The household production of men's and women's health in the United States

Abstract

The inverse association between individuals' own education and adverse health outcomes is well established, but the influence of other people's education -- particularly those with close social ties or who are family members -- and adult health outcomes is not. The material and non-material resources available to individuals via their own education likely are shared within a marriage to become resources at the household or family-level. Research on spousal education and adult health outcomes is sparse -- especially in the United States. Therefore, this dissertation examines how husbands and wives' education combine within marriage to influence each other's self-rated health and annual risk of death in the United States. The analyses utilize two nationally representative data sources: the National Health Interview Survey (NHIS) and the National Health Interview Survey Linked Mortality File (NHIS-LMF). Chapter Two establishes an inverse association between spousal education and poor/fair self-rated health among married adults in the United States. The results also showed that spousal education attenuated the association between one's own education and fair/poor self-rated health more for married women than married men and age-specific analyses revealed that these differences were largest among married persons ages 45-64. Chapter Three reveals that individuals' own education and their spouse's education each share an inverse association with the annual risk of death among married adults. Although this association generally does not vary by gender, spousal education apparently is a more important determinant of all-cause mortality risk among married non-Hispanic whites in comparison to married non-Hispanic blacks. Age-specific analyses also suggest that the influence of own and spousal education on adult mortality risk weakened with increasing age. Chapter Four assesses life expectancy differentials between men and women in different marital status groups at different points in the educational distribution. The results imply that spousal education substantially contributes to life expectancy disparities between married and unmarried persons. The results also imply that focusing only on the relationship between married persons' own education and life expectancy masks substantial heterogeneity within educational groups attributable to spousal education. Overall, the findings strongly suggest that education is a shared or household health resource among husbands and wives.