Courtney Thomas | UCLA Fielding School of Public Health (original) (raw)

Papers by Courtney Thomas

Substantial evidence has accumulated supporting a causal link between childhood adversity and ris... more Substantial evidence has accumulated supporting a causal link between childhood adversity and risk for poor health years and even decades later. One interpretation of this evidence is that this linkage arises largely or exclusively from a process of biological embedding that is not modifiable by subsequent social context or experience—implying childhood as perhaps the only point at which intervention efforts are likely to be effective. This paper considers the extent to which this long-term association arises from intervening differences in social context and/or environmental experiences—a finding that would suggest that post-childhood prevention efforts may also be effective. Based on the argument that the selected research definition of adult health status may have implications for the early adversity-adult health linkage, we use a representative community sample of black and white adults (N=1252) to evaluate this relationship across three health indices: doctor diagnosed illnesses, self-rated health, and allostatic load. Results generally indicate that observed relationships between estimates of childhood adversity and dimensions of adult health status were totally or almost totally accounted for by variations in adult socioeconomic position (SEP) and adult stress exposure. One exception is the childhood SEP allostatic
load association, for which a statistically significant relationship remained in the context of adult stress and SEP. This lone finding supports a conclusion that the impact of childhood
adversity is not always redeemable by subsequent experience. However, in general, analyses suggest the likely utility of interventions beyond childhood aimed at reducing exposure to social stress and improving social and economic standing. Whatever the effects on adult health that derive from biological embedding, they appear to be primarily indirect effects through adult social context and exposure.

This study examines how the intersecting consequences of race/ethnicity, gender, SES, and age inf... more This study examines how the intersecting consequences of race/ethnicity, gender, SES, and age influence health inequality. We draw on multiple hierarchy stratification and life course perspectives to address two main research questions. First, does racial/ethnic stratification of health vary by gender and/or SES? More specifically, are the joint health consequences of racial/ethnic, gender, and socioeconomic stratification additive or multiplicative? Second, does this combined inequality in health decrease, remain stable, or increase between middle and late life? We use panel data from the HRS (N=12,976) to investigate between- and within-group differences in in self-rated health among whites, blacks and Mexican Americans. Findings indicate that that effects of racial/ethnic, gender and SES stratification are interactive, resulting in the greatest racial/ethnic inequalities in health among women and those with higher levels of SES. Furthermore, racial/ethnic-gender-SES inequalities in health tend to decline with age. These results are broadly consistent with intersectionality and aging-as-leveler hypotheses.

This article proposes a new look at the black middle class; continued study of this group and the... more This article proposes a new look at the black middle class; continued study of this group and their dually privileged, yet marginalized, statuses may provide further insight into the mechanisms by which race and class continue to act as systems of stratification. This work highlights significant contributions of black middle class research and areas for growth within urban sociology, education and work, and medical sociology. Among the challenges to advancing a new research agenda on the black middle class are: the need for consistent operational definitions of the middle class, variations in methodological approaches, and the consideration of heterogeneity within this group. Overall, there is a need for a theoretical framework to link the many theories of the black middle class, since study of this group promises to advance a broader understanding of social stratification.

Abstracts by Courtney Thomas

Objectives: Prior research documents psychosocial risk factors that diminish Black men's health; ... more Objectives: Prior research documents psychosocial risk factors that diminish Black men's health; nevertheless, sources of resilience remain less clear. Resilience refers to social and psychological resources that facilitate successful adaptation and ability to thrive in the face of adversity. This study examines psychosocial resilience patterns among Black men to clarify the mechanisms linking adverse mental and physical health outcomes in this population.

Substantial evidence has accumulated supporting a causal link between childhood adversity and ris... more Substantial evidence has accumulated supporting a causal link between childhood adversity and risk for poor health years and even decades later. One interpretation of this evidence is that this linkage arises largely or exclusively from a process of biological embedding that is not modifiable by subsequent social context or experience—implying childhood as perhaps the only point at which intervention efforts are likely to be effective. This paper considers the extent to which this long-term association arises from intervening differences in social context and/or environmental experiences—a finding that would suggest that post-childhood prevention efforts may also be effective. Based on the argument that the selected research definition of adult health status may have implications for the early adversity-adult health linkage, we use a representative community sample of black and white adults (N=1252) to evaluate this relationship across three health indices: doctor diagnosed illnesses, self-rated health, and allostatic load. Results generally indicate that observed relationships between estimates of childhood adversity and dimensions of adult health status were totally or almost totally accounted for by variations in adult socioeconomic position (SEP) and adult stress exposure. One exception is the childhood SEP allostatic
load association, for which a statistically significant relationship remained in the context of adult stress and SEP. This lone finding supports a conclusion that the impact of childhood
adversity is not always redeemable by subsequent experience. However, in general, analyses suggest the likely utility of interventions beyond childhood aimed at reducing exposure to social stress and improving social and economic standing. Whatever the effects on adult health that derive from biological embedding, they appear to be primarily indirect effects through adult social context and exposure.

This study examines how the intersecting consequences of race/ethnicity, gender, SES, and age inf... more This study examines how the intersecting consequences of race/ethnicity, gender, SES, and age influence health inequality. We draw on multiple hierarchy stratification and life course perspectives to address two main research questions. First, does racial/ethnic stratification of health vary by gender and/or SES? More specifically, are the joint health consequences of racial/ethnic, gender, and socioeconomic stratification additive or multiplicative? Second, does this combined inequality in health decrease, remain stable, or increase between middle and late life? We use panel data from the HRS (N=12,976) to investigate between- and within-group differences in in self-rated health among whites, blacks and Mexican Americans. Findings indicate that that effects of racial/ethnic, gender and SES stratification are interactive, resulting in the greatest racial/ethnic inequalities in health among women and those with higher levels of SES. Furthermore, racial/ethnic-gender-SES inequalities in health tend to decline with age. These results are broadly consistent with intersectionality and aging-as-leveler hypotheses.

This article proposes a new look at the black middle class; continued study of this group and the... more This article proposes a new look at the black middle class; continued study of this group and their dually privileged, yet marginalized, statuses may provide further insight into the mechanisms by which race and class continue to act as systems of stratification. This work highlights significant contributions of black middle class research and areas for growth within urban sociology, education and work, and medical sociology. Among the challenges to advancing a new research agenda on the black middle class are: the need for consistent operational definitions of the middle class, variations in methodological approaches, and the consideration of heterogeneity within this group. Overall, there is a need for a theoretical framework to link the many theories of the black middle class, since study of this group promises to advance a broader understanding of social stratification.

Objectives: Prior research documents psychosocial risk factors that diminish Black men's health; ... more Objectives: Prior research documents psychosocial risk factors that diminish Black men's health; nevertheless, sources of resilience remain less clear. Resilience refers to social and psychological resources that facilitate successful adaptation and ability to thrive in the face of adversity. This study examines psychosocial resilience patterns among Black men to clarify the mechanisms linking adverse mental and physical health outcomes in this population.