Variable military service-related experiences, such as combat exposure, psychiatric disorders (PD... more Variable military service-related experiences, such as combat exposure, psychiatric disorders (PD), and traumatic brain injuries (TBI), may differentially affect the likelihood of having health care professional-identified high blood pressure (i.e., hypertension). PURPOSE: Compare the odds of self-reported hypertension among non-combat and combat veterans with and without PD/TBI to non-veterans and each other. METHODS: We used data from men from the 2011 Behavioral Risk Factor Surveillance System and distinguished: non-veterans (n = 21,076); non-combat veterans with no PD/TBI (n = 3,150); combat veterans with no PD/TBI (n = 1,979); and veterans (combat and non-combat) with PD and/or TBI (n = 805). Multivariable, hierarchical logistic regression models included exogenous demographic, socioeconomic attainment and family structure, health behavior and conditions, and methodological control variables. RESULTS: One-third of men reported having been told at least once by a medical professional that they had high blood pressure. Bivariate analyses indicated that each veteran group had a higher prevalence of self-reported hypertension than non-veterans (design-based F = 45.2, p<0.001). In the fully adjusted model, no statistically significant differences in the odds of self-reported hypertension were observed between non-veterans and: non-combat veterans without PD/TBI (odds ratio [OR] = 0.92); combat veterans without PD/TBI (OR = 0.87); veterans with PD and/or TBI (OR = 1.35). However, veterans with PD and/or TBI had greater odds of reporting hypertension than both combat and non-combat veterans without PD/TBI (p<0.05). DISCUSSION: Military service-related experiences were differentially associated with a survey-based measure of hypertension. Specifically, veterans self-reporting PD and/or TBI had significantly higher odds of self-reporting hypertension (i.e., medical provider-identified high blood pressure).
Originality/Value: Few medical sociologists have focused on transgender embodiment. Findings enha... more Originality/Value: Few medical sociologists have focused on transgender embodiment. Findings enhance our understanding of how transgender embodiment and minority stress processes influence access to needed SSCS.
The Social Science of Same-Sex Marriage: LGBT People and Their Relationships in the Era of Marriage Equality, 2022
Marriages involving transgender individuals are heterogeneous and complex. What appears from the ... more Marriages involving transgender individuals are heterogeneous and complex. What appears from the perspective of an observer – be that family, friends, researchers, or the state – to be a same-sex marriage might or might not be considered one from the perspective of the participants. Moreover, a marriage may change from being a different-sex marriage to a same-sex marriage, or vice versa, as it endures over time and through the gender transition of one or both of its members. In this chapter, we draw on narrative data from a qualitative, in-depth interview study involving a diverse sample of 39 adults who identified with the term “transgender” and were living in a gender different from their sex assigned at birth. We focus primarily on the stories of the eleven currently married participants and present illustrative examples. We develop our analysis with reference to the life-course perspective because its five principles – linked lives, agency, lives in time and place, life-long development, and timing and sequencing – are useful conceptual lenses through which to focus an analysis of gender transition, legal sex designation, and sexuality in relation to same-sex marriage. Our results elucidate the personal, social, and cultural salience of marriage in the lives of transgender persons, and the ways that the lived experiences of married transgender individuals can complicate conceptualizations of “same-sex” and “different-sex” marriage.
ABSTRACT Researchers have made significant efforts to combine quantitative and qualitative method... more ABSTRACT Researchers have made significant efforts to combine quantitative and qualitative methods in welfare reform policy research in the United States. This paper draws on several examples arising from the American experience to argue that mixed-methods research (particularly, but not exclusively, with integrated sampling, data collection, and data analysis) can yield important and unexpected insights that neither method alone could generate. We caution that each method has strengths and weaknesses that must be borne in mind so as not to oversell the promise of mixed-methods research.
A multiple causes perspective contends that economic development and poor health contributed to e... more A multiple causes perspective contends that economic development and poor health contributed to early 20th-century southern race-related differences in fertility. The authors link the 1910 IPUMS to the 1916 Plantation Census (1909 data), southern disease (malaria and hookworm), and sanitation indicators to examine fertility differentials, while accounting for child mortality (an endogenous demographic control). They find that African-American and white women in counties with higher malaria mortality had higher child mortality. Additionally, African-American women exposed to poorer sanitation and plantation development had higher child mortality. Consistent with a multiple causes perspective, white women’s fertility was lower where land improvement and school enrollment were higher. African-American women’s fertility was lower in health-place contexts of higher malaria mortality and greater plantation development.
