Climate Change and Pollution Affect How Communities Plan, Adapt, and Mitigate Risk

Environmental forces like wildfire, extreme heat, and pollution can have profound effects on our health, jobs, and decisions on where to live.

Wildfire. Drought. Lead Exposure. Oil spill.

Environmental events and changes can have profound effects on our health and jobs and help shape our decisions on where we live.

A new, special issue of the journal, Population and Environment, explores the ways that environmental forces shape people’s lives and behaviors, and identifies policy approaches community leaders can use to plan, adapt, and mitigate risks in specific settings worldwide.

The featured studies draw on the expanding availability of environmental data, which reflects growing interest in the human implications of climate change and the increasing frequency of extreme weather events, report Katherine Curtis, Marcy Carlson, and Malia Jones of the University of Wisconsin-Madison, editors of this special issue.

Much of the research in this journal issue grapples with the impact of dynamic forces in the natural environment on child health and migration:

  • U.S. children exposed to air pollution and household lead face a higher risk of incarceration and lower incomes in adulthood.1 The study also linked high levels of air pollution—disproportionately found in Black and Latino neighborhoods—to a greater likelihood of teen childbearing. White children were much less likely to be exposed to either air pollution or household lead, suggesting that efforts to clean up neighborhood toxins could increase social mobility and decrease inequality. Policy Summary.
  • Children whose families lost income or jobs related to the BP Deepwater Horizon oil spill were more likely to have persistent health problems.2 Children affected by the oil spill had poorer health compared with their peers, whether they had physical contact with toxins or their household lost jobs or income because of the disaster. While the effects of physical exposure to the oil spill dissipated over time, the effects of related job or income loss persisted. These findings underscore the need for policies and programming that better support the long-term health of children who have experienced a disaster. Policy Summary.
  • Climate change-related declines in water availability impact child health and growth in West Africa’s Sahel region.3 Child health and growth suffer in Burkina Faso, Mali, and Senegal when the quality and quantity of surface water (waterholes) declines, analysis shows. These countries are already experiencing chronic food insecurity and childhood malnutrition, and their rapidly growing populations are dependent on livestock and crops in a region predicted to experience hotter and drier conditions. Research results highlight the potential importance of monitoring waterholes and ensuring clean drinking water is available locally for the health of people—especially children—and livestock. Policy Summary.
  • Better rainfall linked to more time farming and less time breastfeeding among Ethiopian mothers.4 More favorable rainfall conditions for crop production may impact mothers’ time use, possibly reducing the time they have available to breastfeed their babies, the study finds. This information can help policymakers develop targeted interventions that reflect the dynamic needs of farming households, such as suppling technologies that make planting and harvesting more efficient. Policy Summary.
  • Climate change-induced extreme heat and wildfire dampen migration in U.S. regions high in natural amenities.5Rural counties with outdoor recreation and environmental features such as ample sunshine, dramatic topography, warm and dry climates, and forests are most affected by these migration shifts, researchers find. Policymakers and planners have relied on migration models that predict more people moving to U.S. counties rich in amenities, but climate change is likely to alter migration trends, impacting economic development. Policy Summary.
  • Repeated droughts in rural Thailand and Vietnam trap poorer households, reducing migration.6 Both household assets and consumption shrink in rural areas that have experienced two years of drought, analysis shows. Particularly among poorer households, this decrease creates an obstacle to those who would migrate for income-earning opportunities. As extreme weather events like drought become more frequent and severe, the need for safety nets and social protection programs, such as cash transfer and insurance programs, becomes crucial, especially when targeted to poorer households. Policy Summary.

Extreme Weather Hits Under-Resourced People Hardest; Research to Support Climate Adaptation Crucial

“Environmental shocks and stressors expose and often exacerbate existing inequalities, taking the greatest toll on the most disadvantaged people,” note Curtis, Carlson, and Jones. They point to the tsunami in Southeast Asia (2004) and Hurricane Katrina in New Orleans (2005) as examples.

The resources and infrastructure needed to plan and adapt to climate events are unevenly distributed around the globe, underscoring the importance of linking scholars with policymakers, they argue.

Recent technological advancements mean that the data and tools needed to identify ways to mitigate climate-related risks are available, notes Barbara Entwisle of the University of North Carolina at Chapel Hill in a piece in the special issue.7 Demographers are poised to “contribute significantly to a larger and deeper understanding of environmental change and its consequences, locally, regionally, and globally,” she writes.

But as researchers work with data linked to specific geographic locations, they must strike a balance between privacy and accuracy so that confidentiality is not breached, Lori Hunter of the University of Colorado, Boulder and colleagues assert in another article in the journal.8 The authors compare unaltered data from surveys and vegetation information from rural South Africa with similar data generated by a series of geomasking techniques designed to reduce the likelihood that individual respondents can be identified. They find that geomasking approaches that use buffers and account for population density produce the most accurate results. But they also show that higher levels of accuracy increase the likelihood that potential respondents can be identified.

Yet the challenges of this research should not be an obstacle, argue Curtis, Carlson, and Jones. “Environmental change is happening. Environmental events are occurring,” they write. “These environmental forces have demonstrable consequences for human lives and livelihoods and, by extension, for the welfare” of the entire human family.

The special issue of Population and Environment is based on a conference supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) (Grant HD 096853).


  1. Robert Manduca and Robert J. Sampson, “Childhood Exposure to Polluted Neighborhood Environments and Intergenerational Income Mobility, Teenage Birth, and Incarceration in the USA,” Population and Environment 42, no. 4 (2021).
  2. Tim Slack et al., “Deepwater Horizon Oil Spill Exposure and Child Health: A Longitudinal Analysis,” Population and Environment 42, no. 4 (2021).
  3. Kathryn Grace and Frank Davenport, “Climate Variability and Health in Extremely Vulnerable Communities: Investigating Variations in Surface Water Conditions and Food Security in the West African Sahel,” Population and Environment 42, no. 4 (2021).
  4. Heather Randell, Kathryn Grace, and Maryia Bakhtsiyarava, “Climatic Conditions and Infant Care: Implications for Child Nutrition in Rural Ethiopia,” Population and Environment 42, no. 4 (2021).
  5. Richelle L. Winkler and Mark D. Rouleau “Amenities or Disamenities? Estimating the Impacts of Extreme Heat and Wildfire on Domestic US Migration,” Population and Environment 42, no. 4 (2021).
  6. Esteban J. Quiñones, Sabine Leibenehm, and Rasadhika Sharma, “Left Home High and Dry–Reduced Migration in Response to Repeated Droughts in Thailand and Vietnam,” Population and Environment 42, no. 4 (2021).
  7. Barbara Entwisle, “Population Responses to Environmental Change: Looking Back, Looking Forward,” Population and Environment 42, no. 4 (2021).
  8. Lori Hunter et al., “Working Toward Effective Anonymization for Surveillance Data: Innovation at South Africa’s Agincourt Health and Demographic Surveillance Site, Population and Environment 42, no. 4 (2021).




U.S. Racial Inequality May Be as Deadly as the Coronavirus

The mortality rate for Black Americans in non-pandemic years is higher than the mortality rate for white Americans who died from COVID-19 and all other causes in 2020.

Coronavirus Pandemic Temporarily Shortens Average U.S. Lifespan by About a Year

While the pandemic is shortening the average U.S. lifespan—temporarily—its effects will be felt most heavily by Black Americans, whose mortality rate in ordinary years is higher than the rate for white Americans during the pandemic. Each coronavirus-related death will likely impact about nine close family members.

These impacts are among the findings of new research supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) that aims to put the pandemic’s magnitude in context and inform responses.

Extreme Racial Inequality in COVID-19 Deaths Layers on Top of Existing Stark Disparities

Black Americans experience a higher mortality rate every year than white Americans are experiencing during the coronavirus pandemic, finds Elizabeth Wrigley-Field of the University of Minnesota.Her analysis focuses on death rates and compares the scale of this pandemic to racial inequality, which she calls “another U.S. catastrophe.”

Using demographic models, Wrigley-Field estimates how many deaths of white Americans would be needed to raise the white age-adjusted mortality rate to the best-ever (lowest) Black age-adjusted rate.

At least 400,000 excess deaths of white Americans—deaths above and beyond the number expected in a non-pandemic year—would be needed to reach the best mortality rate ever recorded for Black Americans, which occurred in 2014, she finds.

Black Americans’ age-adjusted, confirmed COVID-19 deaths are more than 2.5 times higher than that of white Americans, she reports.2

Social factors rather than innate vulnerabilities drive these mortality differences: Mounting research suggests these stark disparities are driven by differences in exposure to the coronavirus. In particular, Black Americans are overrepresented in service jobs with high public contact and are particularly overrepresented among low-paid workers who may lack the power to demand adequate protection.3

For white mortality to reach levels that Black Americans experience outside of the pandemic, excess mortality in 2020 for white Americans would need to increase by 5.7 times the level of cumulative COVID-19 mortality reached in July 2020 (when the research findings were published), Wrigley-Field reports.

