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Download - Code Red: The Critical Condition of Health in Texas

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Education also improves the stability of full-time employment by decreasing the probability of ever havingbeen unemployed.Health improves steadily with participation in the labor force. Persons in full-time employment havethe best health and those unable to work have the worst health (Mirowsky & Ross, 2003). Mirowsky andRoss (2003) point to three possible mechanisms that can account for differences in health acrossemployment statuses. Traits that influence employment, such as age, gender and marital status, canaffect both health and employment. However, health differences by employment remain after controllingfor these factors, indicating that some other mechanism is at work. The two remaining mechanisms arecausation and selection. Employment may cause better health because employed individuals have aneconomic advantage as well as healthier behaviors. Selection implies that good health increases thelikelihood of full-time employment while bad health causes people to not be in the labor force becauseemployers tend not to hire individuals in poor health. Mirowsky and Ross (2003) report that bothprocesses are present, but that the link between employment and health mainly operates through a causalmechanism. They find evidence that employment and health are in symbiotic relationship: “Just as fulltimeemployment helps individuals to stay or become healthy, health helps them stay or becomeemployed full-time” (Mirowsky & Ross, 2003, p. 112). Selection seems to be a minor mechanism in therelationship between employment and health and to be declining over time.Workers, particularly men, with lower levels of education tend to be in occupations where exposureto physical, chemical or biological hazards and noxious environments is more common. Better educatedworkers are less likely to be in harsh or dangerous occupations (Mirowsky & Ross, 2003). However, dueto the remarkable safety of most of today’s workplaces, occupation has little effect on overall health anddoes not explain the differences in health by education (Mirowsky & Ross, 2003). Jobs that allow workersto use creativity, to have control over what they do and how to do it, and that involve autonomy andcreativity favor health (Mirowsky & Ross, 2003). The classic Whitehall study of British civil service providesevidence that there is a gradient in health and mortality across job classification (Marmot M. G. et al.,1991). Marmot emphasizes that better health is associated with greater control over working conditionsand job demands. More autonomous and creative jobs are usually at the top of workplace hierarchy, arewell paid, and tend to go to better-educated individuals.Social Resources. Better-educated people are more likely to be married and tend to have more stableand supportive relationships (Mirowsky & Ross, 2003). Social support, and in particular marriage, areprotectors of health. Married people have better health than those who are not married, probably becausethey face less economic hardship, have more social support, especially emotional support, and lead amore orderly and regulated life. General social support improves psychological well-being that isassociated with better physical health. Married people also tend to have more contact with the health caresystem resulting in earlier detection and treatment of disease. The effect of marriage on health behaviorsis mixed. Married people are less likely to smoke or to drink heavily, and are less prone to injuries andrisky sexual behavior. However, they are less likely to exercise and more likely to be overweight (Mirowsky& Ross, 2003).Biological Risk. A possible explanation for educational inequality in health is differential exposure tochronic and acute stress. We have discussed above how persons with less education are more likely to beexposed to various types of stressors: physical, economic and social. Recent literature has attempted toelucidate the biological pathways that mediate educational-related exposures to stressors and increasedmorbidity and mortality (Marmot M. G. et al., 1995; Seeman T. E. & Crimmins, 2001; Seeman T. E. et al.,2004). Many studies have reported higher traditional risk factors for coronary heart disease, such aselevated blood pressure, cholesterol, weight, glucose, and fibrinogen, among lower SES individuals(Seeman T. E. et al., 2004, p. 1986). Recently, the concept of allostatic load has been used in explainingeducational related differential in health. Allostatic load is defined by Seeman et al (Seeman T. E. et al.,2004, p. 1986) as reflecting “the cumulative total of physiological deregulations across multiple physiologicregulatory systems, a total that is postulated to impact significantly on health and longevity” (Seeman T. E.et al., 2004). The burden of such physiological wear and tear results, partially, from life experiences andE-33

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