Question

Health Behaviors

Based on ar0cle by Krueger and Chang 2008 AJPH

Ar0cle Outline

• This is an empirical research ar0cle that follows a rela0vely standard outline

• – Literature review: background info on what is already known about the topic from previous studies and/or theory

• – Data and methods: detailed descrip0on of how the authors did the study

• – Results: the findings of the study

• – Conclusion/Discussion: where the authors recap the main findings and put them into the context of the literature review, discuss study limita0ons, suggest direc0ons for future research, and offer implica0ons

Overview

• The authors set out to study the link between perceived stress and risk of death (mortality), with a focus on whether harmful health behaviors are the mechanism linking stress with mortality risk.

– They use data represen0ng the popula0on of the U.S.

– They break down data to look at different SES groups

Background

• • Perceived stress can lead to unhealthy behaviors in an aTempt to relieve or cope with stress

• • Higher levels of perceived stress are associated with higher risk of death

• • Unhealthy behaviors, like smoking and physical inac0vity, are associated with increased risk of death

• • Research ques0on: Does the effect of unhealthy behaviors exacerbate the effect of stress on mortality? If so, does it do this differently by SES?

Theore0cal Background

• • Double jeopardy hypothesis: when mul0ple factors combined are more harmful than any one risk factor

• • Blaxter hypothesis: the effects of health behaviors is not as important for low SES people because so many other social and environmental factors maTer more for their mortality risk.

Data and Methods

• The researchers use na0onally representa0ve survey data from 1990 that was linked to death records

• – This allows them to examine the survey responses of those who hadn’t died within their study 0me frame compared to those who did die within the 0me frame.

• – A na0onally representa0ve and very large sample allows the researchers to use sta0s0cal analysis and draw conclusions about the U.S. popula0on as a whole

Perceived Stress and Health Behaviors

• On page 890, the authors describe the survey ques0ons that asked people about stress:

“We used 2 ques0ons to assess perceived stress. The first asked, ‘During the past 2 weeks, would you say that you experienced a lot of stress, a moderate amount of stress, rela0vely liTle stress, or almost no stress at all?’ The second ques0on asked about the ‘past year’ rather than the ‘past 2 weeks.’ Par0cipants responded on a scale ranging from 1 to 4.”

• They look at 3 health behaviors:
– CigareTe smoking (current, former, never)

– Number of alcoholic drinks (in a day of drinking)

– Physical inac0vity (based on 3 ques0ons about exercise)

Research Findings
• Findings support double jeopardy hypothesis

– unhealthy behaviors exacerbate the effect of stress on mortality

• Findings are contrary to the Blaxter hypothesis – Low SES people are most harmed by combina0on

of high perceived stress and unhealthy behaviors

– Unhealthy behaviors did not significantly exacerbate the effects of stress on mortality for middle SES and high SES Americans.

Implica0ons

• The authors succinctly state public health implica0ons on page 894:

“stress, unhealthy behaviors (especially former smoking and physical inac0vity), and low SES combine to increase mortality and to form a truly disadvantaged segment of the popula0on.”

Questions

1. Krueger and Chang's research shows that unhealthy behaviors exacerbate the effects of stress on mortality regardless of SES.

True

False

2. Which of the following are based on evidence reviewed by Krueger and Chang?

A.		unhealthy behaviors are associated with higher mortality risk
B.		none of these
C.		both of these
D.		higher perceived stress is associated with higher mortality risk

3. Which of the following statements accurately reflects Krueger's and Chang's research findings? (choose all that apply) more then one answer

		A. unhealthy behaviors tend to exacerbate the effects of stress on mortality, especially for high SES people
		B.the findings support the "double jeopardy" hypothesis
		C. unhealthy behaviors tend to exacerbate the effects of stress on mortality, especially for middle SES people
		D. unhealthy behaviors tend to exacerbate the effects of stress on mortality, especially for low SES people
		E. unhealthy behaviors do not significantly increase the effects of stress on mortality for middle and high SES people
		F.the findings support the "Blaxter hypothesis"

4. Krueger and Chang used survey data to find out who was dead.

True

False

5. The "Blaxter hypothesis" suggests that unhealthy behaviors should not be as consequential for the mortality risk of low SES people because of the many other sources of disadvantage that they face.

True

False

Answer 1

1. Krueger and Chang's research shows that unhealthy behaviors exacerbate the effects of stress on mortality regardless of SES.

Ans:- True.

2. Which of the following are based on evidence reviewed by Krueger and Chang?

Ans:- Both of these.

3. Which of the following statements accurately reflects Krueger's and Chang's research findings?

Ans:

"A" .the findings support the "double jeopardy" hypothesis "B" unhealthy behaviors tend to exacerbate the effects of stress on mortality, especially for low SES people

4. Krueger and Chang used survey data to find out who was dead.

Ans:- True

5. The "Blaxter hypothesis" suggests that unhealthy behaviors should not be as consequential for the mortality risk of low SES people because of the many other sources of disadvantage that they face.

Ans:- True