Effect of life course transitions on health inequalities. Health consequences of changes in romantic partnership, work and employment status among men and women

研究问题：本项目旨在通过生命过程的转变，增进我们对社会健康不平等现象的出现和再现的认识。基于累积优势/劣势模型的理论前提，我们首先分析了与健康相关的变化作为浪漫伙伴关系和就业领域的转变的函数。其次，我们将重点放在这些生命历程转变对伴侣和孩子健康的影响上。在整个项目中，将特别关注这些生命过程转变的性别特定的健康结果。理论模型：理论模型基于这样的假设，即生命过程的转变对健康(因果关系)有影响，反过来又受到健康(选择)的影响，导致随着时间的推移，健康状况不佳与健康状况良好的潜在自我强化的动态。潜在的因果途径(资源、压力源和压力以及健康行为)将在三个工作包中进行分析：工作包1，伙伴关系转变：在这个工作包中，我们分析健康对工会形成和工会解散的影响，以及这些转变的与健康有关的后果。我们区分婚姻关系和非婚姻关系，以及一级婚姻和高级婚姻。工作包2，就业过渡：这一工作包侧重于职业流动、失业和健康之间的联系。首先，我们考察向上和向下的职业流动如何影响健康。第二步，分析失业和再就业对健康的影响。我们的重点是失业对健康的影响是如何被以前的职业状况缓和的，这个问题到目前为止还很少受到关注。工作包3，健康的社会动态：在这个工作包中，我们调查家庭成员在多大程度上缓冲(向下)流动或失业带来的负面健康后果。与此同时，我们感兴趣的是一个家庭成员的转变对其他家庭成员健康的溢出效应。数据和方法：使用来自德国社会经济小组的数据，分析将在很大程度上依赖于利用受试者内部差异的纵向方法，例如针对顺序结果的固定效应面板回归。此外，还将使用二元数据分析来研究社会背景通过家庭关系对健康和健康行为的影响。影响：关于生命过程和社会进程中的关键阶段的循证知识，通过这些阶段形成和复制健康不平等，可能为设计公共卫生措施和社会政策提供重要的投入。因此，我们将向医生、社会工作者和政策制定者提供该项目的研究结果。

Research questions: This projects aims at advancing our knowledge about the emergence and reproduction of social health inequalities through life course transitions. Based on the theoretical premises of the cumulative advantage/disadvantage model we first analyse health-related shifts as a function of transitions in the domains of romantic partnerships and employment. Second, we extend our focus to the effects these life course transitions have on the health of partners and children. Throughout the project, particular attention will be paid to gender-specific health outcomes of these life course transitions. Theoretical model: The theoretical model rests on the assumption that life course transitions have an effect on health (causation) and in turn are affected by health (selection), leading to a potentially self-reinforcing dynamics of poor health vs. good health over time. Potential causal pathways (resources, stressors and strains, and health behaviour) will be analysed within three work packages: Work package 1, Partnership transitions: In this work package, we analyse effects of health on union formation and union dissolution as well as health-related consequences of these transitions. We distinguish between marital and non-marital relationships as well as between first and higher order marriages. Work package 2, Transitions in employment: This work package focusses on the associations between occupational mobility, unemployment and health. First, we examine how upward and downward occupational mobility influences health. In a second step, health effects of unemployment and reemployment are analysed. We focus on how the health consequences of unemployment are moderated by previous occupational status, a question that has received very little attention so far. Work package 3, Social dynamics of health: In this work package we investigate in how far family members buffer negative health consequences of (downward) mobility or unemployment. At the same time, we are interested in spillover effects of one family member's transitions on the other family members' health. Data and methods: Using data from the German Socio-Economic Panel, the analysis will rest heavily on longitudinal methods exploiting within-subject variation, e.g. fixed effects panel regression for ordinal outcomes. In addition, dyadic data analysis will be used to study social context effects on health and health behaviour through family relations. Implications: Evidence-based knowledge about critical stages in the life course and social processes through which health inequalities are shaped and reproduced may provide a crucial input for designing public health measures and social policies. We will thus make findings from the project available to medical practitioners, social workers and policy makers.