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Agency and Mental Health: a Transition to Adulthood Paradox

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Agency and Mental Health: a Transition to Adulthood Paradox Society and Mental Health 2015, Vol. 5(3) 163–181 Agency and Mental Health: Ó American Sociological Association 2015 DOI: 10.1177/2156869315573632 A Transition to Adulthood http://smh.sagepub.com Paradox Steven Hitlin1, Lance D. Erickson2, and J. Scott Brown3 Abstract Building on calls within the health literature for a deeper engagement with the concept of agency, we utilize nationally representative survey data from the National Longitudinal Study of Adolescent to Adult Health (N = 13,592) to develop an empirical conception of the traditional treatment of health agency focused on two social psychological constructs that build upon current foci on personal control within the stress pro- cess model: (1) ‘‘subjective vitality’’ and (2) a forward-looking orientation (‘‘optimism’’). We find an inter- esting paradox: adolescents with higher health-based agency early in the transition to adulthood have sig- nificantly higher status attainment (occupational and educational) outcomes, but early mental health advantages disappear over the transition to adulthood. This suggests that while subjective beliefs about health agency put adolescents on trajectories toward higher socioeconomic status, they also set them up for declines in mental health due to unachieved expectations. There seem to be objective upsides and subjective downsides of possessing greater agency in adolescence. Keywords adolescents, agency, depression, life course Sociology, in particular, medical sociology, has We derive a social psychologically informed been characterized by underdeveloped empirical construct capturing two aspects of agency that models relating agency to social structure (Cock- are less developed within the stress process litera- erham 2005). Most sociologists agree that both ture linking structure and health and status attain- aspects of this long-standing theoretical debate ment outcomes, building in part on Thoit’s (2006) are important for life outcomes and that structural suggestions for studying factors that increase position influences an individual’s capacity to agency. We argue for a novel empirical measure exert control over his or her life (e.g., Archer of ‘‘health agency’’ that captures distinct elements 2003; Giddens 1984; Mirowski and Ross 2007; from the typically employed measures of personal Sewell 1992), which suggests that at least some control/mastery. This measure captures motiva- of the relationship between social structure and tional aspects of agency (1) captured in the life outcomes flows through individual agentic capacities. However, empirical treatments of agency have lagged behind notable theoretical 1University of Iowa, Iowa City, IA, USA advances (e.g., Thoits 2006) and wider agency dis- 2Brigham Young University, Provo, UT, USA cussions (e.g., Emirbayer and Mische 1998; Sew- 3Miami University, Oxford, OH, USA ell 1992). Consequently, empirical models linking Corresponding Author: social structure to health outcomes have been Steven Hitlin, Department of Sociology, University of underspecified because they have not sufficiently Iowa, W140 Seashore Hall, Iowa City, IA 52242, USA. examined how they are related. Email: [email protected] Downloaded from smh.sagepub.com at ASA - American Sociological Association on October 30, 2015 164 Society and Mental Health 5(3) underutilized construct of ‘‘vitality,’’ translating circumstance’’ (Elder, Johnson, and Crosnoe traditional aspects of mastery into a subjectively 2003:11). The idea of subjective agency as oriented notion of capacity to engage one’s life socially meaningful is most often tied into related course, and (2) a subjective appraisal of those constructs of personal control, mastery, and self- life chances that serves as an important link efficacy (e.g., Clausen 1991, 1993; Shanahan, between social structure and life outcomes (Hitlin Elder, and Miech 1997; Shanahan, Hofer, and and Johnson forthcoming). This incorporates Miech 2003; Thoits 2003). Theoretical treatments agency into the study of health in four ways: (1) of agency focus on the importance of time (e.g., by illustrating an empirical measure of agency Emirbayer and Mische 1998), but this is rarely useful for health researchers developing an emo- extended into empirical treatments. A sense of tionally anchored future-based self- agency shapes interpretations one makes about conception; (2) by suggesting the utility of this one’s capacities and life difficulties and forms construct in adolescence for predicting successful a lens through which one interprets potential stres- life outcomes (e.g., Clausen 1991, 1993); (3) by sors (Thoits 2006). Somebody with a strong sense illustrating a counterintuitive aspect