Final analysis of 2020 is likely to reveal “a deadly pandemic causing a spike in mortality for whites that nevertheless remains lower than the mortality Blacks experience routinely, outside of any pandemic,” she suggests.

This disparity in mortality rates has an impact on life expectancy during the pandemic as well. For white Americans, life expectancy in 2020 will remain higher than life expectancy for Black Americans has ever been unless nearly 700,000 excess white deaths occur, Wrigley-Field finds.4

“If Black disadvantage operates every year on the scale of whites’ experience of COVID-19, then so too should the tools we deploy to fight it,” she argues. “Our imagination should not be limited by how accustomed the United States is to profound racial inequality.”

COVID-19 Expected to Shorten the Average U.S. Lifespan in 2020

With the U.S. population as a whole experiencing nearly 350,000 COVID-19 deaths in 2020 and more to come in 2021, life expectancy may appear to be plummeting.5

But in estimating the magnitude of the pandemic, demographers at the University of California, Berkeley have found that COVID-19 is likely to shorten the average U.S. lifespan in 2020 by about a year.6

In July 2020, demographers Ronald Lee and Joshua Goldstein calculated the consequences of U.S. lives lost to COVID-19 that year in order to put COVID-19 mortality rates into historic, demographic, and economic perspective. They used two scenarios: One based on a projection of 1 million deaths for the year, the other on 250,000 deaths, which is closer to the current estimate of 345,700 deaths by Johns Hopkins University.7

One million deaths in 2020 would cut about three years off the average U.S. life expectancy, they conclude, while 250,000 deaths would reduce lifespans by about 10 months.

That said, without the societal efforts implemented to lessen COVID-19’s impact, 2 million deaths were projected by the end of 2020—a reduction of the average U.S. lifespan by five years, the researchers point out.

Their estimated drop in life expectancy is modest, in part because 250,000 deaths is not a large increase on top of the 3 million non-COVID-19 deaths expected for 2020. The study also notes that older people, who typically have fewer remaining years of life than others do, represent the most COVID-19 fatalities.

Still, while COVID-19 mortality rates in general remain lower than those of the 1918 Spanish flu pandemic, the toll of the coronavirus in the United States could be just as devastating as the country’s longer-lasting HIV and opioid epidemics if mitigation efforts fail, the researchers said.

“The death toll of COVID-19 is a terrible thing, both for those who lose their lives and for their family, friends, colleagues, and all whom their lives touched. Those are real people, not abstract statistics,” says Lee.

“But the population perspective helps put this tragedy in a broader context. As we work to contain the coronavirus, it is important to know that the United States has been through such mortality crises before,” he adds.

About Nine Close Relatives Suffer Grief With Each COVID-19 Fatality

The ripple effects of each COVID-19 death will impact the mental and physical health of about nine surviving close family members, a study of kinship networks shows.8

For example, when 190,000 people were dead from the disease in September 2020, 1.7 million Americans experienced the loss of a close relative, explains Ashton Verdery of Penn State University. A kinship network includes grandparents, parents, siblings, spouses, and children. Black Americans had a slightly higher number of close relatives than white Americans, averaging an estimated 9.2 people compared with 8.9, they found.

If 1 million people eventually die from COVID-19, then 8.9 million—or about 3 out of 100 Americans—would be in mourning.

These findings can help raise awareness about the scale of the disease and the ripple effects that deaths may have on a community, as well as prepare officials and business leaders to manage those effects, according to Verdery.

“It’s very helpful to have a sense of the potential impacts that the pandemic could have,” he says. “And, for employers, it calls attention to policies around family leave and paid leave. At the federal level, it might inform officials about possible extensions for FMLA (Family and Medical Leave Act). There could also be some implications for caretaking. For example, a lot of children grow up in grandparent-led houses and they would be impacted.”

Many people are also facing the loss of a close loved one at a younger age because of the disease, according to Verdery, who worked with Emily Smith-Greenaway of the University of Southern California, Rachel Margolis of the University of Western Ontario, and Jonathan K. Daw at Penn State.

“There are a substantial number of people who may be losing parents that we would consider younger adults and a substantial number of people may be losing spouses who are in their 50s or 60s,” he suggests.

Their findings could help local officials understand and prepare for the waves of grief that may affect specific geographic areas and regions of the country.

This article was produced under a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). Yasmin Anwar of the University of California Berkeley and Matt Swayne of Penn State University contributed to this article. The work of researchers from the following NICHD-funded Population Dynamics Research Centers was highlighted: University of California, Berkeley (2P2CHD073964-05A1); University of Minnesota (5P2CHD041023-19); and Penn State University (5P2CHD041025-19).

A list of newly published research on the pandemic by NICHD Population Dynamics Research Centers can be found here.


  1. Elizabeth Wrigley-Field, “U.S. Racial Inequality May Be as Deadly as COVID-19,” Proceedings of the National Academies of Sciences 117, no. 36 (2020): 21854-6.
  2. Centers for Disease Control and Prevention, “COVID-19 Hospitalization and Death by Race/Ethnicity,” updated Nov. 30, 2020, https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-race-ethnicity.html.
  3. Noreen Goldman et al., “Racial and Ethnic Differentials in COVID-19-Related Job Exposures by Occupational Status in the US,” MedRxiv (2020), https://doi.org/10.1101/2020.11.13.20231431.
  4. This study does not examine life expectancy for non-Hispanic Black Americans and non-Hispanic White Americans separately by sex. PRB notes that in 2017, non-Hispanic Black females had a longer life expectancy (78.1 years) than non-Hispanic White males (76.1 years). Data on life expectancy are from Kenneth D. Kochanek et al., “Deaths: Final Data for 2017,” National Vital Statistics Reports 68, no. 9 (2019).
  5. Johns Hopkins University, Coronavirus Resource Center, accessed on Jan. 4, 2021, https://coronavirus.jhu.edu/us-map.
  6. Joshua R. Goldstein and Ronald D. Lee, “Demographic Perspectives on the Mortality of COVID-19 and Other Epidemics,” Proceedings of the National Academies of Sciences 117, no. 36 (2020): 22035-41.
  7. Johns Hopkins University, Coronavirus Resource Center, accessed on Jan. 4, 2021, https://coronavirus.jhu.edu/us-map.
  8. Ashton M. Verdery et al., “Tracking the Reach of COVID-19 Kin Loss With a Bereavement Multiplier Applied to the United States,” Proceedings of the National Academies of Sciences 117, no. 30 (2020): 17695-701.
Pouring Cola

Taxes, Health-Warning Labels May Help Limit Consumption of Sugary Beverages and Improve Health

To combat obesity and diabetes, lawmakers in a number of U.S. cities have taxed sodas, sports drinks, and sweetened tea, and many are now considering health warning labels.

Growing evidence suggests that both strategies—taxes and warning labels—can reduce the purchase and consumption of sugary drinks, research supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) shows.

Health-Warning Labels Influence What People Buy and Consume

Even brief exposure to health warnings on sugar-sweetened beverages reduces purchases of those beverages, providing evidence that such warnings can promote healthier drink choices, a new study demonstrates.1

A team of researchers from the University of North Carolina at Chapel Hill (UNC)—including Anna Grummon, Lindsey Smith Taillie, Shelley Golden, Marissa Hall, and Noel Brewer—examined how health warnings influence what consumers actually buy in real settings. This randomized controlled trial assigned 400 consumers of sugary beverages to groups that saw either a health warning or a label that looked like a barcode.

“We worked in a convenience-store laboratory that allowed us to control whether the sugary drinks had warnings,” explains Grummon, now at Harvard University. “We are also one of the first studies to measure what consumers actually buy after seeing warnings, when they have their own money on the line.”

Participants who saw the health warning labels purchased about 22% fewer calories from sugary drinks compared with participants who saw a neutral label. The study also found that the warnings were influential across diverse groups: The effect of health warnings on beverage purchases did not differ by participants’ race/ethnicity, education, age, gender, sexual orientation, income, body weight, or health-literacy level.

According to Grummon, critics of health warning labels argue that consumers won’t notice or pay attention to the warnings. However, three-quarters of the participants in this study reported noticing the health warnings, and most of those participants also reported that they read and looked closely at the labels.

In another study, Grummon and Hall synthesized the findings of 23 studies and found that health warnings labels not only reduced purchases of sugary drinks but also caused stronger emotional responses, increased perceptions that sugary drinks contribute to disease, and reduced intentions to purchase or consume sugary drinks.2 All these responses are key indicators when it comes to long-term behavior change, they note.

“Our findings suggest that sugary drink warnings help consumers better understand products’ healthfulness and encourage them to make healthier choices about what drinks to buy,” says Grummon.

In a related mathematical simulation, UNC researchers show that a national policy requiring health labels on sugar-sweetened beverages could reduce obesity prevalence by about 3.1 percentage points over five years, if sustained.3

“While three percentage points might sound modest, on a national scale it equates to more than five million fewer people with obesity,” says Grummon. “Warnings are a highly scalable strategy for helping consumers make healthier choices. These findings suggest that warnings are also promising for addressing obesity in the U.S.”

