Research
Interests
Social epidemiology, health policy, population aging, work/retirement, and mental health
Mental health in mid and late life
Depression is a key marker of poor well-being in old age and is a risk factor for health outcomes like cognitive decline, cardiovascular disease, and disability. The first paper of my dissertation characterized changes in depressive symptoms over ages 51-90 by gender, race/ethnicity, education, and birth cohort to highlight social inequalities and time trends in depressive symptoms in the U.S. (paper here). Working with a team of colleagues, I have also studied racial/ethnic disparities in depression and anxiety in late life, focusing on the important role of stress appraisal (paper here). Because depressive symptoms often co-occur with physical health conditions in adulthood, I examined the role of depression on recovering from acute hospitalizations by comparing hospital readmission rates, falls, and mortality among depressed and non-depressed Medicare beneficiaries in a range of post-acute care settings (paper here). Together, these projects highlight ways that social and health policies might reduce the prevalence, inequities, and consequences of late-life depression.
Health equity and retirement timing
Retirement is a key life transition that is anticipated for decades, and its timing is important to individuals, families, employers, and government programs. I recently published a paper showing 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 (paper here). In a follow-up study, I found that unexpectedly not working at age 62 was significantly associated with depressive symptoms, whereas working longer than expected was not (paper here). During my two-year Sloan Fellowship, I explored how poor health and strenuous working conditions present challenges for disadvantaged populations to work into old age. In one project, I examined the scheduling conditions of older service workers as they relate to worker well-being and job retention (paper here). In another, I decomposed the contribution of working conditions to educational disparities in work disability (paper here). I also incorporated research questions regarding how the COVID-19 pandemic relates to employment status among retirement-age Americans and the mental health consequences of unexpected work disruptions (paper here).
Trends in life expectancy and chronic disease mortality
A long history of life expectancy improvements in the U.S. 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 have demonstrated that stagnating declines in cardiovascular disease mortality made a larger contribution to stalls in life expectancy than drug overdose deaths (paper here). To understand who is 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 (paper here). Our finding on the importance of cardiovascular disease motivated a recent 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 (paper here).