To examine whether having a parent and/or a sibling currently serving in the military is associat... more To examine whether having a parent and/or a sibling currently serving in the military is associated with major depression and use of mental health services among 12-17 year old adolescents in the United States. Method: Descriptive and multivariate logistic regression analyses are conducted using pooled data from the 2016-2019 National Survey of Drug Use and Health (NSDUH). Analyses are weighted and standard errors are adjusted for the complex sampling design. Results: Adolescents are more likely to have a sibling than a parent currently serving in the military. Having a sibling currently in the military increases the likelihood of having a lifetime and a past-year major depressive episode (MDE), but not a past-year MDE with severe role impairment or use of mental health services. Having a parent in the military is not associated with any measure of MDE, but increases use of specialty outpatient, specialty inpatient/residential, and non-specialty mental health services net of MDE and sociodemographic controls. Conclusion: Considerable attention has focused on risk and resilience among the dependent children of current service members. A better understanding of how the current military service experiences of siblings, as well as parents, influences related adolescents' mental health, mental health care service use, substance use, and health behaviors has the potential to contribute to programs and interventions that can enhance the well-being of youth with intra-generational, as well as intergenerational, connections to the military. Adolescents who have a sibling currently serving in the military are an at-risk population for MDE and potentially other mental and behavioral health problems.
Although the military has enduring effects on the lives of service members and their families, it... more Although the military has enduring effects on the lives of service members and their families, it is often overlooked as an institutional force that shapes the life course. This chapter aims to bring military service to the attention of life-course scholars by: providing a conceptual model for understanding the impact of military service on lives that builds on the core principles of the life-course perspective; reviewing empirical evidence regarding how military service is related to childhood and adolescence, influences the transition to adulthood, and has long-term consequences for various outcomes in mid-to-late life; and identifying methodological challenges and relatively unexplored questions that should be the focus of future inquiry. In doing so, this chapter facilitates an understanding of military service in lives while also underscoring the role of social institutions in shaping the life course.
Vascular aging, which is associated with cardiovascular disease risk and mortality, is characteri... more Vascular aging, which is associated with cardiovascular disease risk and mortality, is characterized by increasing arterial stiffness. The gold standard method for the assessment of arterial stiffness is carotid-femoral Pulse Wave Velocity (cfPWV). An emerging body of research suggests that cfPWV can be reasonably estimated from two commonly measured clinical variables—age and blood pressure. Thus, estimated Pulse Wave Velocity (ePWV) holds promise as a novel and easily obtained measure of arterial stiffness that can be used to study vascular aging, particularly with nationally representative datasets that collect biomarker data on sufficiently large sample sizes to examine race/ethnic differences. This analysis uses data from the 2006-2016 Health and Retirement Study to examine race/ethnic variation in the relationship between ePWV and mortality risk. We estimate logistic regression models predicting mortality over an eight-year period for four racial/ethnic groups: White, Black, O...
Military suicide prevention efforts would benefit from population-based research documenting patt... more Military suicide prevention efforts would benefit from population-based research documenting patterns in risk factors among service members who die from suicide. We use latent class analysis to analyze patterns in identified risk factors among the population of 2660 active-duty military service members that the Department of Defense Suicide Event Report (DoDSER) system indicates died by suicide between 2008 and 2017. The largest of five empirically derived latent classes was primarily characterized by the dissolution of an intimate relationship in the past year. Relationship dissolution was common in the other four latent classes, but those classes were also characterized by job, administrative, or legal problems, or mental health factors. Distinct demographic and military-status differences were apparent across the latent classes. Results point to the need to increase awareness among mental health service providers and others that suicide among military service members often involv...