Improved Child Health Projected in Wake of Mexico’s Soda Tax

The Mexican government enacted the first national tax on sugar-sweetened beverages after a 2012 study indicated that more than 70% of the country’s population was overweight or obese, and that in excess of 70% of the added sugar calories in the Mexican diet were coming from sugary drinks.

In the two-year period spanning 2014 to 2015, a research team that included Barry M. Popkin and Shu Wen Ng of UNC found that:

  • The one-peso-per-liter excise tax on sugar-sweetened beverages in Mexico resulted in a 6% reduction in purchases of taxed beverages during the first year and continued to decline, with a 10% decrease in purchases in the second year.
  • During the same study period, purchases of untaxed beverages such as bottled water increased 2.1%.
  • Residents of households with lower socioeconomic levels, for whom health care costs are most burdensome, reduced their purchases of sweetened beverages the most.4

The findings run counter to initial reports from the sugar-sweetened soda industry, which said that the purchases of sugary drinks actually went up after the initial tax year. However, the researchers found those reports did not account for numerous significant factors, including inflation and shifts in population.

In addition, a new analysis co-authored by Popkin estimates that Mexico’s sugar-sweetened beverage tax could result in meaningful weight control and life-long health benefits for the country’s children and adolescents, particularly those who had been high consumers of the beverages before the tax.5 Childhood obesity is a strong predictor for obesity later in life, which can also lead to chronic illnesses such as diabetes, hypertension, and heart disease, the researchers emphasize.

To estimate the one-year effect of the tax on the body weight of children ages 5 to 17, by taking into account patterns of childhood growth and obesity in Mexico and assuming that the known reductions in sugar-sweetened beverage purchases would reflect changes in consumption.

Findings show that one year after the implementation of the current tax, children and adolescents should experience an average reduction in body weight of 0.26 and 0.61 kg (one kilogram equals about 2.2 pounds). For those who had been high consumers of sugary drinks, the team estimates the positive impact on body weight would be even greater, with an average body weight reduction of 0.50 kg for children and 0.87 kg for adolescents. Sustained over several years, such weight loss could mean some children and adolescents would not longer be considered obsese.

“Taxation represents one of the most effective ways to reduce consumption of unhealthy sugar-sweetened beverages, which can make a meaningful impact on future excessive weight gain and significantly reduce the long-term risks of becoming obese,” says Popkin. “If the taxation revenue is used to support child and adolescent healthy eating, then the benefits of such taxes are enhanced.”

Public Support Is Key to Policies Limiting Sugary Beverages

For taxes on sugary beverages to become a widely used strategy for improving public health, public support and acceptance are key.

Public opinion on the policies’ unintended consequences may affect attitudes toward the policy, argue Melissa Knox, Jessica Jones-Smith, and Vanessa Oddo of the University of Washington, who analyzed perceptions of the effects of Seattle’s 2017 sugary beverage tax.6

“We find that a majority of participants (59%) support the sugary beverage tax in Seattle and correspondingly, most people believed that the tax will positively impact health, and will not negatively affect general and personal economics in Seattle,” they report. “However, lower-income, versus higher-income, respondents were more concerned about the possible negative economic consequences of the tax,” such as job loss or increased financial costs for their family and friends.

A related study shows that attitudes toward sugary beverage taxes may be difficult to accurately estimate in phone surveys.7 Phone respondents (but not web respondents) under-report their sugary beverage consumption by about 25% and over-report positive attitudes toward the tax by about 11%, the researchers determined. These differing results likely reflect respondents’ answering interviewers’ questions in ways they believe are more socially desirable or acceptable rather than choosing responses that reflect their true thoughts or feelings, a tendency known as social desirability bias.

The researchers offer advice to lawmakers implementing soda taxes.

  • Policymakers “should be wary of solely relying on self-reported measures of intake when evaluating the effectiveness of these policies,” they write, noting that consumers may consume more sweetened beverages than they report.
  • Lawmakers should strengthen “their public messaging regarding the health and economic benefits of sweetened beverage taxes, even if they believe that attitudes are generally positive. Without a pro-tax messaging campaign that informs the public about the positive health and economic effects of these taxes, the taxes may eventually lose public support.”

The researchers point out that “recent successful efforts to block U.S. municipalities from enacting future beverage taxes by banning the taxes at the state level have relied heavily on informational campaigns that focused on the negative economic effects of the taxes. These campaigns, often funded by the beverage industry, may ultimately shift social norms in the direction of more favorable attitudes toward sweetened beverages, with unpredictable effects on public health.”

This article was produced under a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). The Communications and Marketing team at the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill contributed to this article. The work of researchers from the following NICHD-funded Population Dynamics Research Centers was highlighted: University of North Carolina at Chapel Hill (P2CHD050924) and University of Washington (5P2CHD042828-18).



  1. Anna H. Grummon et al., “Sugar-Sweetened Beverage Health Warnings and Purchases: A Randomized Controlled Trial,” American Journal of Preventive Medicine 57, no. 5 (2019): 601-10.
  2. Anna H. Grummon and Marissa G. Hall, “Sugary Drink Warnings: A Meta-Analysis of Experimental Studies,” PLOS Medicine (2020), https://doi.org/10.1371/journal.pmed.1003120.
  3. Anna H. Grummon et al., “Health Warnings on Sugar-Sweetened Beverages: Simulation of Impacts on Diet and Obesity Among U.S. Adults,” American Journal of Preventive Medicine 57, no. 6 (2019): 765-74.
  4. M. Arantxa-Colchero et al., “In Mexico, Evidence of Sustained Consumer Response Two Years After Implementing a Sugar-Sweetened Beverage Tax,” Health Affairs 36, no. 3 (2017): https://doi.org/10.1377/hlthaff.2016.1231
  5. Rossana Torres-Álvarez et al., “Body Weight Impact of the Sugar-Sweetened Beverages Tax in Mexican Children: A Modeling Study,” Pediatric Obesity 15, no. 8 (2020): e12636, https://doi.org/10.1111/ijpo.12636.
  6. Vanessa M. Oddo et al., “Perceptions of the Possible Health and Economic Impacts of Seattle’s Sugary Beverage Tax,” BMC Public Health 19 (2019): 910.
  7. Melissa A. Knox et al., “Is the Public Sweet on Sugary Beverages? Social Desirability Bias and Sweetened Beverage Taxes,” Economics & Human Biology 38 (2020): 100886.

Cohabiting Couples in the United States Are Staying Together Longer but Fewer Are Marrying

More unmarried couples today are living together, and doing so for longer than in the past, but fewer of these relationships lead to marriage, new research finds. This change may in part reflect shifting attitudes toward cohabitation, and it results in more separations and re-partnering during young adulthood.

Most young women today will live with a romantic partner at least once, compared with just one-third of young women in the late 1980s.1 During that decade, most cohabiting relationships were short-lived and frequently led to marriage.

The new research, conducted by graduate students and faculty at the Center for Family and Demographic Research at Bowling Green State University, examined how cohabitation and marriage patterns have changed for young women over the past four decades. Their research was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).

In their study, Esther Lamidi, now at the University of Colorado Colorado Springs, and colleagues Wendy Manning and Susan Brown at Bowling Green, drew on data from the National Survey of Family Growth (NSFG) to compare women ages 15 to 39 who lived with a first romantic partner in 1983-1988 and in 2006-2013.They examined changes in whether couples who lived together had married or split up within five years.

They found that while cohabiting relationships are still relatively short-lived, couples today are cohabiting longer—increasing from about 12 months in the 1983-1988 cohabitation cohort to 18 months in the later cohort—and that this longer duration is linked to couples delaying or forgoing marriage altogether. After five years, similar shares of women in both cohorts were still living with their partner, but the distribution of those still cohabiting as compared to those who had married had shifted. Among the early cohort, 23% of women were still cohabiting five years later, and 42% had married their partner. These shares were reversed among the later cohort—43% were still cohabiting and only 22% had married.

Women With Less Education Experience More Changes in Cohabitation

Over the past five decades, changes in family behaviors such as declining rates of marriage have been more pronounced among women with less education compared with women who have more education. Lamidi and her colleagues confirmed this divergence—similar to what’s been observed in other family behaviors and frequently termed “diverging destinies”—when they examined patterns of cohabitation across different sociodemographic groups.

Their analysis found that the more recent cohort was much less likely to marry their cohabiting partner, and while this pattern was observed across all sociodemographic groups, it occurred more frequently among women with less education.

After accounting for women’s educational attainment, their results show that between the two cohorts only women with less than a college education experienced a decline in marrying their cohabiting partner. In addition, women having one or more children while cohabiting—an occurrence more common among women with less education—delayed or inhibited marriage more for the later cohort than the earlier cohort, they found.

Cohabitation Changes Reveal a Widening Social Class Divide

Sociodemographic characteristics are associated with the pathways out of cohabitation—break ups or marriages—and changes among the cohabiting population’s characteristics can be reflected in changes in cohabitation outcomes. Yet while the researchers noted that the cohabiting population grew in size, became more racially and ethnically diverse and more highly educated, and had more births while living together, they found these compositional changes had little impact on the changes in cohabitation outcomes across the two cohorts.

