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Despite mixed evidence, researchers often suggest that married adults tend to live generally healthier lifestyles than their unmarried counterparts. In this chapter, we propose and test a reconceptualization of the health lifestyle that distinguishes between “homebody” risks and “hedonic” risks that may help to make sense of previous findings concerning marriage and health-related behavior.

Using data from the 2004 Survey of Adults (n = 1,385), we employ ordinary least squares regression to model indices of normative and conventional homebody risks (greater body mass, infrequent exercise, poorer diet, and abstinence from alcohol) and unconventional and potentially dangerous hedonic risks (smoking, heavy drinking, going out to bars, eating out, inadequate sleep, and driving without seatbelts) as a function of marital status.

Our key findings indicate that married adults tend to score higher on homebody risks and lower on hedonic risks than never married adults, net of controls for age, gender, race/ethnicity, citizenship, interview language, education, employment status, household income, and religious involvement.

Research limitations include cross-sectional data, restricted indicators of health-related behavior, and narrow external validity.

Contrary to previous research, we conclude that the lifestyle of married adults is not uniformly healthy.

Although established theoretical models suggest that race differences in physical health are partially explained by exposures to environmental toxins, there is little empirical evidence to support these processes. We build on previous research by formally testing whether black–white differences in self-rated physical health are mediated by the embodiment of environmental toxins.

Using cross-sectional data from the National Health and Nutrition Examination Surveys (2007–2008), we employ ordinary least squares regression to model environmental toxins (from urine specimens) and overall self-rated health as a function of race and ethnicity. We employ the Sobel test of indirect effects to formally assess mediation.

Our results show that non-Hispanic black respondents tend to exhibit higher levels of total toxins, lead, and cadmium in their urine and poorer physical health than non-Hispanic whites, even with adjustments for age, gender, and socioeconomic status (SES). Our mediation analyses suggest that blacks may exhibit poorer physical health than whites because they tend to embody higher levels of cadmium.

Research limitations include cross-sectional data and restricted indicators of SES.

This study contributes to previous work by bridging the fields of social epidemiology and environmental inequality and by formally testing established theoretical models.

Purpose – Although recent work has made significant contributions to our theoretical understanding of white fragility, more empirical work is needed to establish the social causes of this particular form of racial stress. Our chapter builds on previous research by assessing gender and socioeconomic variations in white fragility.

Methodology/Approach – Data come from the 2018 Survey of White Fragility, a convenience sample of 279 non-Hispanic white undergraduate students aged 18 years and over attending two large public universities in the southeastern and southwestern United States.

Findings – Results indicate that women tend to exhibit higher levels of remorse fragility (feeling sad, guilty, and angry). There were no gender differences in depletion fragility (feeling drained/exhausted, unsafe, attacked, and confused). Parental education was unrelated to levels of white fragility. Overall parental socioeconomic status was initially associated with lower levels of remorse and depletion fragility, but these associations were confounded by a general measure of nonspecific psychological distress.

Research Limitations/Implications – Research limitations include a nonprobability sampling design and low external validity.

Originality/Value of Paper – This study contributes to previous work by establishing gender variations in white fragility. We also reveal that socioeconomic variations in white fragility may be confounded by the broader social distribution of psychological distress.

In this chapter, we draw on health lifestyle, human capital, and health commodity theories to examine the effects of educational attainment on a wide range of individual dietary behaviors and dietary lifestyles.

Using data from the 2005-2006 iteration of the National Health and Nutrition Examination Survey (n = 2,135), we employ negative binomial regression and binary logistic regression to model three dietary lifestyle indices and thirteen healthy dietary behaviors.

We find that having a college degree or higher is associated with seven of the thirteen healthy dietary behaviors, including greater attention to nutrition information (general nutrition, serving size, calories, and total fat) and consumption of vegetables, protein, and dairy products. For the most part, education is unrelated to the inspection of cholesterol and sodium information and consumption of fruits/grains/sweets, and daily caloric intake. We observe that having a college degree is associated with healthier dietary lifestyles, the contemporaneous practice of multiple healthy dietary behaviors (label checking and eating behaviors). Remarkably, household income and the poverty-to-income ratio are unrelated to dietary lifestyles and have virtually no impact on the magnitude of the association between education and dietary lifestyles.

Our findings are consistent with predictions derived from health lifestyle and human capital theories. We find no support for health commodity theory, the idea that people who are advantaged in terms of education live healthier lifestyles because they tend to have the financial resources to purchase the elements of a healthy lifestyle.

The disparities of COVID-19 vaccination rates between the rural and urban areas have become apparent during this pandemic. There is a need to understand the root causes of vaccine hesitancy demonstrated by the rural population to increase coverage and to contain the disease spread throughout the United States. This study aimed to explore other factors influencing vaccine hesitancy among rural dwellers besides the geography-related barriers such as poor health care access and individuals having no or suboptimal insurance coverage.

By reviewing existing data and literature about vaccination, health literacy, and behaviors, and prevailing ideologies, we discuss the potential causes of vaccine hesitancy in rural areas that could create barriers for successful public health efforts related to vaccine coverage and provide suggestions to ameliorate the situation.

Geography-related barriers, health literacy, and preconceived notions are key determinants of adopting healthy behaviors and complying with public health authorities' recommendations among rural individuals during a public-health crisis. We argue that ideology, which is much deeper than preconception or misconception on vaccination, should be incorporated as a key factor to redefine the term “vulnerable populations” in public health research.

The limitation of our study is that we have not found an effective way to encourage the populations who hold conservative religious and political ideologies to join the efforts for public health. Even though geography-related barriers may strongly impact the rural dwellers in achieving optimal health, the various forms of ideologies they have toward certain health behaviors cannot be discounted to understand and address vaccine-related disparities in rural areas. There is a need to redefine the term “vulnerable population” particularly as it relates to rural areas in the United States. During large-scale public health disasters, scholars and public health authorities should consider the ideologies of individuals, in addition to other factors such as race/ethnicity, area of residence (rural vs. urban), and socioeconomic factors influencing the existing vulnerabilities and health disparities.