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：该项目旨在通过生命过程的转变，提高我们对社会健康不平等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转变作为浪漫伙伴关系和就业领域的过渡的函数。其次，我们将重点扩展到这些生命历程的转变对伴侣和儿童健康的影响。在整个项目中，将特别关注这些生命过程过渡的性别健康结果。理论模型：该理论模型基于这样的假设，即生命历程的转变对健康产生影响（因果关系），反过来又受到健康的影响（选择），导致随着时间的推移，健康状况不佳与健康状况良好之间可能会出现自我强化的动态关系。潜在的因果途径（资源，压力和应变，健康行为）将在三个工作包进行分析：工作包1，伙伴关系的过渡：在这个工作包中，我们分析健康对工会的形成和工会解散的影响，以及这些过渡的健康相关后果。我们区分婚姻和非婚姻关系，以及第一次和更高层次的婚姻。第2套工作方案，就业过渡：这套工作方案侧重于职业流动、失业和健康之间的联系。首先，我们研究向上和向下的职业流动性如何影响健康。第二步，分析失业和再就业对健康的影响。我们关注的是失业对健康的影响是如何被以前的职业地位所缓和的，这个问题到目前为止还没有得到足够的关注。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了（向下）流动或失业对健康的负面影响。与此同时，我们感兴趣的是一个家庭成员的过渡对其他家庭成员的健康的溢出效应。数据和方法：使用来自德国社会经济小组的数据，分析将主要依赖于利用受试者内变异的纵向方法，例如顺序结果的固定效应小组回归。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。含义：关于生命历程和社会进程中健康不平等现象形成和再现的关键阶段的循证知识，可为制定公共卫生措施和社会政策提供重要投入。因此，我们将向医生、社会工作者和决策者提供该项目的结果。

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.