What does this finding mean? The researchers conclude that the limited impact of population composition changes on cohabitation outcomes, combined with the decline in marrying a cohabiting partner among women with less education, suggests that the social class divide in the American family appears to be widening.

Their findings also “diminish the traditional view of cohabitation as a prelude to marriage” for women with less education and show, particularly for this population, that “cohabitation is increasingly serving a role similar to that of traditional marriage in offering a viable context for childbearing and child-rearing.”

Young Women Today Are Increasingly Likely to Experience a Breakup

Although cohabiting relationships may be lasting longer, they remain relatively unstable. Kasey Eickmeyer, now at the Center for Policing Equity, reports, “Millennials experienced more relationship instability during young adulthood than earlier birth cohorts of women.” She found that cohabitation experience accounted for this instability.

Eickmeyer asked whether young women see their intimate live-in relationships (either marriage or cohabitation) end more frequently today than earlier generations.3 She analyzed data from multiple cycles of the NSFG to examine women’s experience of ending marriages and cohabiting relationships when they were ages 18 to 25 across several five-year birth cohorts from 1960 to 1985.

She found that among women who had ever married or cohabited, the share breaking up with a live-in partner increased from 31% among women born between 1960 and 1964 to 44% among women born in 1985 to 1989.

Cohabitation explains this increasing likelihood of experiencing a breakup. Compared to women in the 1985-1989 birth cohort, women in the earlier birth cohorts from 1960-1964 through 1975-1979 were significantly less likely to have one or more live-in partnerships end. Once Eickmeyer accounted for women’s cohabitation experience, she found that young women’s increased likelihood of having an intimate partnership end is because union formation during young adulthood shifted from marriage—a relatively stable union—to cohabitation, a relatively unstable union.

More Breakups and Re-Partnering in Young Adulthood Suggest Changing Attitudes About Cohabitation

As more young women enter into and end cohabiting relationships, they have more opportunities to live with multiple partners in a pattern of serial cohabitation. The growing practice of serial cohabitation reflects in part changing attitudes about couples living together without marriage.

Eickmeyer and Wendy Manning wanted to know whether contemporary young adult women who had ever cohabited are more likely to re-partner than prior cohorts of young women.4 Using data from the 2002 and 2006-2013 NSFG, they compared the cohabitation experience of young women ages 16 to 28 across five-year birth cohorts beginning in 1960 through 1980 to examine trends in serial cohabitation.

They found that early Millennial women (born 1980-1984) were 53% more likely to live with more than one romantic partner during young adulthood compared with the late Baby Boomers (born 1960-1964), even after taking into account sociodemographic characteristics such as race and ethnicity and educational level, and relationship characteristics such as their age when their first cohabiting relationship ended and whether they had children.

Not only were early Millennial women more likely to live with more than one partner without marriage, they also formed subsequent cohabiting relationships more quickly than the late Baby Boomers—dropping from nearly four years between live-in relationships to just over two years.

The characteristics most strongly associated with serial cohabitation—such as identifying as non-Hispanic white, having less than a college education, and growing up with a single parent—remained stable across birth cohorts, Eickmeyer and Manning found. And, much like the cohabiting population, the composition of women who had previously lived with a partner changed across cohorts, but this shift does not explain the increase in serial cohabitation.

The researchers conclude that the increase stems from more young adults cohabiting, the continued instability of cohabiting relationships, the increasing length of time between first cohabitation and first marriage, and the growing acceptance of cohabitation during young adulthood.

Their findings highlight the instability in many contemporary young adults’ lives and the increasing role cohabitation plays in relationship churning. Although multiple live-in romantic relationships could have negative consequences for young adults’ well-being (and any children they may have), Eickmeyer and Manning suggest “that young adult relationships may be evolving, and young women may be learning to end coresidential relationships that are not working.”

This article was produced under a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). The work of researchers from the NICHD-funded population dynamics research center at Bowling Green State University (P2CHD050959) was highlighted in this article.


  1. Paul Hemez and Wendy D. Manning, Twenty-Five Years of Change in Cohabitation in the U.S., 1987-2013, National Center for Family and Marriage Research Family Profiles, No. FP-17-02 (2017), http://www.bgsu.edu/ncfmr/resources/data/family-profiles/hemez-manning-25-years-change-cohabitation-fp-17-02.html
  2. Esther O. Lamidi, Wendy D. Manning, and Susan L. Brown, “Change in the Stability of First Premarital Cohabitation Among Women in the United States, 1983-2013,” Demography, 56 (2019): 427-50.
  3. Kasey J. Eickmeyer, “Cohort Trends in Union Dissolution During Young Adulthood,” Journal of Marriage and Family 81 (2019): 760-70.
  4. Kasey J. Eickmeyer and Wendy D. Manning, “Serial Cohabitation in Young Adulthood: Baby Boomers to Millennials,” Journal of Marriage and Family 80 (2018): 826-40.

When a Parent Is Incarcerated, Partners and Children Also Pay a Price

“We live in a country where we have huge numbers of children exposed to parental incarceration. When we talk about the need to reform the criminal justice and mass incarceration systems, we also need to talk about the unintended victims of the current system,” says Christine Leibbrand of the University of Washington. “Incarceration exposes families to poverty and disadvantage, and the system can self-perpetuate inequality.”

About 3.5% of U.S. children under age 18—or one child in every classroom of about 29 students—had a parent behind bars in 2015, mainly their fathers.1

Black children were more than five times more likely than white children to be separated from a parent by incarceration, report sociologists Bryan Sykes of University of California, Irvine and Becky Pettit of University of Texas at Austin. These patterns reflect a system that disproportionately imprisons disadvantaged and minority men, they argue.

A growing body of research documents the toll U.S. incarceration takes on the families of those imprisoned, widening disparities and exacerbating existing disadvantages. New research supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development provides further evidence on the wide-ranging ways a parent’s incarceration shapes the lives and life chances of their partners and children, from the neighborhoods where they live to the levels of adversity their children experience.

Children of Incarcerated Fathers Are More Likely to Live in High-Poverty Neighborhoods and Move More Often

Children whose fathers were incarcerated move more frequently and live in neighborhoods that are more socioeconomically disadvantaged than their peers whose fathers have never been in prison, find Leibbrand and Erin Carll of the University of Washington, Angela Bruns of the University of Michigan now at Gonzaga University, and Hedwig Lee of Washington University in St. Louis.2

Using data from the national Fragile Families and Child Wellbeing Study—research following thousands of families in 20 large U.S. cities since 1998—the team examined the neighborhoods of children whose fathers were in prison or recently released. Families with a father currently or recently in prison tend to live in neighborhoods with higher percentages of residents who are single mothers, receive public assistance, lack a high school diploma, and live below the poverty line, they show.

The financial hardship families with imprisoned members face, researchers say, perpetuates what they call “downward mobility.” A father in prison is one less wage earner at home or paying child support. Families with limited income have fewer choices of where to live, they may move often, and the neighborhoods they end up in may be marked by lower quality schools, greater unemployment, and higher rates of crime and violence, Leibbrand and her colleagues report.

“When we think about where people live or move to, we think of people weighing the pros and cons of different places. That’s far too simple. Many families may be forced to move because of eviction or budget constraints, for example, and these forced moves are often to worse neighborhoods where families have little choice of where they would like to live,” says Leibbrand.

Mothers With a Partner in Prison Are More Likely to Hold Multiple Jobs

Mothers with incarcerated partners are more likely to work multiple jobs than women in otherwise similar circumstances, finds Bruns in another study.3

Partner incarceration is linked to additional employment—a third shift—on top of the paid work and caregiving women already do, she finds, based on analysis of Fragile Families and Child Wellbeing Study data.

An additional job may cover basic expenses but also compounds the burden that women with incarcerated partners already shoulder, she points out.

“Staying in touch and supporting an inmate—responding to his requests for food, clothing and books, preparing packages to the correctional institution’s specifications, coordinating family member visits, and keeping up with legal cases and appeals—can feel like a second job in and of itself,” explains Bruns.

Mothers with partners who are incarcerated usually have sole responsibility for children who may be “struggling with the absence of their fathers,” according to Bruns. Holding multiple jobs is also a known stressor that could raise mothers’ risk of stress-related health conditions.

Low-skilled women are often stuck in low-wage, dead-end jobs that can barely pay the bills, she asserts.

“Balancing multiple work roles in addition to family member incarceration may keep women from going to school or participating in other activities that improve their socioeconomic standing over the long-term,” writes Bruns.

Youth With a Parent in Prison Face More Trauma and Adversity

Youth ages 11 to 17 who experience the incarceration of a parent are more likely to have behavioral problems or mental health issues than their counterparts whose parents have never been jailed, Samantha J. Boch, Barbara L. Warren, and Jodi L. Ford of Ohio State University show.4

The team finds that household poverty plays a role, as does the number of traumatic events the young person has experienced, including homelessness, eviction, foster care, and serious injury or death in the family. Overall, they find that youth who deal with the incarceration of a parent experience three times as many adverse childhood experiences (ACEs) as their unaffected peers.

