Professional Education

  • Doctor of Philosophy, University of California Berkeley (2015)
  • Master of Arts, University of California Berkeley (2013)
  • Master of Public Health, Yale University (2006)
  • Bachelor of Science, James Madison University (2004)

Stanford Advisors


All Publications

  • Blue-collar work and women's health: A systematic review of the evidence from 1990 to 2015. SSM - population health Elser, H., Falconi, A. M., Bass, M., Cullen, M. R. 2018; 6: 195–244


    Despite the implications of gender and sex differences for health risks associated with blue-collar work, adverse health outcomes among blue-collar workers has been most frequently studied among men. The present study provides a "state-of-the-field" systematic review of the empiric evidence published on blue-collar women's health. We systematically reviewed literature related to the health of blue-collar women published between January 1, 1990 and December 31, 2015. We limited our review to peer-reviewed studies published in the English language on the health or health behaviors of women who were presently working or had previously worked in a blue-collar job. Studies were eligible for inclusion regardless of the number, age, or geographic region of blue-collar women in the study sample. We retained 177 studies that considered a wide range of health outcomes in study populations from 40 different countries. Overall, these studies suggested inferior health among female blue-collar workers as compared with either blue-collar males or other women. However, we noted several methodological limitations in addition to heterogeneity in study context and design, which inhibited comparison of results across publications. Methodological limitations of the extant literature, alongside the rapidly changing nature of women in the workplace, motivate further study on the health of blue-collar women. Efforts to identify specific mechanisms by which blue-collar work predisposes women to adverse health may be particularly valuable in informing future workplace-based and policy-level interventions.

    View details for DOI 10.1016/j.ssmph.2018.08.002

    View details for PubMedID 30417066

  • Early-life Predictors of Late-life Health Aging, Place, and Health edited by Satariano, W. A., Maus, M. 2017
  • Sex-Based Differences in the Determinants of Old Age Life Expectancy: The Influence of Perimenopause. Biodemography and social biology Falconi, A. M. 2017; 63 (1): 54–70


    Studies using the sensitive periods framework typically examine the effects of early life exposures on later life health, due to the significant growth and development occurring during the first few years of life. The menopausal transition (i.e., perimenopause) is similarly characterized by rapid physiological change, yet rarely has been tested as a sensitive window in adulthood. Cohort mortality data drawn from three historic populations, Sweden (1751-1919), France (1816-1919), and England and Wales (1841-1919), were analyzed using time series methods to assess whether conditions at midlife significantly influenced or "programmed" later life longevity. Results indicated a significant inverse association between mortality at ages 45-49, the average age range in which perimenopause occurred, and life expectancy at age 60 among females in all three countries. Study findings suggest a degree of plasticity associated with women's aging and, in particular, the age group correlated with perimenopause.

    View details for DOI 10.1080/19485565.2016.1273755

    View details for PubMedID 28287306

  • Public and Private Coverage in the United States Navigating Health Insurance edited by Pozen, A., Stimpson, J. P. 2017
  • Stroke-attributable death among older persons during the great recession ECONOMICS & HUMAN BIOLOGY Falconi, A., Gemmill, A., Karasek, D., Goodman, J., Anderson, B., Lee, M., Bellows, B., Catalano, R. 2016; 21: 56-63


    Epidemiological evidence indicates an elevated risk for stroke among stressed persons, in general, and among individuals who have lost their job, in particular. We, therefore, tested the hypothesis that stroke accounted for a larger fraction of deaths during the Great Recession than expected from other deaths and from trends, cycles, and other forms of autocorrelation. Based on vital statistics death data from California spanning 132 months from January 2000 through December 2010, we found support for the hypothesis. These findings appear attributable to non-Hispanic white men, who experienced a 5% increase in their monthly odds of stroke-attributable death. Total mortality in this group, however, did not increase. Findings suggest that 879 deaths among older white men shifted from other causes to stroke during the 36 months following the start of the Great Recession. We infer the Great Recession may have affected social, biologic, and behavioral risk factors that altered the life histories of older white men in ways that shifted mortality risk toward stroke.

