Browsing by Subject "Health expectancy"
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Item A cross-national comparison of health expectancy : Japan, the United States and Taiwan(2013-08) Chiu, Chi-Tsun; Hayward, Mark D.Japan is the longest lived population in the world and has led the world in low mortality for over two decades. The United States, although its GDP exceeds all other countries, has a life expectancy that falls substantially below most other western countries. Taiwan, although it has an emerging economy with rapid aging population, has a life expectancy approaching that of the United States. Previous studies have investigated multiple domains of physical health for elderly Japanese, American, and Taiwanese, but very few studies have compared mortality across these countries and even fewer have examined how mortality and morbidity intersect differently across the countries to influence differences in healthy life expectancy. This dissertation is aimed at filling this gap. Based on studies in the United States and other Western countries, education is increasingly characterized as a "fundamental cause" of health -- with more years of educational attainment associated with better health. Although the association is robust for a variety of health measures and mortality in the United States and other Western countries, studies in East Asia report more modest associations or no associations. Thus, whether the association extends beyond the Western context is less clear. In my dissertation, I investigate these issues in detail. In the United States, the more-educated enjoy longer life expectancy and a compression of mortality comparing with their less-educated counterpart. Here, data from Taiwan and Japan are used to assess whether education has similar consequences in two important non-Western settings. In sum, the findings reveal that: (1) older Japanese people not only have the highest total life expectancy but also have the highest absolute healthy life expectancy in each gender group, (2) older American and Taiwanese people have similar total life expectancy in each gender group, but they have very different health profiles, (3) educational gradients on mortality/health differ across gender and country groups, and (4) within a population, having more education helps maximize lifespan, changes and delays the biological aging process in the different contexts. Overall, the results underscore the importance of international perspective in explicating health disparities, especially educational differentials in health.Item The social consequences of the fall of Communism : a sociological analysis of the health crisis in Eastern Europe(2013-05) Minagawa, Yuka; Hummer, Robert A.Sociological interest in the relationship between the social structure and health began with the classic work of Durkheim, who first identified socially constructed patterns of suicide rates in Western European countries. Drawing on this structural tradition, a large literature has investigated how health is influenced and shaped by societal factors. Despite a great deal of research on the social causation of health, however, the potentially adverse effects of social structures have been rarely studied. If people's health is linked to broader social conditions, then it follows that health is also subject to societal disruption, especially in the wake of the breakdown or failure of the existing social structure. This dissertation advances our understanding of the relationship between the social structure and health at the population level, focusing on post-communist Eastern Europe as a case study. There are three interrelated goals in this dissertation: first, to elucidate differences in health and mortality outcomes between East Central Europe and the former Soviet Union; second, to numerically substantiate the association between drastic social change and the risk of death due to suicide; and third, to reveal the structural factors related to overall population health status in Eastern Europe. Using aggregate-level data for Eastern European countries for the post-communist period, I find that (1) there are growing inequalities in life expectancy and infant mortality between East Central Europe and the former Soviet Union, and mechanisms associated with disparities vary by gender and age; (2) consistent with Durkheim's theory of suicide, drastic structural change is related to increased suicide death rates for the period immediately after the collapse of communism; and (3) the malfunctioning of the social structure is inversely associated with the health status of populations. Taken together, fully understanding the health consequences of communism's fall in Eastern Europe requires research that looks beyond individual-level risk factors to incorporate the broader characteristics of the social structure in which populations are embedded.