The researchers base their analysis on interviews with more than 600 parents or other caregivers participating in the Adolescent Development in Context study, a representative sample of Columbus, Ohio, and its surrounding suburbs.

The behavioral problems and mental health issues exhibited more frequently in children who experience a parent’s incarceration include poor attention, excessive anxiety, and externalizing behaviors such as rule breaking, temper outbursts, and property destruction, the analysis finds.

The researchers examined a wide-ranging set of 30 ACEs that includes aspects of financial distress and household churning or instability such as changes in household composition (for example, when a parent or parent’s new partner leaves or joins the household or when a child goes to live with grandparents) and residential moves.

“Well-documented research investigating the cumulative effect of ACEs indicates that youth exposed to parental incarceration may have a much greater likelihood for engaging in maladaptive coping behaviors (such as cigarette, alcohol, and illicit drug use, or violent delinquent behaviors) and experiencing depression, anxiety and post-traumatic stress disorder across the lifespan,” the researchers report.

They argue that mental health providers should view a parent’s incarceration as an important consideration of the child’s and family’s well-being that warrants continued observation, support, and follow-up. More research is needed to determine the best ways to screen and identify these youths using non-stigmatizing approaches that build on their strengths, they suggest. 

A Parent’s Incarceration Can Shape a Child’s Identity and Influence Anti-Social Behavior

Among young adults with an incarcerated parent, those who had a high need for parental approval were more likely to identify themselves as a troublemaker or partier during young adulthood than those who were emotionally independent, a recent study finds.5

Self-identities influence behavior, including criminal activity, making understanding the precursors of self-identity important to interventions designed to improve the life prospects of children with incarcerated parents, according to the researchers Jessica G. Finkeldey of the State University of New York at Fredonia, and Monica A. Longmore, Peggy C. Giordano, and Wendy D. Manning of Bowling Green State University.

The team examined publicly available incarceration records and analyzed data from the Toledo Adolescent Relationships Study, a regional survey of more than 900 men and women ages 18 to 28 interviewed five times between 2001 and 2011.

Developing “high emotional independence, or values, beliefs, and identities in contrast to and separate from an incarcerated parent,” may set young adults on a path shaped by different choices than those made by their incarcerated parent, the researchers suggest.

“It is possible that exposing children of incarcerated parents to positive role models and mentors, such as through mentorship programs, might help to reduce the transmission of antisocial identities and behaviors and should be investigated,” says Finkeldey.

This article was produced under a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). The work of researchers from the following NICHD-funded population dynamics research centers was highlighted in this article: University of Washington, University of Michigan, Ohio State University, Bowling Green State University, and University of Texas at Austin.



  1. Bryan L. Sykes and Becky Pettit, “Measuring the Exposure of Parents and Children to Incarceration,” in Handbook on Children with Incarcerated Parents, ed. J. Mark Eddy and J. Poehlmann-Tynan, (Geneva: Springer, 2019): 11-23.
  2. Christine Leibbrand et al. “Barring Progress: The Influence of Parental Incarceration on Families’ Neighborhood Attainment,” Social Science Research 84 (2019): 102321
  3. Angela Bruns, “The Third Shift: Multiple Job Holding and the Incarceration of Women’s Partners,” Social Science Research 80 (2019): 202-15.
  4. Samantha J. Boch, Barbara L. Warren, and Jodi L. Ford, “Attention, Externalizing, and Internalizing Problems of Youth Exposed to Parental Incarceration,” Issues in Mental Health Nursing 40, no. 6 (2019): 466-75.
  5. Jessica G. Finkeldey et al. “Identifying as a Troublemaker/Partier: The Influence of Parental Incarceration and Emotional Independence,” Journal of Child and Family Studies 29, no. 3 (2020): 802-16.
Untidy Kitchen slow motion.

Married Women With Children and Male Partners Do More Housework Than Single Moms

Women with children and a heterosexual male partner do the most housework—more even than single moms, according to an analysis of time-use data.1

Specifically, married and cohabiting mothers report more housework than never-married or divorced/separated mothers, but all mothers report about the same amount of child-care time, find Joanna Pepin of the University of Texas at Austin, Liana Sayer of the University of Maryland, and Lynne Casper of the University of Southern California (see table).

TABLE: Mothers With a Male Partner Do More Housework,
Sleep Less Than Single Mothers

Predicted Minutes of Mother’s Time in Activities, by Marital Status
  Married Cohabiting Never Married Divorced / Separated
Childcare 120 115 119 118
Housework 171 165 138 145
Leisure 209 243 219 201
Sleep 513 513 527 520

Note: Based on American Time Use Surveys (2003-2012). Model controls for extended family member, number of children, children under two years old, children ages two to five, education, employment, race, age, and weekend diary day.

Source: Joanna R. Pepin, Liana C. Sayer, and Lynne M. Casper, “Marital Status and Mothers’ Time Use: Childcare, Housework, Leisure, and Sleep,” Demography 55, no. 1 (2018): 107-33.

For the study, they examined 24-hour time-use diaries from participants in the nationally representative American Time Use Survey (ATUS) between 2003 to 2012; they focused on white, black, and Hispanic mothers ages 18 to 54 with at least one child under age 13 living with them. Their analysis takes into account weekday and weekend schedules, and other differences such as employment, education, age of children, and the presence of other extended family members in the household.

Married Mothers Sacrifice Sleep and Leisure

After adjusting for other factors, married mothers did significantly more housework and slept less than never-married and divorced mothers, which runs counter to the notion that single mothers are time poor because they lack a partner to help with household chores and work for pay, Pepin notes.

The findings show the trade-offs mothers make in the face of limited time. All mothers protected their time with their children, doing roughly the same amount of child care once other factors are controlled. But married mothers did more housework at the expense of their own leisure and sleep, while nonpartnered mothers tended to do less housework and sleep somewhat more, the researchers find.

Cohabiting mothers spent about the same amount of time doing housework and sleeping as married mothers, but cohabiting mothers reported more leisure time. The differences in leisure time between married and cohabiting mothers may reflect differences in work hours, work schedules, or commuting times, but more research is needed to clarify the reason.

Married women may feel that to be a good wife, they must prioritize housework and child care ahead of their own leisure and sleep.

Social Expectations Shape Women’s Time

The data show that women with a male partner in the home put more time into housework, such as home-cooked meals—work that is symbolic of women’s feminine roles. “Being in a partnership appears to ratchet up the demands or expectations for housework,” Pepin points out.

Married women may feel that to be a good wife, they must prioritize housework and child care ahead of their own leisure and sleep, Pepin suggests. In other research, women have told interviewers that they feel social pressure to provide home-cooked meals, clean clothes, and a well-kept house; these expectations appear to be closely tied to contemporary definitions of appropriate behavior for wives and mothers.

Mothers’ Quality and Quantity of Leisure Time Differ

While never-married and cohabiting mothers reported more leisure time than married and divorced/separated mothers, they were more likely to spend it in sedentary activities, such as watching television, usually alone. Pepin notes this time-use pattern may be partially explained by physically demanding jobs, although more research is needed to be certain. By contrast, married mothers were slightly more likely to report leisure activities that were social and active, such as going out with friends or exercising.

Work Schedules Challenge the Traditional Household Division of Labor

Another study using ATUS time-diary data examined time spent on various types of housework in U.S. heterosexual married-couple families with children.2 Regardless of whether or not they are employed outside the home, women tend to do more traditionally female housework tasks (interior cleaning, laundry, and meal preparation) and men do more traditionally male-typed housework tasks (home maintenance, yard work, and vehicle care).

However, work schedules and time constraints can contribute to nontraditional divisions of housework tasks between parents, report researchers Noelle Chesley of the University of Wisconsin–Milwaukee and Sarah Flood of University of Minnesota–Twin Cities.

They analyzed parents’ housework time and tasks, comparing breadwinner father/at-home mother couples with breadwinner mother/at-home father couples. They drew on ATUS time diary data for 2008 to 2012 from more than 4,500 participants; their analysis controlled for a variety of characteristics including age, education, race, unemployment, income, retirement, disability, and the number and ages of children in the household.

Cooking, Cleaning, and Laundry Comprise the Bulk of Housework Tasks

The way couples divide traditionally female household tasks drives the overall division of housework time because female-typed tasks tend to be done much more frequently (often daily) than male-typed tasks, they find.

Breadwinners spend less time doing housework tasks traditionally linked to their gender on work days. Housework time differences among breadwinner mothers and breadwinner fathers shrink as their daily work hours increase, suggesting that time availability plays a role in reducing gender differences in housework among parents in similar situations.

Women feel socially accountable for the appearance of the household.

“Our comparisons also suggest that at-home parents may do more gender nontraditional household tasks on days their spouses work,” they report.

In breadwinner mother/at-home father couples, differences in housework time depend on whether breadwinner mothers are at work on a given day. On their days off, breadwinner mothers do more housework than at-home fathers, spending as much time doing housework as at-home mothers. By contrast, at-home mothers appear to do more housework daily whether breadwinner fathers are at work or not.

“Among working parents, mothers and fathers likely feel different housework pressures,” the researchers suggest. “Women feel socially accountable for the appearance of the household.”

