Contemporary topics in American adult health and mortality: obesity and immigration
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Two contemporary topics in American health and mortality are investigated: obesity and immigration. In the first essay, I investigate mortality attributable to obesity among U.S. middle-aged adults in the Health and Retirement Study. I find that obesity is a small source of attributable mortality challenging the viewpoint that obesity will stem long-term declines in U.S. mortality. In the second essay, I address another controversial issue pertaining to obesity and mortality, namely that of period trends. Across three major U.S. data (NHANES, Framingham, and NHIS), I find systematic evidence that the effect of obesity on mortality declined during 1968-2003. This decline is entirely attributed to a declining effect of obesity on cardiovascular-specific mortality. Therefore, prior studies, which either combine periods or rely on older data, do not provide a contemporary view of the mortality effects of obesity. In the third essay, I investigate the contextual determinants of obesity. In a multilevel framework, I estimate the association between the restaurant environment and BMI. While previous literature focuses on fast food, I investigate fast food and full service restaurants as well as individual- and contextual-level socioeconomic correlates. I find that a higher density of fast food is associated with higher BMI. In contrast, a higher density of full service restaurants is associated with lower BMI, suggesting a need for research into the comparative healthfulness of foods served at different types of restaurants. In the fourth essay, I investigate migrant selection and health among U.S. immigrants from the former Soviet Union (FSU), an understudied group. Unlike other U.S. immigrants, I uncover that FSU immigrants report higher levels of physical limitations compared to U.S.-born whites (ages 50-84). I use changes in immigration policy as a "natural experiment" to investigate the health effects of migrant selection. Results indicate that FSU immigrants who arrived under stricter migration policies, and therefore were more highly selected, display lower levels of physical limitations compared to those who migrated under policies that were more lenient. I compare Russian-born U.S. immigrants to that of nonimmigrants in Russia. Results indicate a positive health selection for Russian-born U.S. immigrants from their originating population.
THES
Mehta, Neil K.
Elo, Irma T.
2009
3381756
231-n/a
University of Pennsylvania
Ann Arbor
9781109430011
2490
