The Loved Ones Left Behind: Examining the Health Implications of Bereavement

PROJECT SUMMARY Although experiencing death within a family or network powerfully shapes survivors’ health, we know little about how network death contributes to health differences between population groups. The objective of the proposed study is to quantify familial and household exposure to deaths and their relationship to differences between population groups in psychological distress and all-cause mortality. My specific aims are to: 1) Quantify the prevalence of and differences between population groups in network mortality from nuclear family, extended family, and household members by lifecourse stage and SES, exploring differences before and during distinct historical periods; 2) identify key perceived mechanisms through which exposure to death may impact the SES–health feedback loop throughout the lifecourse and intergenerationally using semi-structured interviews; and 3a) estimate the contribution of exposure to premature and cumulative deaths to differences between population groups in psychological distress, and to all-cause mortality; and 3b) determine the extent to which SES mediates the relationship of network mortality with psychological distress and all-cause mortality. To do this, I will analyze data from the Panel Study of Income Dynamics (PSID) and conduct semi-structured interviews. This project is innovative in its focus on examining death from broader social network ties including extended kin and household members as well as how network deaths can initiate a cascade of SES consequences that contribute to adverse health for survivors. This K01 project will enhance my prior sociological and demographic training with additional training in: 1) social epidemiology; 2) network analysis, survival analysis, and structural equation modeling; 3) qualitative and mixed methods; and 4) use of PSID data. My access to excellent resources and mentoring at Emory University is supplemented with affiliations at Harvard University and the University of Michigan. Study findings will provide an evidence base for efforts to reform bereavement and family leave policies that do not account for the collateral health effects of individuals embedded in networks beyond the traditional nuclear family. The K01 will facilitate my transition to a scientific leader advancing policy-relevant research to address health differences between population groups.