Earlier research shows that breadwinner mother/at-home father couples engage in a “domestic handoff” on breadwinner mothers’ days off, either as a way for mothers to feel in control or to give the at-home fathers a break, according to the researchers.

They find that breadwinner mother/at-home father couples are frequently economically disadvantaged. The arrangement is often an adaptation to male job loss or job instability rather than a choice made “out of a strong desire to fulfill gender egalitarian ideas.”

This article was produced under a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). The work of researchers from the following NICHD-funded population research centers was highlighted in this article: University of Maryland, University of Minnesota, and University of Texas-Austin.



  1. Joanna R. Pepin, Liana C. Sayer, and Lynne M. Casper, “Marital Status and Mothers’ Time Use: Childcare, Housework, Leisure, and Sleep,” Demography 55, no. 1 (2018): 107-33.
  2. Noelle Chesley and Sarah Flood, “Signs of Change? At-Home and Breadwinner Parents’ Housework and Child-Care Time,” Journal of Marriage and the Family 79, no. 2 (2017): 511-34.
Women walking toward the camera.

Eliminating Smoking and Obesity Could Shrink U.S. Health Disparities, But Where People Live Matters Too

Smoking and obesity are the two leading causes of preventable death, disability, and chronic disease in the United States. New research shows that eliminating them could go a long way in reducing racial health gaps. But location also plays a key role in health disparities, with neighborhood setting and state-level policies shaping residents’ health, this new study and another suggest.1

“We know that, compared to white peers, black men and women enjoy fewer years of life expectancy and healthy life expectancy, which is the number of years individuals can expect to live without disability. Meanwhile, immigrant- and U.S.-born Hispanics live longer than U.S.-born whites, despite their ethnic minority and lower socioeconomic status,” says Michelle Frisco of Penn State University, who conducted the first study with her Penn State colleague Jennifer Van Hook and Robert Hummer of the University of North Carolina, Chapel Hill. Their research was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).

The researchers wanted to explore how obesity and smoking contributed to these differences because both health problems are concentrated in some groups in ways that are likely to produce health disparities. For example, white men and women smoke more than Hispanic immigrants, and black women are more likely to be obese and have a tougher time quitting smoking than white women.

Eliminating Smoking and Obesity Would Reduce the Black-White Health Gap

The research team analyzed data on health and mortality from almost 20,000 U.S.-born white, black, Hispanic, and foreign-born Hispanic men and women from the National Health and Nutrition Examination Survey. They focused on life expectancy and years spent disability-free for each racial or ethnic group. They then simulated how many years each group could expect to live overall and disability-free if no one ever smoked or was obese. Their findings showed some striking reductions in group differences.

“The actual disparity in the life expectancy between white and black women in the U.S. is approximately two years,” Frisco reports. “When we simulated the elimination of smoking and obesity, that gap was reduced to three months. Nearly every significant group difference was reduced to the point that gaps between groups were no longer statistically significant.”

There was one exception: Foreign-born Hispanic men and women retained their nearly three-year life-expectancy advantage over white peers even when the simulation eliminated both obesity and smoking.

“Hispanic immigrants typically have a longer life expectancy than whites to begin with. Eliminating obesity and smoking did not change this,” says Frisco. Not only do Hispanic immigrants smoke less than their U.S.-born peers, they are more likely to eat diets healthier than the typical American diet and live in tight-knit communities with widespread social support. They are also less likely to have substance abuse disorders, according to the researchers. In addition, they report that Hispanics who migrate to the United States tend to be healthier than their counterparts who remain in their country of origin.

Not Just Individual Behavior—Neighborhood Setting Shapes Health

The findings suggest that interventions aimed at preventing obesity and weight gain, reducing smoking, and increasing smoking cessation could be more effective if they’re tailored to specific populations. However, the researchers noted that these programs shouldn’t blame the victim by focusing only on individual behavior.

“We know that the places where people live influence smoking and obesity. For example, segregation leads U.S. black men and women to have elevated risks of long-term smoking and obesity in part because of the ways that tobacco companies disproportionately target minority neighborhoods, as do fast food restaurants and corporations who sell soda. These and other forms of structural racism must be addressed if we want to ensure greater health equity in the U.S.,” Frisco says.

The Disproportionate Health Consequences of State Policies

Some states invest more heavily in the health and well-being of their people, and these investments have “disproportionate consequences” for people with low education and income levels, Mark Hayward of the University of Texas at Austin, Jennifer Montez of Syracuse University, and Anna Zajacova of Western University show in the second study.

American adults with less education tend to report more chronic diseases and disabilities, and die sooner than those with more education, and these disparities have widened in recent decades, according to Hayward.

While more-educated people usually have higher incomes and less physically demanding jobs than less-educated people, the dynamics are more complicated than that, he explains. Blaming lifestyle differences between the two groups neglects the economic and social contexts where people live, he says.


A college education acts as a ‘personal firewall,’ protecting a person wherever they live.


The research team analyzed state-level health data on U.S-born adults ages 45 to 89 in two nationally representative data sets—the National Longitudinal Mortality Study and the American Community Survey. They focused on seven health measures including various functional difficulties, and problems with mobility, vision, hearing, and cognition, as well as overall self-reported health.

They found that the health gap between more- and less-educated people varies widely among states. The size of that gap is mainly related to the health levels of adults with less education.

A college education acts as a “personal firewall,” protecting a person wherever they live, Hayward suggests. “Well-educated persons have better access and support for healthy lifestyles and care, good jobs and rewards, and valuable networks and relationships, and they have sophisticated cognitive skills and a greater sense of control and human agency,” he says. By contrast, less-educated people are more vulnerable to differences in state policies and programs “precisely because they have fewer personal resources and are exposed to greater risks.”

The researchers point to Massachusetts and Mississippi to illustrate the wide differences in state-related policies affecting health. Unlike Massachusetts, Mississippi does not supplement the Earned Income Tax Credit that benefits working poor families, did not expand state Medicaid coverage following the 2010 Affordable Care Act, and has limited cigarette sales taxes.

Policies among the 50 U.S. states began to diverge in the 1970s with devolution—national policy changes that allowed states to opt out of federal programs and gave them more discretion over the services they offered.

Cigarette Taxes Influence Who Smokes

Hayward and colleagues explore excise taxes on cigarettes as an example of state-level policy differences that drive health disparities. Previous research has shown that tobacco control policies such as cigarette excise taxes shape smoking behavior.2

Hayward and colleagues find that smoking prevalence differs widely by state among less-educated people but is similar among those with higher levels of education. They show that state cigarette tax levels influence the prevalence of smoking among less-educated people but have a limited effect on their more-educated peers. Less-educated people tend to smoke less if cigarette taxes are high, while more-educated people have more resources and experience other incentives and disincentives to smoking, they suggest.

The five states with the largest increases in cigarette excise taxes between 1990 and 2014 saw smoking prevalence differences between less- and more-educated adults shrink by two-thirds—from an 11.2 percentage-point gap to a 3.8 percentage-point gap. But the gap nearly doubled in the five states with the smallest increases in state cigarette excise taxes, from a difference of 8.4 percentage points to 16.1 percentage points.

How Can We Close the Health Gap?

The adverse health effects of low education levels are much less evident in states with strong social safety nets and policies that encourage investments in residents’ health and well-being, Hayward reports. “These types of state policies and contextual factors can compensate for the effects of low education on health.”

When social safety nets are weak and investment in the well-being of their populations is low, states can exacerbate the health effects of low education, he suggests.

“States have become a major institutional force affecting incentives and capacities of residents to create healthy lives,” he says. This study on cigarette taxes and health is part of a growing body of research on the impact of state policy differences on health. Earlier studies by Hayward and colleagues show that state policies contribute to state-level differences in premature deaths and disability, particularly among less-educated women.3

This article was produced under a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). The work of researchers from the following NICHD-funded population dynamics research centers was highlighted in this article: Penn State University, University of North Carolina at Chapel Hill, and University of Texas at Austin.



  1. Michelle L. Frisco, Jennifer Van Hook, and Robert A. Hummer, “Would the Elimination of Obesity and Smoking Reduce U.S. Racial/Ethnic/Nativity Disparities in Total and Healthy Life Expectancy?” SSM Population Health 7, no. 1 (2019); and Jennifer Karas Montez, Mark D. Hayward, and Anna Zajacova, “Educational Disparities in Adult Health: U.S. States as Institutional Actors on the Association,” Socius 5, no. 1 (2019): 1-14.
  2. Chloe E. Bird and Patricia P. Rieker, Gender and Health: The Effects of Constrained Choices and Social Policies (New York, Cambridge University Press: 2018).
  3. Mark D. Hayward, Robert A. Hummer, and Isaac Sasson, “Trends and Group Differences in the Association Between Educational Attainment and U.S. Adult Mortality: Implications for Understanding Education’s Causal Influence,” Social Science and Medicine 127, no. 1 (2015): 8-18; Jennifer Karas Montez, Anna Zajacova, and Mark D. Hayward, “Explaining Inequalities in Women’s Mortality Between U.S. States,” SSMPopulation Health 2, no. 1 (2016): 561-71; Jennifer Karas Montez, Anna Zajacova, and Mark D. Hayward, “Disparities in Disability by Educational Attainment Across U.S. States,” American Journal of Public Health 107, no. 1 (2017): 1101-8; Jennifer Karas Montez, Mark D. Hayward, and Douglas A. Wolf, “Do U.S. States’ Socioeconomic and Policy Contexts Shape Adult Disability?” Social Science and Medicine 178, no. 1 (2017): 115-26; and Jennifer Karas Montez, “Deregulation, Devolution, and State Preemption Laws’ Impact on U.S. Mortality Trends,” American Journal of Public Health 107, no. 1 (2017): 1749-50.

