Browsing by Author "Kamis, Christina"
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Item Open Access Childhood Adversities and Adult Mental Health: Conceptualizing and Measuring Heterogeneity in Adversity Experience(2022) Kamis, ChristinaThe life course perspective has long theorized that childhood is a sensitive period for mental, physical, and emotional development, meaning that negative experiences during childhood can have long-lasting impacts on health and wellbeing. Thus, adverse childhood experiences (ACEs), such as parental alcoholism, sexual abuse, and physical neglect, during this sensitive period of the life course may elicit poor mental health both in childhood and as children age into adulthood. Although research on the long term impact of childhood adversity is growing, this research has been somewhat limited in the measurement of childhood adversity, focusing on dichotomous measures (occurred/ did not occur) or the summation of such dichotomous measures. In doing so, this research fails to capture heterogeneity in adversity experience, such as the severity, duration, and context of childhood adversities as well as how specific types of adversities may co-occur, consequently underestimating the impact of negative experiences for those at greatest risk of poor mental health. In this dissertation, I explore how these sources of distinction pattern mental health trajectories, with consequences for mental health disparities across the life course. In broadening the definition of childhood adversity beyond the simple occurrence of negative events, this dissertation provides an analytic blueprint for future research assessing childhood adversity, contributing to stress, life course, and mental health studies. In Chapter 2, I focus on a single adverse experience, parental mental health problems in childhood, to showcase how differences in severity, duration, and context of an adversity correspond to different mental health patterns across adulthood. Using six waves of data from the Panel Study of Income Dynamics (PSID; 2007-2017) and applying growth curve methods I find that more severe and longer exposures to parental mental health problems in childhood correspond to even greater distress in adulthood. The gender of the parent afflicted does not predict differences in adult mental health, but those individuals exposed to both maternal and paternal poor mental health in childhood have the greatest distress in adulthood. Chapters 3 and 4 focus on two other sources of heterogeneity in childhood adversity experience: the number and type of childhood adverse events. These chapters employ latent class analysis (LCA) to capture latent subtypes who are similar in their responses to a set of indicators, essentially estimating adversity classes that capture both the number and type of adversities that co-occur. These classes are then used to predict mental health trajectories across the life course. Before assessing latent classes of childhood adversity, Chapter 3 sets the groundwork for the analytic strategy of predicting outcome trajectories by latent classes. To date, there are several methods for including a distal outcome in latent class models, with no clear analytic strategy for when the outcome of interest is a growth model. Therefore, in Chapter 3, I employ a simulation study assessing the performance of five different methods under 27 different data conditions. Results from this study suggest that a maximum-likelihood (ML) approach best captures the true parameter estimates while maintaining substantive clarity. Chapter 4 uses the identified method in Chapter 3 (ML approach) to assess how latent classes of childhood adversity relate to trajectories of mental health using four waves of data from the National Longitudinal Study of Adolescent to Adult Health (Add Health, Wave I-IV). Findings suggest that in addition to a class represented by low adversity experience, there are two classes with greater experiences of adversity. One adversity class, characterized by household dysfunction, has greater depressive symptoms than the low adversity class in early life, and this gap is maintained into mid-adulthood. The other adversity class, characterized by maltreatment, has both greater depressive symptoms than the low adversity class in early life and becomes increasingly more depressed than this group across the life course. Overall, this dissertation contributes both methodologically and substantively to the study of childhood adversity and life course mental health. Childhood adversity has the ability to shape one’s mental health outcomes for many years after childhood, but this relationship is conditional on the lived experiences of adversity. These findings underscore the importance of severity, duration, context, type, and number of adverse events for patterning which children are at greatest risk for mental health problems in adulthood. Future work should consider these elements in favor over an over-simplified measure that may obscure the life course impact of these negative experiences.
