The effects of household and neighborhood poverty on the individual's risks of mortality.

This dissertation aims to test hypotheses relating household and neighborhood poverty to an individual's risk of mortality, building on past research that has inversely associated an individual's socioeconomic status with her or his chances of dying. The underlying conceptual framework concentrates on social settings in which individuals live and broadly hypothesizes that poverty within the household and neighborhood raises the risks of mortality. Empirical tests of this framework involve modeling the mortality risky among adults in the U.S., based on data from the Panel Study of Income Dynamics over the 1972 to 1992 time period. Discrete-time, event-history analysis techniques are used to obtain estimates of the relationship between household and neighborhood poverty and the individual's risk of mortality. The key findings are as follows. Individuals who live in poor households have significantly higher odds of dying than individuals from households that are above twice the poverty threshold. Household poverty significantly reduces the survival advantage that married persons from more affluent households enjoy. Race does not significantly differentiate the odds of dying, after controlling for income-to-needs. Efforts to lessen mortality disparities across individuals need to incorporate and consider the role of poverty at the household level, especially in contradistinction to a person's level of education or employment status. The first poverty spell and first years in a poverty spell emerge as the most harmful influence on mortality, while subsequent spells and years in poverty are associated with declining risks of mortality. Interventions promoting better health outcomes should identify the qualities of poor households that enable certain individuals to survive the most pernicious effects of poverty spells. Among poor households, high neighborhood poverty raises the risks of mortality. These risks decline in mixed-income neighborhoods and then rise in affluent ones. In the poorest neighborhoods, basic goods and services may not be available. In affluent neighborhoods, individuals from poor households may not have access to the goods and services they need, due to both material and social barriers. In any case, efforts to improve an individual's risk of mortality require an approach tailored to the influence of the larger social environment.Ph.D.DemographyPublic policySocial SciencesUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/131062/2/9825314.pd