Childhood Trauma Has Lifelong Health Consequences for Women

Trauma and adversity in childhood raise the risk of numerous health problems such as diabetes, heart disease, cancer, and mental illness in adulthood.1 Several recent studies found that women who experienced childhood adversity are more likely to have their first child early or outside of marriage and face a higher risk of cancer than men. Lower-income women are particularly vulnerable to health issues related to adverse childhood experiences (ACEs). And of all ACEs, child abuse may affect adult health more directly than any other.

“Childhood adversity creates a chain of risk that has a lifelong impact on health; preventing adversity and promoting resilience among exposed youth should be a public health priority like obesity and high blood pressure,” argues Kristi Williams, an Ohio State University sociology professor affiliated with their Institute for Population Research.

Researchers are still trying to fully explain how experiences in a person’s early years shape their health decades later.

“There’s physical and biological evidence that toxic stress alters brain development affecting health in later life; our research shows that social processes also play a key role,” explains Williams.

Childhood Adversity Linked to Early First Births or First Child Outside of Marriage

Williams and her collaborator, Brian Karl Finch of the University of Southern California, examined several types of ACEs by analyzing 25 years of data from the nationally representative National Longitudinal Study of Youth: 2

  • Emotional neglect.
  • Physical and sexual abuse.
  • Alcohol abuse or mental illness within the household.
  • Parental absence due to divorce/separation or incarceration.
  • Parental death.

They found that that the more ACEs women were exposed to as children, the more likely they were to have an early first birth (before age 25) or a first child outside of marriage, which in turn were strongly related to poorer health by around age 40.

Experiencing childhood adversity is as strongly related to early and unmarried childbearing as is being from a socioeconomically disadvantaged household, the researchers report.


Preventing adversity and promoting resilience among exposed youth should be a public health priority…


Exposure to trauma affects emotional regulation, impulsivity, and ability to form intimate ties, according to Williams. Earlier studies have linked ACEs to risky sexual behavior, adolescent childbearing, and unintended pregnancy. This new study provides evidence on the relationship among ACEs, early and nonmarital childbearing, and health problems in later life.

Williams suggests that programs targeting teenagers with messages about preventing early pregnancy may be “too little, too late.”

“Interventions that promote the so-called ‘success sequence’ of completing high school, securing employment, and waiting until age 21 to marry and have children may be ineffective at reducing poverty and improving the well-being of women and children, if, as our results suggest, ACEs are fundamental precursors to nonmarital and early fertility,” the researchers write.

In Williams’ view, reducing children’s exposure to stress and adversity may be more effective in improving maternal and child health and well-being.

Childhood Adversity Increases Women’s Cancer Risk More Than Men’s

Another recent study shows exposure to childhood adversity is linked to a higher lifetime cancer risk among women—but not among men.3 This study is among several studies supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) that are probing the long-term effects of childhood adversity, offering insights into early-life interventions that could pay health dividends later in life.

Using data from the 2011 Behavioral Risk Factor Surveillance System (BRFSS), a national survey of 112,000 American adults ages 18 and older, researchers examined whether respondents reported any of eight kinds of ACEs and a lifetime cancer diagnosis (excluding skin cancer). Their analysis, which took into consideration smoking and other factors, showed that among women, seven ACEs (physical, sexual, or emotional abuse; or living with someone who was mentally ill, a problem drinker, a drug user, or in a household where adults treated each other violently) were associated with higher cancer risk. For men, only one ACE—emotional abuse—was linked to greater cancer risk. Neither men nor women face increased odds of receiving a cancer diagnosis if they had separated or divorced parents.

The researchers, based at Stony Brook University and the University of California Los Angeles, note that women experience many ACEs at higher rates than men, and sexual abuse can expose them to cancer-causing viruses such as HPV. The researchers point out that women with histories of childhood sexual abuse may avoid cervical cancer screenings, and they recommend making less-invasive options available.

Higher Incomes May Buffer the Health Effects of Early Adversity for Women

Lower-income women appear more vulnerable to the health impact of childhood adversity than higher-income women, another study shows.4 University of Texas at Austin researchers used data on a representative sample of 2,400 California mothers ages 30 and older with young children from the Geographic Research on Wellbeing survey (GROW) conducted in 2012-2013. They examined the relationship between a set of family-related childhood adversities (neglect, hunger, foster care, frequent racial/ethnic discrimination, and parental alcohol/drug abuse, divorce, or incarceration) and important chronic diseases and related conditions (diabetes, hypertension, high cholesterol, and heart disease).

They found that higher levels of childhood adversity increased the odds of reporting one or more chronic diseases after taking into account age, race/ethnicity, marital status, education, and income. Each unit increase in the number of adversities experienced corresponded to about a 10-percent increase in the odds of reporting one or more chronic diseases. Having an income at least twice the poverty level buffered the adult health impacts of childhood adversity.

Their analysis showed diabetes and high cholesterol levels were the main chronic conditions linked to family adversity, potentially pointing to the role of dietary differences that could be addressed. They suggest that these results provide “further evidence of the health-damaging impact of experiencing adversity during childhood,” particularly economic- and family-related adversity.

Policies that expand “living wages, paid family leave, and affordable housing can support families’ economic well-being and stability,” the researchers argue.

High levels of cortisol—the stress hormone—are linked to health problems, but studies show that having stable and supportive caregivers can buffer or prevent elevated cortisol in response to distressing situations. The researchers suggest that “expanding family support services could reduce parental stress and improve parenting skills for socioeconomically disadvantaged families, potentially offsetting” the impacts of family adversity on children’s later health.

The researchers also recommend “evidence-based, trauma-informed interventions” for affected children and their families. These types of interventions are provided by people who are trained to recognize the signs of trauma, understand that children’s misbehavior is often a response to highly stressful situations, and adjust procedures in ways that support the child’s resilience.5

Child Abuse May Take the Heaviest Toll on Health in Later Life

Child abuse may affect adult health more directly than other adversity or family dysfunction.6 Researchers from the University of Texas at Austin and Ohio State University used BRFSS data to explore the relationship among the number and type of ACEs and five health risks—depression, obesity, tobacco use, binge drinking, and self-reported sub-optimal health. Their analysis assessed whether social and economic conditions in adulthood—marriage, divorce and separation, educational attainment, income, and insurance status—affected the relationship between ACEs and health.

Their analysis showed that the health risks related to domestic violence, and parental divorce or incarceration were nearly entirely explained by socioeconomic conditions in adulthood. But they found that child abuse (physical, emotional, and sexual) was strongly associated with several adult health risks, independent of the effects of other adversities, and that socioeconomic conditions in adulthood explained only a small portion of these associations. “These findings suggest that the pathways to poor adult health differ by types of ACEs, and that childhood abuse is more likely than other adversities to have a direct impact,” they report.

The researchers argue that improving the efficacy of states’ child protection systems may reduce the impacts of childhood adversities on adult health because “unlike other adversities children may face, the responsibility and authority of the government to protect children from abuse, and to intervene when abuse has occurred, is explicit.” In addition, they note that in some state statutes, other ACEs can be defined as forms of child neglect, such as exposure to domestic violence or parental substance abuse, which can also trigger intervention.

For those with adverse experiences other than abuse, “interventions focused on improving their socioeconomic opportunities may have a protective effect against depression, tobacco use, obesity, and self-reported sub-optimal health,” they write. Additional interventions they suggest include early learning opportunities and kindergarten readiness to improve school achievement for young children, and dropout prevention and preparedness for the workforce to improve economic opportunities for teens.

The researchers report a link between ACEs and adult relationship difficulties but note that interventions to promote marriage and prevent divorce among adults have had little success. They suggest that intervening earlier may help: “To the extent that childhood adversities can result in insecure attachments and interfere with the formation of healthy relationships throughout the life course, interventions promoting secure attachment in childhood may reduce the risks of divorce and separation in adulthood.”


This article was produced under a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). The work of researchers from the following NICHD-funded population research centers was highlighted in this article: Ohio State University, University of Texas at Austin, and University of California Los Angeles.



[1]  Centers for Disease Control and Prevention, Adverse Childhood Experiences Journal Articles by Topic Area, https://www.cdc.gov/violenceprevention/childabuseandneglect/acestudy/journal.html.

[2]  Kristi Williams and Brian Karl Finch, “Adverse Childhood Experiences, Early and Nonmarital Fertility, and Women’s Health at Midlife,” Journal of Health and Social Behavior 60, no 3 (2019): 1-17.

