This article advances the field by integrating insights from intersectionality perspectives with the emerging literatures on structural racism and structural sexism—which point to promising new ways to measure systems of inequality at a macro level—to introduce a structural intersectionality approach to population health. We demonstrate an application of structural intersectionality using administrative data representing macrolevel structural racism, structural sexism, and income inequality in U.S. states linked to individual data from the Behavioral Risk Factor Surveillance System to estimate multilevel models (N = 420,644 individuals nested in 76 state-years) investigating how intersecting dimensions of structural oppression shape health. Analyses show that these structural inequalities: (1) vary considerably across U.S. states, (2) intersect in numerous ways but do not strongly or positively covary, (3) individually and jointly shape health, and (4) are most consistently associated with poor health for black women. We conclude by outlining an agenda for future research on structural intersectionality and health.
Our study suggests that having high levels of resilience prior to spousal loss may help offset persistent depressive symptoms, especially for men. Implications for future research and clinical practice are discussed.
Objectives Increased loneliness is a common consequence of widowhood in later life. However, individuals with high levels of perceived social support from friends tend to cope more effectively following major social losses like widowhood. Military service is associated with cultivation of strong social support structures. This effect may not only influence those who serve, but also their spouses. Roughly half of older women today are married to veterans, which could shape how they cope with widowhood. We tested two hypotheses: (a) widows of veterans will be less lonely following widowhood compared to their nonveteran counterparts, and (b) this effect will be explained by perceived social support from friends. Methods We used the Health and Retirement Study (HRS) to examine changes in loneliness following widowhood among wives of veterans and nonveterans. We used Ordinary Least Squares regression and mediation tests to address our hypotheses. Results Net of baseline differences, widows of veterans reported statistically lower levels of loneliness (p < .05) following widowhood compared to widows of nonveterans. Widows of veterans retained the same level of perceived social support from friends pre- and postwidowhood, whereas nonveteran wives experienced a loss. Perceived social support from friends mediated the association between veteran status of the deceased spouse and loneliness. Discussion Our findings suggest wives of veterans may have more resilient social support structures than nonveteran spouses, helping them cope at widowhood. Future research should explore whether these effects persist in association with other major stressful events in later life.
Social support provides important benefits following widowhood. One context promoting social support throughout life may be the military, where benefits extend to both service members and their spouses. A substantial proportion of older men served in the military, so many widowed women today were married to veterans. We tested two hypotheses: 1) surviving military spouses will experience lower persistent loneliness following widowhood compared to their nonmilitary counterparts, and 2) this benefit is explained by increased emotional and structural social support. Our study uses the Health and Retirement Study (HRS) to examine changes in loneliness following widowhood among spouses of veterans and nonveterans. We used OLS regression and mediation tests to address our hypotheses. Overall, results supported our hypotheses. Widows of veterans reported lower levels of loneliness following widowhood compared to nonveteran widows (=-0.122; p<0.05). Emotional and structural social support mediated the relationship between veteran status of the deceased spouse and loneliness. Specifically, the beneficial effect of veteran status was reduced by almost 50% and became nonsignificant. Our findings suggest the military may facilitate lifelong cultivation of social support that flows not only to veterans but also to their families. These findings are suggest that the military may offer important opportunities to cultivate emotional and structural social supports that enhance the ability of veteran wives to more readily adjust to widowhood. Additionally, they emphasize the importance of having social support in later life when faced with adversity, as it seems to ameliorate some of the negative effects.
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