Marital dissolution is a stressful transition that can lead to unhealthy coping strategies, including smoking and drinking. Using fixed effect linear probability models to assess health behavior changes, we analyzed 6,607 women and 6,689 men in the Household, Income, and Labour Dynamics in Australia data set who were either continuously married or experienced marital separation between 2002 and 2020. We observed 1,376 separations (744 women, 632 men). We found that drinking and smoking increases leading to and in the year of separation, with variability by gender, education, and parenthood status. From Cox proportional hazards models, we showed that among individuals who smoked (N = 337) or drank (N = 756) in the year of separation, cessation was most likely for the highly educated and/or women. Unhealthy coping mechanisms throughout marital dissolution suggests a need for targeted support to those separating, especially for men and those with children and lower education.
Cannabis can provide patients benefits for pain and symptom management, improve their functionality, and enhance their well-being. Yet restrictive medical cannabis programs can limit these potential benefits. This article draws on four years of research into Minnesota's medical cannabis program-one of the most restrictive in the United States-including in-depth interviews with patients and a survey of health care professionals. Drawing on the new materialist concepts of Deleuze and Guattari, this article analyzes (a) the benefits patients in Minnesota's medical cannabis program derive from cannabis, (b) how program restrictions mediate access to cannabis and its derived benefits, and (c) some key ways in which medical and criminal justice institutional authorities are reconfigured around medical cannabis. I show how the imperative to authoritatively govern "dangerous drugs" persists in consequential ways as the War on Drugs shifts toward a medicalized, criminalized, and commercial-legalized mixed regime.
The debt collection industry in the United States has grown in tandem with rising indebtedness. Prior research on debt and mental health mainly treats debt as a resource and liability rather than a power relationship between creditors and debtors. We study the mental health consequences of debt collection pressure using data from the National Longitudinal Survey of Youth-1997 Cohort (N = 7,236). Drawing on stress theory and health power resources theory, we posit collection pressure as a relational stressor that undermines well-being through negative interactions with debt collectors, financial strain, role strain, and stigma. We find that more than one out of every three young adults in this cohort faced debt collection pressure by around age 40, with higher rates among low-income and Black young adults. Individual fixed-effects and lagged dependent variable regression models indicate that debt collection pressure is associated with increased psychological distress, with more severe consequences among low-income young adults.
This article examines how U.S. immigration law extends into the health care safety net, enacting medical legal violence that diminishes noncitizens' health chances and transforms clinical practices. Drawing on interviews with health care workers in three U.S. states from 2015 to 2020, I ask how federal citizenship-based exclusions within an already stratified health care system shape the clinical trajectories of noncitizens in safety-net institutions. Focusing specifically on cancer care, I find that increasingly anti-immigrant federal policies often reshape clinical practices toward noncitizens with a complex, life-threatening condition as they approach a "specialty care cliff" by (1) creating time penalties that keep many noncitizens in a protracted state of injury and (2) deterring noncitizens from seeking care through threats of immigration enforcement. Through these processes, medical legal violence also creates the potential for moral injury among health care workers, who must adapt clinical practices in response to socio-legal boundaries of belonging.
Early initiation and consistent use of prenatal care is linked with improved health outcomes. American Indian birthing people have higher rates of inadequate prenatal care (IPNC), but limited research has examined IPNC among people living on American Indian reservations. The current study uses birth certificate data from the state of Montana (n = 57,006) to examine predictors of IPNC. Data on the community context is integrated to examine the role of community health in mediating the associations between reservation status and IPNC. Results suggest that reservation-dwelling birthers are more likely to have IPNC, an association partially mediated by community health. Odds of IPNC are higher for reservation-dwelling American Indian people compared to reservation-dwelling White birthers, highlighting intersecting inequalities of race and place.
Health lifestyles are a well-theorized mechanism perpetuating health and social inequalities, but empirical research has not yet documented crucial aspects: (1) health lifestyles' collective nature or content beyond behaviors and (2) how people choose among available lifestyles in their social contexts. We conducted interviews, observations, and focus groups with families in two middle- to upper-middle-class communities. Contemporary class-privileged parenting involves constructing an individualized health lifestyle reliant on an expansive understanding of health and composed of parents' identities and narratives, children's health behaviors and identity expressions, and community norms. Children's predominant health lifestyles in our sample vary by focus on parent versus child identity expression and on future achievements versus present well-being. Parents expect health lifestyles to influence future socioeconomic attainment and health inequalities. Understanding how health lifestyles encompass more than behaviors and are locally contextualized and how people choose them within structural constraints can inform research and policy.