    View details for DOI 10.1016/j.ehb.2015.11.005

    View details for Web of Science ID 000378970400004

    View details for PubMedID 26744999

  • The longitudinal relation of stress during the menopausal transition to fibrinogen concentrations: results from the Study of Women's Health Across the Nation MENOPAUSE-THE JOURNAL OF THE NORTH AMERICAN MENOPAUSE SOCIETY Falconi, A. M., Gold, E. B., Janssen, I. 2016; 23 (5): 518-527


    Life course theory suggests that exposures during critical or sensitive periods have particularly profound effects on health. Most research on this subject has focused on the occurrence of such windows early in life. We investigated whether perimenopause, a period of dramatic neuroendocrine changes at midlife, represents a sensitive period for response to stress by evaluating the relation of perceived stress to fibrinogen, a biomarker for inflammation.The study sample was composed of participants in the Study of Women's Health Across the Nation, a longitudinal study on women's health during the menopausal transition (n = 3,287). We fitted linear mixed effects models to estimate the longitudinal relationship between stress and menopausal stage and the association between stress and fibrinogen over the menopausal transition.Women in early and late perimenopause reported perceiving higher levels of stress than premenopausal women (P < 0.05), adjusted for confounding variables. This increased perception of stress during perimenopause, however, was unrelated to changes in fibrinogen.Although neuroendocrine changes during the menopausal transition may exacerbate the negative health effects of stress, the findings of this study do not suggest such interaction, as measured by changes in fibrinogen. The significant association observed between perceived stress and menopause status, however, may still have important implications, given prior literature linking perceived stress with numerous health outcomes.

    View details for DOI 10.1097/GME.0000000000000579

    View details for Web of Science ID 000375154000010

    View details for PubMedID 26886885

  • Health Impacts of the Great Recession: A Critical Review. Current epidemiology reports Margerison-Zilko, C., Goldman-Mellor, S., Falconi, A., Downing, J. 2016; 3 (1): 81-91


    The severity, sudden onset, and multipronged nature of the Great Recession (2007-2009) provided a unique opportunity to examine the health impacts of macroeconomic downturn. We comprehensively review empirical literature examining the relationship between the Recession and mental and physical health outcomes in developed nations. Overall, studies reported detrimental impacts of the Recession on health, particularly mental health. Macro- and individual-level employment- and housing-related sequelae of the Recession were associated with declining fertility and self-rated health, and increasing morbidity, psychological distress, and suicide, although traffic fatalities and population-level alcohol consumption declined. Health impacts were stronger among men and racial/ethnic minorities. Importantly, strong social safety nets in some European countries appear to have buffered those populations from negative health effects. This literature, however, still faces multiple methodological challenges, and more time may be needed to observe the Recession's full health impact. We conclude with suggestions for future work in this field.

    View details for PubMedID 27239427

  • Timing of Birth: Parsimony Favors Strategic over Dysregulated Parturition AMERICAN JOURNAL OF HUMAN BIOLOGY Catalano, R., Goodman, J., Margerison-Zilko, C., Falconi, A., Gemmill, A., Karasek, D., Anderson, E. 2016; 28 (1): 31-35


    The "dysregulated parturition" narrative posits that the human stress response includes a cascade of hormones that "dysregulates" and accelerates parturition but provides questionable utility as a guide to understand or prevent preterm birth. We offer and test a "strategic parturition" narrative that not only predicts the excess preterm births that dysregulated parturition predicts but also makes testable, sex-specific predictions of the effect of stressful environments on the timing of birth among term pregnancies.We use interrupted time-series modeling of cohorts conceived over 101 months to test for lengthening of early term male gestations in stressed population. We use an event widely reported to have stressed Americans and to have increased the incidence of low birth weight and fetal death across the country-the terrorist attacks of September 2001. We tested the hypothesis that the odds of male infants conceived in December 2000 (i.e., at term in September 2001) being born early as opposed to full term fell below the value expected from those conceived in the 50 prior and 50 following months.We found that term male gestations exposed to the terrorist attacks exhibited 4% lower likelihood of early, as opposed to full or late, term birth.Strategic parturition explains observed data for which the dysregulated parturition narrative offers no prediction-the timing of birth among gestations stressed at term. Our narrative may help explain why findings from studies examining associations between population- and/or individual-level stressors and preterm birth are generally mixed.

    View details for DOI 10.1002/ajhb.22737

    View details for Web of Science ID 000368501000003

    View details for PubMedID 25998321

  • Do macroeconomic contractions induce or 'harvest' suicides? A test of competing hypotheses JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH Gemmill, A., Falconi, A., Karasek, D., Hartig, T., Anderson, E., Catalano, R. 2015; 69 (11): 1071-1076


    Researchers often invoke a mortality displacement or 'harvesting' mechanism to explain mortality patterns, such that those with underlying health vulnerabilities die sooner than expected in response to environmental phenomena, such as heat waves, cold spells and air pollution. It is unclear if this displacement mechanism might also explain observed increases in suicide following economic contraction, or if suicides are induced in persons otherwise unlikely to engage in self-destructive behaviour. Here, we test two competing hypotheses explaining an observed increase in suicides following unemployment-induction or displacement.We apply time series methods to monthly suicide and unemployment data from Sweden for the years 2000-2011. Tests are conducted separately for working age (20-64 years old) men and women as well as older (aged 65 years and older) men and women.Displacement appeared among older men and women; an unexpected rise in unemployment predicted an increase in suicides 6 months later, followed by a significant decrease 8 months later. Induction appeared among working age men, but not among working age women; an unexpected rise in unemployment predicted an increase in suicides 4-6 months later.Displacement and induction both appear to have operated following unexpected labour market contractions in Sweden, though with different population segments.

