Whereas my dissertation work focuses on a single health behavior and socioeconomic status broadly conceptualized, in my ongoing collaboration with the Michigan Recession and Recovery Study (MRRS) research team, I have been examining the various specific facets of socioeconomic status and how they may be associated with health and health behaviors. MRRS is a longitudinal survey of Detroit-area residents that includes a wealth of data about both financial status of respondents and their health.

Health and Debt

Along with Sarah Burgard, I’ve used MRRS to study the relationship between debt and foregone medical care and foregone medications. We find that the respondents who have high credit card debts and/or high medical debts were most at risk of both of these outcomes. Our results emphasize the salience of income and asset measures as relative constructs, to be contrasted to the money owed. We argue that debt takes on varied meanings for health, which are conditional on both the presence of additional resources, but also on the socioeconomic status one expects to attain through for example a mortgage or a student loan.

We further build on our work on foregone care and debt in a new paper, with Sarah Burgard and Kristin Seefeldt, where we highlight the implications of not having any debt or only having what we refer to as “fringe” debt, in a country where 72% of all residents hold some time of formal debt. In this new work, we track the pathways of our respondents from fringe to formal debt and the opposite, and connect them to fluctuations in their health behaviors. We find that the most disadvantaged group are those in the middle, who straddle their way between formal and fringe debts, and most advantaged those with some form of traditional debt.

Health and Employment Trajectories

In another ongoing MRRS project with Sarah Burgard, we investigate fluctuations in individuals’ employment experiences over the course of the Great Recession and during the period of economic recovery, and how these relate to changes in health. We use monthly labor force participation calendar data to construct labor force trajectories that span the months between January 2007 and April 2013. Through sequence analysis, we characterize meaningful trajectory groups, and examine associations between these trajectory groups and depression and self-rated health. We find a great deal of heterogeneity in employment paths that individuals take, sometimes involving multiple transitions and varying degrees of labor force attachment over short periods. Results show that those who were long-term unemployed or out of the labor force had worse self-rated health at follow-up, and those who were unstably employed were more likely to be classified as depressed at follow-up, even accounting for prior health.