Early-Life Health Consequences of Unequal Kinship Networks

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Project Summary I graduated with a joint Ph.D. in Demography and Sociology from University of Pennsylvania and an M.Eng in Operations Research and Industrial Engineering from Cornell University. My dissertation examined the consequences of health insurance policies on inequalities between gender, race/ethnicity, and access to care. During my postdoctoral fellowship at UCLA’s Department of Health Policy and Management (HPM), I expanded my work in safety nets to include informal kin-based sources. My work thus far has focused on dyadic relationships and proximate determinants of health. The K99 will allow me to broaden this focus and (1) develop of methodological expertise in network analyses; and (2) gain expertise in the study of biological markers of health to address the question: “Do differences in kinship support networks explain the health gap between socioeconomic groups?” The R00 phase will allow for a pilot study whose findings will motivate a future R01 that will collect data needed to answer this question directly. Current health policy strengthens the importance of kin through dependent coverage of spouses and children. The changing landscape of family ties is often missing from policy debates. Diverging trends in mortality, family formation, and childbearing between people who have more, and less socioeconomic resources may reinforce or exacerbate health inequalities. Adults with supportive ties to their spouses and parents may benefit from stronger safety nets. Children who are born and grow up in these strong kinship networks may have access to greater resources than children who have fewer parents, grandparents, and whose family relationships are made complex by step-kin. This proposal will (1) quantify the unequal kinship networks stemming from diverging trends in mortality, fertility and martial histories and its resulting disparities in support; (2) establish an association between kin-based safety nets with health in-utero and early life; and (3) simulate the potential population-level health impact of kinship networks stemming from unequal demographic histories of multiple generations. The proposed training program and research project will set the foundations for an independent research program whose goal is to ascertain the contribution of disparate family processes in population health inequality. The findings will help to create health policies that consider the diverse and evolving kinship networks that beneficiaries are embedded in and to identify effective opportunities for intervention. During the K99 phase, I will develop methodologies to create simulations of kinship networks using population-representative data. I will also collaborate with a research lab to collect repeated biomarker data along with information on social support from families as they go through pregnancy, birth, and the first year of the infant’s life. During the R00 phase, I will analyze the data and incorporate its findings into the kinship network models developed during the K99 phase. UCLA is the ideal place for my training and research as it has faculty and institutional resources that are critical for the completion of this project.