Item Open Access Empirical evidence on structural racism as a driver of racial inequities in COVID-19 mortality.(Frontiers in public health, 2022-01) Brown, Tyson H; Kamis, Christina; Homan, PatriciaObjective
This study contributes to the literature by empirically testing the extent to which place-based structural racism is a driver of state-level racial inequalities in COVID-19 mortality using theoretically-informed, innovative approaches.Methods
CDC data are used to measure cumulative COVID-19 death rates between January 2020 and August 2022. The outcome measure is a state-level Black-White (B/W) ratio of age-adjusted death rates. We use state-level 2019 administrative data on previously validated indicators of structural racism spanning educational, economic, political, criminal-legal and housing to identify a novel, multi-sectoral latent measure of structural racism (CFI = 0.982, TLI = 0.968, and RMSEA = 0.044). We map B/W inequalities in COVID-19 mortality as well as the latent measure of structural racism in order to understand their geographic distribution across U.S. states. Finally, we use regression analyses to estimate the extent to which structural racism contributes to Black-White inequalities in COVID-19 mortality, net of potential confounders.Results
Results reveal substantial state-level variation in the B/W ratio of COVID-19 death rates and structural racism. Notably, regression estimates indicate that the relationship between the structural racism and B/W inequality in COVID-19 mortality is positive and statistically significant (p < 0.001), both in the bivariate model (adjusted R2 = 0.37) and net of the covariates (adjusted R2 = 0.54). For example, whereas states with a structural racism value 2 standard deviation below the mean have a B/W ratio of approximately 1.12, states with a structural racism value 2 standard deviation above the mean have a ratio of just above 2.0.Discussion
Findings suggest that efficacious health equity solutions will require bold policies that dismantle structural racism across numerous societal domains.Item Open Access Immigration and health among non-Hispanic whites: The impact of arrival cohort and region of birth.(Social science & medicine (1982), 2020-02) Read, Jen'nan Ghazal; West, Jessica S; Kamis, ChristinaImmigration is central to our understanding of U.S. racial and ethnic health disparities, yet relatively little is known about the health of white immigrants - a group whose ethnic origins have become increasingly diverse. To the extent that whites are included in social stratification research, they are typically used as the reference category for gauging health inequities, with little attention to diversity among them. This study addresses this question using nationally representative data from the American Community Survey (2008-2017). We disaggregate non-Hispanic whites by nativity, region of birth, and period of arrival in the U.S. and examine differences in physical disability among adults aged 40 and older (n = 12, 075, 638). The analysis finds that foreign-born whites have a slightly lower prevalence of disability than U.S.-born whites, and this varies by arrival cohort. Immigrants who arrived in the 1981-1990 and 1991-2000 cohorts have a smaller advantage over U.S.-born whites than immigrants in the earlier and later cohorts. Compositional changes in the region of birth of white immigrants, especially the influx of eastern Europeans and Middle Easterners during the 1980s and 1990s, explained this variation. These findings challenge the oft-assumed notion that whites are a monolithic group and highlight growing intra-ethnic heterogeneity that is obscured by the aggregate category. Our findings also suggest that the standard practice of using whites as the reference for benchmarking health inequities may mask health inequities not only among them, but also between whites and other racial and ethnic populations.Item Open Access Overcrowding and COVID-19 mortality across U.S. counties: Are disparities growing over time?(SSM - population health, 2021-09) Kamis, Christina; Stolte, Allison; West, Jessica S; Fishman, Samuel H; Brown, Taylor; Brown, Tyson; Farmer, Heather RA growing line of research underscores that sociodemographic factors may contribute to disparities in the impact of COVID-19. Further, stages of disease theory suggests that disparities may grow as the pandemic unfolds and more advantaged areas are better able to apply growing knowledge and mitigation strategies. In this paper, we focus on the role of county-level household overcrowding on disparities in COVID-19 mortality in U.S. counties. We examine this relationship across three theoretically important periods of the pandemic from April-October 2020, that mark both separate stages of community knowledge and national mortality levels. We find evidence that the percentage of overcrowded households is a stronger predictor of COVID-19 mortality during later periods of the pandemic. Moreover, despite a relationship between overcrowding and poverty at the county-level, overcrowding plays an independent role in predicting COVID-19 mortality. Our findings underscore that areas disadvantaged by overcrowding may be more vulnerable to the effects of COVID-19 and that this vulnerability may lead to changing disparities over time.Item Open Access The Long-Term Impact of Childhood Disability on Mental Health Trajectories in Mid- to Late-Life.(Journal of aging and health, 2022-10) West, Jessica S; Kamis, ChristinaObjectives
We draw from the life course and stress process frameworks to examine how experiencing disability in early life influences mental health in adulthood.Methods
Data come from the Health and Retirement Study Cross-Wave Childhood Health and Family Aggregated Data file (2008-2018, n = 15,289). Childhood disability status is a retrospective self-report of whether respondents were disabled for six months or more because of a health problem before the age of 16 (n = 581). We used age-based growth curve models to construct trajectories of depressive symptoms by childhood disability status.Results
Respondents who experienced childhood disability exhibit more depressive symptoms at age 50 compared to those who did not experience this stressor. However, there is no difference in the growth of depressive symptoms with age between these groups, suggesting maintained inequality over the late adulthood life course.Discussion
Findings suggest that childhood disability has long-term implications for life course mental health.