Research

Interests

Social epidemiology, health policy, population aging, work/retirement, and mental health

Why aren't Americans living longer?

A long history of life expectancy improvements in the United States stalled over the past decade, with many scholars pointing to the rise in drug-relate deaths as the culprit. A team of colleagues and I demonstrated that stagnating declines in cardiovascular disease mortality made a larger contribution to stalls in life expectancy than drug overdose deaths (PNAS 2020). To understand who has been most impacted by stagnating cardiovascular disease declines, I have examined trends by urbanicity and calculated the impact of cardiovascular disease mortality stagnation on the urban-rural life expectancy gap (IJE 2021). I have also looked at variation in cardiovascular disease mortality trends at the state and county level (AJE 2024). Our finding on the importance of cardiovascular disease motivated a report showing that adverse mortality trends in retirement ages have made a larger contribution to US life expectancy stalls than the well-known increase in mortality in midlife (PNAS 2023). This paper sparked a lively series of letters in Proceedings of the National Academy of Sciences regarding how counterfactual analyses are used to understand mortality trends.

In ongoing research, my collaborators and I are working to determine why middle-aged and older adults in the United States are not experiencing the declines in cardiovascular disease that were enjoyed by prior generations.

Can Americans work longer?

As the US population ages, there is increasing financial strain on the Social Security program. Longer working lives may help - but is this a realistic solution for older Americans given trends and inequalities in morbidity, mortality, and job demands?

My dissertation showed the prevalence of unmet expectations about retirement timing around the 2008 Great Recession, revealing high rates of unexpectedly not working at age 62 among Black and Hispanic Americans and those with low educational attainment (Ageing & Society 2020). In a follow-up study, I showed that unexpectedly not working at age 62 was significantly associated with depressive symptoms, whereas working longer than expected was not (JGSS 2021). During my two-year Sloan Postdoctoral Fellowship, I explored how poor health and strenuous working conditions present challenges for working longer. One study examined the scheduling conditions of older service workers as they relate to worker well-being and job retention (Gerontologist 2022). I also considered the degree to which functional abilities explain negative associations between chronic conditions and employment (SSM 2023). In a third study, I decomposed the contribution of working conditions and health to educational disparities in work disability (JGSS 2023).

I have also studied how the COVID-19 pandemic related to work disruptions and mental health consequences among retirement-age Americans (JGSS 2021), experiences of employment discrimination among Black older Americans (JAH 2024) and the implications of new technology in the workplace for low-wage older workers (In Press).

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