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Macro-social Influences on Individual Health and Well-being

A second theme of my research focuses on macro-social influences on individual health and well-being. I have long being interested in understanding how do individuals react to social contexts and public policies experienced over the life course. The vast majority of previous research on this area is restricted to high-income countries and runs on separate avenues, with national studies using individual data to explore micro-social processes and cross-national studies using aggregate data to explore macro-social processes. I have addressed these limitations by assembling and utilizing a massive dataset with multilevel scope and longitudinal dimension, including about 500,000 individuals that were observed in 100 countries since 1980. The inclusion of a large number of low- and middle-income countries over time provides a unique opportunity to answer the call for research on social and policy influences on health to be more cross-national and dynamic in its orientation. My key publications in this area focus on individuals within a larger context, with particular attention to subjective well-being and lifestyle of individuals in countries varying with respect to unemployment program characteristics, pension policy design, cultural values, economic development, unemployment rates, and anti-tobacco legislation.


My results suggest that the institutional design of national pension and unemployment systems influence subjective well-being. I find that the individualization of risk in pension policy has less subjective emotional impact than the redistribution of resources and alleviation of need. My results also highlight that pension policies are embedded in cultural and economic contexts that help explain how people react subjectively to them. When looking at national unemployment systems, I find that the mere presence of a system is not enough to influence subjective well-being. Instead, I find that the association between unemployment programs and subjective well-being depends on the specific benefit and financing configuration of the program, as well as on the specific types of social uncertainties that the program needs to deal with.


I have also explored variations in the well-documented detrimental effects of unemployment on subjective well-being. My results suggests that the subjective well-being effects of unemployment vary in complex ways, depending on multiplicative interactions between individual unemployment status and country-level unemployment rates, as well as on whether workers, students, homemakers, or retirees are included in the comparison group. Thus, I argue that the individual experience of unemployment should be understood within the broader context of national unemployment and should be examined in contrast to other labor force statuses.


Results from my research on teenage smoking in Chile provide evidence on the effectiveness of smoking bans on developing countries. Specifically, they suggest that teenagers react to smoke free areas, but the decrease in smoking prevalence is greater for students in 100% smoke free areas than in partially free smoking areas. However, 100% smoke free areas are not enough to change smoking behavior of older students or heavy smokers. Therefore, a more comprehensive set of anti-tobacco policies is needed, including large permanent tax increases, educational campaigns, and cessation programs.


Future research on the macro-social and policy determinants of individual health and well-being will continue to benefit from the continuous expansion of the datasets that I have been assembling over the past years. These massive longitudinal datasets encompass detailed information for hundreds of thousands of individuals throughout the world, as well as fine grained characterization of changes in policies over the last four decades. The raw data are not publicly available in a single dataset and a large fraction come from printed books and reports that research assistants at my lab have been coding for more than five years now. Taking advantage of this enormous coding endeavor, my current projects explore multilevel determinants of well-being, including contextual violence, pervasive stereotypes, and social constructions of age. Continuing the line of research on teenage smoking, we are also exploring geospatial differences and changes introduced by recent policies in Chile. In long-term, I intend to assemble a cross-national dataset using micro-data panel from the HRS, SHARE, and sister surveys around the world. This will allow me to shift the focus from subjective well-being to different health outcomes. Specifically, I intend to use these data to assess how urban environments influence individual cognitive functioning, functional dependency, and depressive symptomatology.