Youth Survival Expectations: Disadvantaged Contexts and Forecasts for Future Health

Abstract

In national studies, some youth report they do not think they will live into adulthood. Belief in risk for early death is more prevalent among youth of color and youth living in poverty, and may become a self-fulfilling prophecy as youth give up on self-care and future life investment. The purpose of this dissertation is two-fold, (1) to gain additional insight into the relationship between socio-developmental context and stability and change in youth survival perceptions, and (2) to describe the relationship between youth survival perceptions over time and health in adulthood. Data are from Waves I-IV of the in-home interviews from the National Longitudinal Study of Adolescent to Adult Health. The study sample included 10,120 respondents participating in all four waves (ages 11-34 years). Multinomial logistic regression models are used to examine relationships between youth socio-developmental context, including measures of resource access, experiences of adversity, and perceptions of safety, and survival perceptions during adolescence and the period of transition to young adulthood. Linear regression models are used to determine the predictive ability of perceived survival over time on adult health outcomes, including self-rated health, diagnostic profiles, and an allostatic load index. Findings reveal significant relationships between multiple aspects of youth socio-developmental context and survival perceptions. Findings also reveal significant relationships between youth survival perceptions and adult health, even with adjustment for measures of social class origin, social location, and antecedent health. Examination of youth survival perceptions may represent a unique mechanism in which to study enduring impacts of social context on youth agency, as well as a mechanism to address health disparities by establishing a link between survival perceptions and long-term health outcomes.