Veterans have the opportunity to accrue health-promoting “military capital,” but they are also at... more Veterans have the opportunity to accrue health-promoting “military capital,” but they are also at risk of experiencing a “military hazard” effect that undermines later-life health and mortality outcomes. Given these possibly competing effects, there is substantial heterogeneity in physical and mental health among older male veterans. The health and mortality outcomes of older veterans who were not substantially harmed during military service appear to be just as good as, if not better than, those of nonveterans. However, older veterans who served in-theater, were exposed to combat or hazardous chemicals, and/or were physically or psychologically harmed during service tend to have worse health and higher mortality than non¬veterans. Some older veterans with these experiences struggle with life-long or late-onset PTSD, while others exhibit resilience and posttraumatic growth. Additional population-level, life-course research is needed on specific war-era cohorts to identify the mechan...
The military is described as a social context that contributes to the (re-)initiation or intensif... more The military is described as a social context that contributes to the (re-)initiation or intensification of cigarette smoking. We draw on data from the 1985-2014 National Survey of Drug Use and Health (NSDUH) and the Wisconsin Longitudinal Study (WLS) to conduct complementary sub-studies of the influence of military service on men’s smoking outcomes across the life course. Descriptive findings from an age–period–cohort analysis of NSDUH data document higher probabilities of current smoking and heavy smoking among veteran men across a broad range of cohorts and at all observed ages. Findings from sibling fixed-effects Poisson models estimated on the WLS data document longer durations of smoking among men who served in the military and no evidence that selection explains the observed relationship. Together, these results provide novel and potentially generalizable evidence that participation in the military in early adulthood exerts a causal influence on smoking across the life course.
Background Carotid-femoral pulse wave velocity (cfPWV), the referent measure of aortic stiffness,... more Background Carotid-femoral pulse wave velocity (cfPWV), the referent measure of aortic stiffness, is an established measure of vascular aging. In studies where cfPWV cannot be measured, alternative methods are needed to help promote research on vascular aging. This study examines the construct validity of a measure of PWV estimated from age and blood pressure (ePWV). The specific aims of the study are to: 1) explore the strength of association between ePWV, cfPWV, and other established measures of vascular aging; 2) examine the sensitivity and specificity of elevated ePWV (>=10m/s) in relation to elevated cfPWV (>=10m/s).
Variable military service-related experiences, such as combat exposure, psychiatric disorders (PD... more Variable military service-related experiences, such as combat exposure, psychiatric disorders (PD), and traumatic brain injuries (TBI), may differentially affect the likelihood of having health care professional-identified high blood pressure (i.e., hypertension). PURPOSE: Compare the odds of self-reported hypertension among non-combat and combat veterans with and without PD/TBI to non-veterans and each other. METHODS: We used data from men from the 2011 Behavioral Risk Factor Surveillance System and distinguished: non-veterans (n = 21,076); non-combat veterans with no PD/TBI (n = 3,150); combat veterans with no PD/TBI (n = 1,979); and veterans (combat and non-combat) with PD and/or TBI (n = 805). Multivariable, hierarchical logistic regression models included exogenous demographic, socioeconomic attainment and family structure, health behavior and conditions, and methodological control variables. RESULTS: One-third of men reported having been told at least once by a medical professional that they had high blood pressure. Bivariate analyses indicated that each veteran group had a higher prevalence of self-reported hypertension than non-veterans (design-based F = 45.2, p<0.001). In the fully adjusted model, no statistically significant differences in the odds of self-reported hypertension were observed between non-veterans and: non-combat veterans without PD/TBI (odds ratio [OR] = 0.92); combat veterans without PD/TBI (OR = 0.87); veterans with PD and/or TBI (OR = 1.35). However, veterans with PD and/or TBI had greater odds of reporting hypertension than both combat and non-combat veterans without PD/TBI (p<0.05). DISCUSSION: Military service-related experiences were differentially associated with a survey-based measure of hypertension. Specifically, veterans self-reporting PD and/or TBI had significantly higher odds of self-reporting hypertension (i.e., medical provider-identified high blood pressure).
Originality/Value: Few medical sociologists have focused on transgender embodiment. Findings enha... more Originality/Value: Few medical sociologists have focused on transgender embodiment. Findings enhance our understanding of how transgender embodiment and minority stress processes influence access to needed SSCS.
