Advisory Committee Chair
David Warner
Advisory Committee Members
Gabe Miller
Patricia Drentea
Tara Warner
Document Type
Thesis
Date of Award
1-1-2025
Degree Name by School
Master of Arts (MA) College of Arts and Sciences
Abstract
Nearly one-in-four young adults ages 18-34 have a chronic disease, which has been linked to worse midlife mental health. Prior studies have little-examined the mechanism behind this association. The life course perspective suggests that because chronic disease in young adulthood is an unexpected and “off-time” event it may disrupt the achievement and timing of key social milestones. Inability to achieve or perceived delays in achieving the social markers of adulthood (e.g., completing school, homeownership, marriage) may therefore lead to worse midlife mental health. To address this proposition, I used panel data from the Youth Development Study (YDS and multivariate regression techniques to examine the association between young adult chronic disease and midlife mental health, formally testing whether social milestone achievement and timing mediate this association. Overall, I find that chronic disease in early adulthood is associated with poorer self-rated health, lower mastery, more depressive affect, and having a mood disorder in midlife. These associations persist net of controls for individual sociodemographic characteristics, adolescent self-esteem, and parent socioeconomic status. Although associated with lower odds of achieving specific milestones (i.e., owning a home, starting a career, being financially independent, cohabiting, and getting married), achieving fewer milestones overall, and late perceived timing or not expecting to achieve a milestone, I find limited evidence that individual social milestones mediate the association between young adult chronic disease and midlife mental health. Achieving fewer total social milestones and perceptions of being off-time (or not expecting to achieve a milestone at all) partially mediate the association. Taken together, these findings suggest that although young adults with chronic disease achieve fewer social milestones (especially financial) and perceive themselves as off-time this does not explain their worse mental health in midlife. Future research should examine differences in the timing of diagnosis and disease severity, as well as consider whether young adult chronic disease spurs a cognitive transformation that decouples social milestone achievement from perceptions of self, discarding the normative expectations of social milestone achievement, and leading to lower subjective-well-being simply because one has a chronic disease.
Recommended Citation
Lindl, Hannah M., "Young Adult Chronic Disease And Midlife Subjective Well-Being And Mental Health: Does Social Milestone Achievement Mediate The Link?" (2025). All ETDs from UAB. 6864.
https://digitalcommons.library.uab.edu/etd-collection/6864
Comments
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