of high ado- of agency—and a sense that applying that capacity lescent levels of agency in adolescence, namely will ultimately pay off in the future—is more that—for this cohort—aging effects appear to out- likely to persevere through life’s challenges or weigh the mental health benefits of early high take risks that may increase life outcomes (Hitlin agency levels; and (4) providing further illustra- and Johnson forthcoming). Children develop tion of long-established literatures drawing on a sense of ‘‘centralized agency’’ that helps unify social psychological factors to explain systematic their sense of self across domains (Proulx and relationships between social structural location Chandler 2009), and the development of such and health outcomes. a sense contributes to capacities (like delaying Using the National Longitudinal Study of Ado- gratification) that increase stratification outcomes lescent to Adult Health (Add Health), we model (Clausen 1991, 1993) and academic success (Met- health agency as a mediator between early struc- calfe and Mischel 1999). tural position and later life outcomes. The results A sense of agency is societally shaped and has demonstrate an apparent paradox: while our demonstrated ramifications for later life outcomes. empirical measure predicts more successful socio- Significant portions of recent young adult cohorts economic outcomes, having more health agency in have met educational expectations, but those with adolescence predicts steeper declines in socioemo- minority ethnic status and lower socioeconomic tional well-being across the transition to adult- status (SES) still experienced constraints with hood, perhaps, we suggest, due to a perception respect to educational achievement (Reynolds of not living up to these initially higher aspira- and Johnson 2011). Students from higher-SES tions. Like related constructs, health agency medi- backgrounds are more likely to retain high educa- ates structural position to both propel success and tional expectations across the transition to adult- set up the potential for emotional declines across hood, contributing to stratification successes the transition to adulthood (Ross and Mirowsky (Johnson and Reynolds 2013). Similarly, child- 2013), a critical part of the developmental process hood mental health problems lead to lower college (Shanahan 2000). enrollment, suggesting how life course orienta- tions are linked with socioeconomic disparities (McLeod and Kaiser 2004). Individual health TRADITIONAL CONCEPTIONS OF and stratification outcomes are linked to social AGENCY AND LIFE COURSE class through such individual functioning across OUTCOMES the life course (e.g., Abel 2008; Dupe´re´, Leven- thal, and Vitaro 2012; Phelan, Link, and Tehrani- A sense of agency stems from capacities devel- far 2010; Schnittker 2004; Thoits 2006). Certain oped early in the life course and influences how structural positions offer more potential for individuals actively shape their own socialization agentic action and shape individual orientations. (Heinz 2003; Kiecolt and Mabry 2000): ‘‘individ- A notion of agency relevant to the study of uals construct their own life course through the health should incorporate aspects beyond those choices and actions they take within the opportuni- in the traditional agency measures of mastery/per- ties and constraints of history and social sonal control. Well-established literatures linking Downloaded from smh.sagepub.com at ASA - American Sociological Association on October 30, 2015 Hitlin et al. 165 mastery/personal control to the stress process (see that are traditionally not the focus of these estab- Ross and Mirowsky [2013] for an overview) draw lished measures. Following Hitlin and Elder on measures that primarily focus on subjective (2007), we focus on subjective beliefs about vital- evaluations of one’s potential to influence their ity (health and recovery potential) alongside life outcomes. With respect to health and the life a more temporal aspect of agency found in meas- course, we suggest that belief about one’s sense ures of optimism. Subjective vitality is ‘‘a function of physical agency captures an additional, essen- of conditions that support agency and growth’’ tial aspect of agency. In addition to a sense of per- (Ryan and Frederick 1997:557). Drawing on sonal control over one’s outcomes, people develop a recent stream of work focusing on the impor- senses of themselves as healthy (or not) people; tance of concepts of the future for steering social having energy and beliefs about illness and recov- action (Frye 2012; Mische 2009; Tavory and Eli- ery potential are underexplored aspects of subjec- asoph 2013), we argue that a proper measure of tive senses of agency and aspects that we suggest health agency also requires a forward-looking both reflect social position (e.g., race, SES)
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