The Social Science of Same-Sex Marriage: LGBT People and Their Relationships in the Era of Marriage Equality, 2022
Marriages involving transgender individuals are heterogeneous and complex. What appears from the ... more Marriages involving transgender individuals are heterogeneous and complex. What appears from the perspective of an observer – be that family, friends, researchers, or the state – to be a same-sex marriage might or might not be considered one from the perspective of the participants. Moreover, a marriage may change from being a different-sex marriage to a same-sex marriage, or vice versa, as it endures over time and through the gender transition of one or both of its members. In this chapter, we draw on narrative data from a qualitative, in-depth interview study involving a diverse sample of 39 adults who identified with the term “transgender” and were living in a gender different from their sex assigned at birth. We focus primarily on the stories of the eleven currently married participants and present illustrative examples. We develop our analysis with reference to the life-course perspective because its five principles – linked lives, agency, lives in time and place, life-long development, and timing and sequencing – are useful conceptual lenses through which to focus an analysis of gender transition, legal sex designation, and sexuality in relation to same-sex marriage. Our results elucidate the personal, social, and cultural salience of marriage in the lives of transgender persons, and the ways that the lived experiences of married transgender individuals can complicate conceptualizations of “same-sex” and “different-sex” marriage.
ABSTRACT Researchers have made significant efforts to combine quantitative and qualitative method... more ABSTRACT Researchers have made significant efforts to combine quantitative and qualitative methods in welfare reform policy research in the United States. This paper draws on several examples arising from the American experience to argue that mixed-methods research (particularly, but not exclusively, with integrated sampling, data collection, and data analysis) can yield important and unexpected insights that neither method alone could generate. We caution that each method has strengths and weaknesses that must be borne in mind so as not to oversell the promise of mixed-methods research.
A multiple causes perspective contends that economic development and poor health contributed to e... more A multiple causes perspective contends that economic development and poor health contributed to early 20th-century southern race-related differences in fertility. The authors link the 1910 IPUMS to the 1916 Plantation Census (1909 data), southern disease (malaria and hookworm), and sanitation indicators to examine fertility differentials, while accounting for child mortality (an endogenous demographic control). They find that African-American and white women in counties with higher malaria mortality had higher child mortality. Additionally, African-American women exposed to poorer sanitation and plantation development had higher child mortality. Consistent with a multiple causes perspective, white women’s fertility was lower where land improvement and school enrollment were higher. African-American women’s fertility was lower in health-place contexts of higher malaria mortality and greater plantation development.
To examine whether having a parent and/or a sibling currently serving in the military is associat... more To examine whether having a parent and/or a sibling currently serving in the military is associated with major depression and use of mental health services among 12-17 year old adolescents in the United States. Method: Descriptive and multivariate logistic regression analyses are conducted using pooled data from the 2016-2019 National Survey of Drug Use and Health (NSDUH). Analyses are weighted and standard errors are adjusted for the complex sampling design. Results: Adolescents are more likely to have a sibling than a parent currently serving in the military. Having a sibling currently in the military increases the likelihood of having a lifetime and a past-year major depressive episode (MDE), but not a past-year MDE with severe role impairment or use of mental health services. Having a parent in the military is not associated with any measure of MDE, but increases use of specialty outpatient, specialty inpatient/residential, and non-specialty mental health services net of MDE and sociodemographic controls. Conclusion: Considerable attention has focused on risk and resilience among the dependent children of current service members. A better understanding of how the current military service experiences of siblings, as well as parents, influences related adolescents' mental health, mental health care service use, substance use, and health behaviors has the potential to contribute to programs and interventions that can enhance the well-being of youth with intra-generational, as well as intergenerational, connections to the military. Adolescents who have a sibling currently serving in the military are an at-risk population for MDE and potentially other mental and behavioral health problems.
Although the military has enduring effects on the lives of service members and their families, it... more Although the military has enduring effects on the lives of service members and their families, it is often overlooked as an institutional force that shapes the life course. This chapter aims to bring military service to the attention of life-course scholars by: providing a conceptual model for understanding the impact of military service on lives that builds on the core principles of the life-course perspective; reviewing empirical evidence regarding how military service is related to childhood and adolescence, influences the transition to adulthood, and has long-term consequences for various outcomes in mid-to-late life; and identifying methodological challenges and relatively unexplored questions that should be the focus of future inquiry. In doing so, this chapter facilitates an understanding of military service in lives while also underscoring the role of social institutions in shaping the life course.
