Assistance for Needy Families (TANF) provides cash assistance to low-income individuals and families in the US, however, states vary in whether they offer the benefits to pregnant individuals. This study uses a difference-in-difference study design to assess the impact of TANF's pregnancy-eligibility requirements on infant and maternal mortality rates.