Abstract:

While death may be one of life's two certainties, it does not visit the world's citizens equally. Across as well as within countries, poor people on average die earlier than their wealthier counterparts. Understanding the mechanisms responsible for these links between income and health is crucial for policy-makers interested in reducing health inequalities. This dissertation tests three pathways through which socioeconomic status and health outcomes might be linked.

Chapter 1 examines the role of maternal health status and health behaviors during pregnancy and early childhood in explaining the relationship between family income and children's health in the United States. Using data from the 1988 National Maternal and Infant Health Survey and 1991 Follow-Up, I find that maternal health behaviors do not explain the relationship between family income and maternal assessed health of the child on a 1-5 scale, but they do explain the relationship between family income and the prevalence of asthma, one of the most common childhood illnesses in developed countries.

Chapter 2 tests the hypothesis that the body's physiological response to stress mediates the relationship between socioeconomic status and health outcomes. Using unique biological data from the Social Environment and Biomarkers Aging Study (SEBAS) from Taiwan, this paper tests the relationship between education, income, and biological markers of stress including allostatic load, a measure of the cumulative effect of stress on multiple systems. The results provide only weak evidence in support of the stress hypothesis. Education and income are inconsistently related to the biological markers of stress in this sample, with some relationships in the healthy and some in the unhealthy direction. Most notably, neither education nor income is related to 12-hour urinary cortisol levels in either men or women.

Chapter 3 examines the role of so-called "reverse causality" in explaining the relationship between income and health. Using longitudinal data from the Health and Living Status Survey of the Elderly and Near-Elderly in Taiwan, I find declines in mobility and declines in self-reported health to be significant predictors of income and economic difficulty in the follow-up period, controlling for economic and health status at baseline.