Vascular aging, which is associated with cardiovascular disease risk and mortality, is characteri... more Vascular aging, which is associated with cardiovascular disease risk and mortality, is characterized by increasing arterial stiffness. The gold standard method for the assessment of arterial stiffness is carotid-femoral Pulse Wave Velocity (cfPWV). An emerging body of research suggests that cfPWV can be reasonably estimated from two commonly measured clinical variables—age and blood pressure. Thus, estimated Pulse Wave Velocity (ePWV) holds promise as a novel and easily obtained measure of arterial stiffness that can be used to study vascular aging, particularly with nationally representative datasets that collect biomarker data on sufficiently large sample sizes to examine race/ethnic differences. This analysis uses data from the 2006-2016 Health and Retirement Study to examine race/ethnic variation in the relationship between ePWV and mortality risk. We estimate logistic regression models predicting mortality over an eight-year period for four racial/ethnic groups: White, Black, O...
Military suicide prevention efforts would benefit from population-based research documenting patt... more Military suicide prevention efforts would benefit from population-based research documenting patterns in risk factors among service members who die from suicide. We use latent class analysis to analyze patterns in identified risk factors among the population of 2660 active-duty military service members that the Department of Defense Suicide Event Report (DoDSER) system indicates died by suicide between 2008 and 2017. The largest of five empirically derived latent classes was primarily characterized by the dissolution of an intimate relationship in the past year. Relationship dissolution was common in the other four latent classes, but those classes were also characterized by job, administrative, or legal problems, or mental health factors. Distinct demographic and military-status differences were apparent across the latent classes. Results point to the need to increase awareness among mental health service providers and others that suicide among military service members often involv...
Veterans have the opportunity to accrue health-promoting “military capital,” but they are also at... more Veterans have the opportunity to accrue health-promoting “military capital,” but they are also at risk of experiencing a “military hazard” effect that undermines later-life health and mortality outcomes. Given these possibly competing effects, there is substantial heterogeneity in physical and mental health among older male veterans. The health and mortality outcomes of older veterans who were not substantially harmed during military service appear to be just as good as, if not better than, those of nonveterans. However, older veterans who served in-theater, were exposed to combat or hazardous chemicals, and/or were physically or psychologically harmed during service tend to have worse health and higher mortality than non¬veterans. Some older veterans with these experiences struggle with life-long or late-onset PTSD, while others exhibit resilience and posttraumatic growth. Additional population-level, life-course research is needed on specific war-era cohorts to identify the mechan...
The military is described as a social context that contributes to the (re-)initiation or intensif... more The military is described as a social context that contributes to the (re-)initiation or intensification of cigarette smoking. We draw on data from the 1985-2014 National Survey of Drug Use and Health (NSDUH) and the Wisconsin Longitudinal Study (WLS) to conduct complementary sub-studies of the influence of military service on men’s smoking outcomes across the life course. Descriptive findings from an age–period–cohort analysis of NSDUH data document higher probabilities of current smoking and heavy smoking among veteran men across a broad range of cohorts and at all observed ages. Findings from sibling fixed-effects Poisson models estimated on the WLS data document longer durations of smoking among men who served in the military and no evidence that selection explains the observed relationship. Together, these results provide novel and potentially generalizable evidence that participation in the military in early adulthood exerts a causal influence on smoking across the life course.
Background Carotid-femoral pulse wave velocity (cfPWV), the referent measure of aortic stiffness,... more Background Carotid-femoral pulse wave velocity (cfPWV), the referent measure of aortic stiffness, is an established measure of vascular aging. In studies where cfPWV cannot be measured, alternative methods are needed to help promote research on vascular aging. This study examines the construct validity of a measure of PWV estimated from age and blood pressure (ePWV). The specific aims of the study are to: 1) explore the strength of association between ePWV, cfPWV, and other established measures of vascular aging; 2) examine the sensitivity and specificity of elevated ePWV (>=10m/s) in relation to elevated cfPWV (>=10m/s).
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Papers by Andrew S. London