In the most recent installment of Innovate’s series highlighting research publications from faculty members at the Boston College School of Social Work, we highlight a paper from Assistant Professor Erika Sabbath that examines the relationships between American women’s exposure to midlife work, and how this affects subsequent mortality risk. The paper was first published in the American Journal of Public Health.
The Issue: Over the past half-century, women’s roles in society have changed greatly. More and more women work, delay their first marriage, and have children when they’re older. The work family trajectory looks very different than it did 50 years ago – is it possible that this reality might affect mortality risk?
The Idea: Sabbath and colleagues were curious about how various combinations of work, marriage, and childrearing affected a women’s risk of death between the ages of 55 and 75, in particular (premature death is defined as taking place before the age of 75). In order to get at this broad question, they used a massive resource – the U.S. Heath and Retirement Study, a longitudinal study that surveys a representative sample of approximately 20,000 Americans over the age of 50 every two years.
The team concentrated on women born between 1935 and 1956, mining the study for data that could be used to calculate employment, marital, and parenthood statuses for each age between 16 and 50.
“The number of possible life paths was theoretically enormous…” Sabbath tells the blog AJPH Talks. “While this diversity is fascinating, summarizing that diversity into a variable that is scientifically meaningful required a complex approach.”
The complex approach Sabbath decided to employ was one taken from the field of genetics, called sequence analysis, which allowed the team to compare “work family sequences” for all 7,536 women in the study, to determine clusters of similar trajectories. They found seven prototypical sequences into which each woman’s general experience could be categorized, and then analyzed which clusters were, on the whole, more likely to die between the ages of 55 and 75.
The Findings: “In general, we found that the healthiest women in our sample were those who simultaneously combined the roles of spouse, parent, and worker for a sustained period of time,” says Sabbath. Second healthiest – those who performed two roles. The least healthy – women who performed only one of the three roles.
The Next Steps: “One thing that we weren’t able to do was to assess how people perceived their work-family situations, or for working women, have them assess certain characteristics of their jobs,” says Sabbath. “Our next step is to see whether, among people who on the surface appear to have the same work-family profile, mortality rates differ by things like stressfulness of work. Answering that question will reveal whether, [as a complement to other larger shifts in policies], changing the work environment could help narrow gaps in health among working women with families. We’re also doing some comparative studies of work-family sequences and long-term health in the U.S. and Europe, to see whether women in countries with stronger social protection policies experience fewer health impacts of difficult work-family situations.”
The Takeaway: The most important takeaway from this project surrounds its methodology; the research team hopes that their approach to big data epidemiology, namely sequence analysis, is recognized as a “promising exposure assessment tool for life course research.”
Ever the social work professor, Sabbath also foresees potential for her findings to mold social policy for the better, in a country that has few existing policies in place that protect the health of working families.
“In general, our findings suggest that social protection policies (for example, childcare subsidies or paid maternity leave) that enable women to more easily combine work and family may yield long-term health dividends.“
Some of Sabbath’s co-authors have already begun to address social protection policies in Europe, publishing on the long-term health impact of maternity leave. Learn more.