Health and Well-Being after Large Scale Shocks

? DESCRIPTION (provided by applicant): This research training project will address three major questions in contemporary research on health and well- being: (1) how do social exposures manifest in physiological processes leading to disease, disability, and death? (2) Which characteristics predispose individuals to faster or slower rates of decline in health over the life course? (3) What coping strategies are most effective at preventing declines in health (resilience) or aid in improvements in health status following health insults (recovery)? Identification of causal effects is a key challenge in the health and mortality literature. Without appropriate data and credible means of identifying causal effects, it is not clear how to interpret associations between exposures and health. There has been explosive growth in the extent and depth of biological information (biomarkers providing quantified measures of physiological states) collected in large scale population surveys. The richness of these data are unlikely to be fully exploited without greater integration of psychosocial and biological mechanisms in models of population processes that describe biologically plausible causal pathways. This project is designed to contribute to filling this gap by providing the candidate, a demographer and sociologist, with the necessary skills and experience to significantly advance population health research. First, she will complete training in the biological foundations of health that will complement her training in demography. Second, she will complete formal training in causal analysis with particular reference to population health in developing countries. Third, she will obtain hands-on training and experience in the collection and use of biomarkers in health research in a low income setting. The proposed research project will examine the health impacts of three large scale events: the 1997 Asian financial crisis in Indonesia, the 2004 Indian Ocean tsunami in Indonesia, and the post 2006 rise in violent crime in Mexico. These analyses will draw on three unique, population-representative longitudinal surveys fielded in Indonesia (IFLS and STAR) and Mexico (MxFLS) which include a rich set of biological and psychosocial health measures and collect information prior to and following these events. Using these datasets and methods of causal analysis, the candidate will examine how exposure to these arguably exogenous events affects health and well-being in the short-, medium-, and long-term; identify individual, household, and community characteristics predicting resilience and recovery from these events; and evaluate whether the type of exposure experienced during the event (e.g., loss of family members vs. loss of housing vs. loss of other assets) offers insight into the specific mechanisms through which these exposures impact health. An innovative component of this project involves the candidate undertaking a new data collection effort collecting new social isolation and biomarker measures in Indonesia specifically designed for this research project. Analyses of these data will enrich understanding of the interplay between biological and psychosocial health.