Where You Live

Maxwell's new Carnegie Fellow studies how state policies influence population health.

By Renée Gearhart Levy

Statistics have long shown a strong relationship between a person’s education level and how healthy and long he or she will live. But, according to sociologist and demographer Jennifer Karas Montez, this correlation cannot be applied uniformly, across the board. It depends on a second factor: where you live.

Jennifer Karas Montez in her officeJennifer Karas Montez in her office at Syracuse University's Aging Studies Institute.

Karas Montez, the Gerald B. Cramer Faculty Scholar of Aging Studies at Maxwell, is researching how state policies often exacerbate or counteract the health-and-longevity effects of education level. Along with long-time collaborators Mark D. Hayward and Anna Zajacova (of the University of Texas at Austin and Western University, respectively), she is studying how state policies have changed — the result of deregulation, federal devolution, and state preemption laws — and how the well-being of those states’ residents may have changed as a result. The work is funded by a five-year, $1.3-million grant from the National Institute on Aging.

“In the 1950s and ’60s there weren’t a lot of differences between states in their social, economic, and health policies, but by the 1970s and ’80s, states began taking very different approaches to things like Medicaid generosity, and whether they offer a state earned income tax credit, and how aggressively they raised cigarette taxes,” explains Karas Montez. “Many of these state policy decisions have a disproportionate influence on lower-educated adults.”

Cigarette taxes are a good example. “New York is very aggressive, trying to discourage smoking with a high cigarette tax, while many states in the South have a negligible sales tax,” she says. The effect on highly educated adults is minimal; smoking by that group has declined everywhere. “But for low-educated adults,” she says, “smoking is declining noticeably in states that have taken these more aggressive stances.” Where there are policies to discourage smoking, the gap between education levels closes. Other places, not so much.

“Many state policy decisions have a disproportionate influence on lower-educated adults.”
Jennifer Karas Montez

Karas Montez, who joined Maxwell in 2015, has made a big impact in a short time. She received the 2017 Chancellor’s Citation and is the first Maxwell faculty member (at least in recent memory) promoted directly from assistant to full professor. In April, she was named an Andrew Carnegie Fellow. The award, considered the most prestigious fellowship in the social sciences and humanities, supports high-level scholarship, generally culminating in a book or major study.

Her accomplishments are more remarkable considering academia is her second career. Karas Montez spent more than a decade as a statistician in private industry. She tired of solving problems uninteresting to her, so began an evening master’s program in sociology. When she enrolled in a demography course (because it fit her schedule) she found her calling. She left industry to obtain a PhD in sociology, with a demography specialization, at the University of Texas, then did postdoctoral training as a Robert Wood Johnson Health & Society Scholar at Harvard.

At Maxwell, Karas Montez uses large data sets from the National Center for Health Statistics to answer questions related to population health. For example: Why is the life expectancy of low-educated white women declining? In a recent article in the Journal of Health and Social Behavior, she reported that low-educated women had a 66-percent higher mortality rate than their highly educated peers. Women most at risk are those who live in rural areas and in southern states. She says it’s possible to draw correlations between policy decisions made by those states and mortality rates.

“Our life expectancy is increasingly being shaped by where we live in the U.S.,” she says. It’s tempting to blame lifestyle-related behaviors, Karas Montez says, but “lifestyle behaviors are not root causes. They are symptoms of the environment and the social and economic deprivation that many parts of the country endure, thanks to decades of policy decisions.”

This article appeared in the spring 2018 print edition of Maxwell Perspective © Maxwell School of Syracuse University. To request a copy, e-mail dlcooke@maxwell.syr.edu.