[3]  Hector Alcalá, A. Janet Tomiyama, and Ondine von Ehrenstein, “Gender Differences in the Association Between Adverse Childhood Experiences and Cancer,” Women’s Health Issues 27, no. 6 (2017): 625-31.

[4]  Catherine Cubbin, Yeonwoo Kim, and Lisa S. Panisch, “Familial Childhood Adversity Is Associated With Chronic Disease Among Women: Data From the Geographic Research on Wellbeing (GROW) Study,” Maternal and Child Health Journal 23, no. 8 (2019): 1117-29.

[5]  Jessica Dym Bartlett and Kathryn Steber, “How to Implement Trauma-Informed Care to Build Resilience to Childhood Trauma,” Child Trends, May 9, 2019, https://www.childtrends.org/publications/how-to-implement-trauma-informed-care-to-build-resilience-to-childhood-trauma.

[6]  Sarah A. Font and Kathryn Maguire-Jack, “Pathways From Childhood Abuse and Other Adversities to Adult Health Risks: The Role of Adult Socioeconomic Conditions,” Child Abuse and Neglect 51, no. 2 (2016): 390-9.

Young adults with arms wrapped around one another, viewed from the back

It’s Nature and Nurture: How Our Genes and Our Friends Shape the Way We Live Our Lives

Scientists have long debated the importance of nature versus nurture—genes versus the environment—in shaping the choices people make and the paths their lives take.

Two decades of research make it increasingly clear that both nature and nurture always play a role—that is, the extent to which genetic factors affect behavior depends on the social environment in which people live, work, and play.

Two recent studies show how individuals’ genes and their social environment interact to influence health and behavior, such as smoking, the friends they choose, and how much education they pursue.

We Are the Company We Keep

A recent article in the Proceedings of the National Academy of Sciences looks at new research on the roles of genes and the environment, focusing on whether an adolescent’s social and school networks had any influence on their height, weight, or educational attainment.1

While researchers found no connection to height or weight, their analysis shows that the genetics of a person’s friends and schoolmates influenced how long they stayed in school, even after accounting for the individual’s genes.

The research team from University of North Carolina at Chapel Hill, Stanford University, Duke University, University of Wisconsin-Madison, Princeton University, and University of Colorado Boulder based their study on data from 5,500 adolescents in the National Longitudinal Study of Adolescent to Adult Health (Add Health), which surveys school populations and asks participants to name their friends.


It’s not just your genes, it’s the cumulative influence of your friends’ and classmates’ genes.


“We show that there is something about the genetic composition of one’s social group that has a positive influence on the individual,” says Jason Boardman of the University of Colorado Boulder, a study author. “It’s not just your genes, it’s the cumulative influence of your friends’ and classmates’ genes.”

According to Boardman, the most likely explanation for why classmates’ genes influence students’ educational attainment is what researchers call “evocative gene-environment correlation.” For example, certain genes increase the likelihood of children having an irritable temperament, which in turn evokes relatively harsh treatment from their parents. “Their genes create the environment to which they are exposed,” he says.

Similarly, says Boardman, teachers may respond positively to certain groups of students because of the way they collectively present themselves in the classroom—perhaps more compliant or more punctual with assignments—and that has an independent influence on all members of the group.

“A group of students may receive better treatment than others because of observable behaviors that have individual genetic origins but take on a social role because they evoke a positive response from the teacher,” he says. And this better treatment may contribute to higher achievement and those students staying in school longer.

Links Among Genes, Smoking, and Staying in School Are Stronger for Gen X and Millennials

A recent American Sociological Review article shows how environmental conditions influence when and how having specific genes may matter.2 A team of researchers finds that the links among genes, educational attainment, and smoking are stronger among Generation X and early Millennials (born 1974 to 1983) than among Baby Boomers and their parents (born 1920 to 1959).

The team from University of Colorado Boulder, University of North Carolina at Chapel Hill, Stanford University, and Harvard University based their research on data from the nationally representative Health and Retirement Study and the Add Health study. They focused on participants of European genetic ancestry because researchers have identified genes linked to smoking and educational attainment in this population.

Earlier research identified sets of genes linked to single behavioral outcomes, including smoking and educational attainment. This study takes that line of research further by examining the relationship among those genes and whether a person smokes and how much education they received, focusing on differences across generations.

Americans with higher levels of education are less likely to smoke. This pattern is more pronounced among more recent generations, the research team finds, suggesting the process is driven by changes in the social environment.

Among the younger generations, “individuals who get more schooling are selected into environments where smoking is no longer acceptable, and therefore, they are less likely to smoke,” they write.


Social environment can shape the extent to which certain genes influence the association between behaviors.


Genes play a role in this changing relationship between education and smoking. People with certain genes linked to higher levels of educational attainment are increasingly less likely to have genes linked to smoking and to be smokers, reports Robbee Wedow of University of Colorado Boulder and the study’s lead author.

Over the past century, U.S. average educational attainment increased, smoking rates declined as the health hazards became well known, and more-educated people tended to smoke less. “The increasing genetic correlation between smoking and education that we found is mediated by increasing education—it reflects the role of increased education during the period,” explains Jason Boardman, a study author.

Their findings suggest that social environment can shape the extent to which certain genes influence the association between behaviors—in this case, the relationship between educational attainment and smoking, he points out.

“Studying human genetics divorced from an understanding of social mechanisms will produce misleading conclusions,” Boardman argues.

Research on the interaction between genes and social environments—called the social genome—holds implications for both genetics and the social sciences. For geneticists, these findings underscore the importance of considering the social context when studying the expression of genetic traits. For social scientists, it provides a more nuanced view of the impact of peers and social networks on individual behavioral choices.

This article was produced under a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). The work of researchers from the following NICHD-funded population research centers was highlighted in this article: Duke University, Princeton University, University of Colorado Boulder, University of North Carolina at Chapel Hill, and University of Wisconsin-Madison.


  1. Benjamin W. Domingue et al., “The Social Genome of Friends and Schoolmates in the National Longitudinal Study of Adolescent to Adult Health,” Proceedings of the National Academy of Sciences 115, no. 4 (2018): 702-707.
  2. Robbee Wedow et al., “Education, Smoking, and Cohort Change: Forwarding a Multidimensional Theory of the Environmental Moderation of Genetic Effects,” American Sociological Review 83, no. 4, (2018): 802-32.

Family Instability in Childhood Affects American Adults’ Economic Mobility

People who did not spend their entire childhoods living in a stable two-parent family face greater chances of downward economic mobility than their peers who did, finds Deirdre Bloome of the University of Michigan.1

Children who experience changes in family living arrangements because of divorce, cohabitation, or remarriage are more likely to “fall down the income ladder” as adults and have a lower income level than their parents.

Children From High-Income, Unstable Families Are at Risk for Low-Income Adulthoods

Overall, Bloome finds that people raised in either stable or unstable families face similar chances of escaping poverty and being upwardly mobile from the bottom of the income distribution (that is, the lowest 20 percent, or fifth, of income earners). But among households at the top of the income distribution, those from unstable families are more likely to be downwardly mobile than their peers raised in stable families.

Her analysis is based on data from 1979 to 2010 for participants in the National Longitudinal Survey of Youth, a national sample of 14- to 22-year-olds followed through adulthood. She grouped participants by childhood family structure, examining their household income level in childhood and at ages 30 to 50.

Bloome’s study finds that people raised outside two-parent families are more likely to end up in the lowest-fifth of income earners, echoing the results of previous research. Specifically, it shows that about 28 percent of children raised outside of two-parent families end up in the lowest fifth of the income distribution as adults, compared with almost 17 percent of those from stable two-parent families.

“Among people from relatively high-income families, those who were raised outside stable two-parent families were less likely to maintain these childhood advantages than those who were raised in stable families,” she says.

The chance of falling into the bottom fifth of the income distribution in adulthood was “particularly high for people experiencing family instability,” Bloome notes. When compared with people raised in stable two-parent families, the chance of those raised in unstable homes having an income in the lowest fifth of the income distribution in adulthood was nearly 50 percent higher for people from the middle fifth of the income distribution and roughly twice as high for those from the top fifth.

Additional Support for Children Raised in Unstable Families Could Change Income Patterns

Bloome’s analysis finds that income mobility between childhood and adulthood is more strongly related to the number of changes in family living arrangements people experience during childhood rather than to the number of years they spend living in a two-parent household.

She also finds that people who grew up in unstable families are less likely to have stable adult marriages, which may contribute to their downward economic mobility.

Because the share of children born to parents who are unmarried or cohabiting at the time of their birth is increasing—and family instability is high for these children—the risk of downward mobility that widens inequality is likely to rise, she points out.

Providing additional support for children raised outside stable two-parent homes could change these income patterns and address inequality, Bloome argues. “Increased availability of preschool programs, affordable higher education, paid parental leave, and flexible work arrangements could provide opportunities for all children to receive the support that children from stable two-parent homes are more likely to receive,” she suggests.



1. Deirdre Bloome, “Childhood Family Structure and Intergenerational Income Mobility in the United States,” Demography 54, no. 2 (2017): 541-69.