    View details for DOI 10.1136/jech-2015-205489

    View details for Web of Science ID 000364995100010

    View details for PubMedID 26188057

  • Twins Less Frequent Than Expected Among Male Births in Risk Averse Populations TWIN RESEARCH AND HUMAN GENETICS Karasek, D., Goodman, J., Gemmill, A., Falconi, A., Hartig, T., Magganas, A., Catalano, R. 2015; 18 (3): 314-320


    Male twin gestations exhibit higher incidence of fetal morbidity and mortality than singleton gestations. From an evolutionary perspective, the relatively high rates of infant and child mortality among male twins born into threatening environments reduce the fitness of these gestations, making them more vulnerable to fetal loss. Women do not perceive choosing to spontaneously abort gestations although the outcome may result from estimates, made without awareness, of the risks of continuing a pregnancy. Here, we examine whether the non-conscious decisional biology of gestation can be linked to conscious risk aversion. We test this speculation by measuring the association between household surveys in Sweden that gauge financial risk aversion in the population and the frequency of twins among live male births. We used time-series regression methods to estimate our suspected associations and Box-Jenkins modeling to ensure that autocorrelation did not confound the estimation or reduce its efficiency. We found, consistent with theory, that financial risk aversion in the population correlates inversely with the odds of a twin among Swedish males born two months later. The odds of a twin among males fell by approximately 3.5% two months after unexpectedly great risk aversion in the population. This work implies that shocks that affect population risk aversion carry implications for fetal loss in vulnerable twin pregnancies.

    View details for DOI 10.1017/thg.2015.22

    View details for Web of Science ID 000355288200011

    View details for PubMedID 25917386

  • Puberty and perimenopause: Reproductive transitions and their implications for women's health SOCIAL SCIENCE & MEDICINE Hoyt, L. T., Falconi, A. M. 2015; 132: 103-112


    This scoping review synthesizes existing research on two major transitions in females' lives: puberty and perimenopause. These two periods of vast physiological change demarcate the beginning and the end of the reproductive life cycle and are associated with major neuroendocrine reorganization across two key systems, the hypothalamic-pituitary-gonadal (HPG) axis the hypothalamus-pituitary-adrenal (HPA) axis. Despite growing evidence suggesting that the timing and experience of puberty and perimenopause are related to various physical and mental health outcomes (e.g., mood disorders, metabolism, cardiovascular health, autoimmune conditions, and cancer), these two processes are rarely examined together. In this paper, we bridge these disparate literatures to highlight similarities, isolate inconsistencies, and identify important areas for future research in women's health.

    View details for DOI 10.1016/j.socscimed.2015.03.031

    View details for Web of Science ID 000353599400013

    View details for PubMedID 25797100

  • Adolescent experience predicts longevity: evidence from historical epidemiology JOURNAL OF DEVELOPMENTAL ORIGINS OF HEALTH AND DISEASE Falconi, A., Gemmill, A., Dahl, R. E., Catalano, R. 2014; 5 (3): 171-177


    Human development reportedly includes critical and sensitive periods during which environmental stressors can affect traits that persist throughout life. Controversy remains over which of these periods provides an opportunity for such stressors to affect health and longevity. The elaboration of reproductive biology and its behavioral sequelae during adolescence suggests such a sensitive period, particularly among males. We test the hypothesis that life expectancy at age 20 among males exposed to life-threatening stressors during early adolescence will fall below that among other males. We apply time-series methods to cohort mortality data in France between 1816 and 1919, England and Wales between 1841 and 1919, and Sweden between 1861 and 1919. Our results indicate an inverse association between cohort death rates at ages 10-14 and cohort life expectancy at age 20. Our findings imply that better-informed and more strategic management of the stressors encountered by early adolescents may improve population health.

    View details for DOI 10.1017/S2040174414000105

    View details for Web of Science ID 000335567200003

    View details for PubMedID 24901655

  • Very low birthweight: Dysregulated gestation versus evolutionary adaptation SOCIAL SCIENCE & MEDICINE Catalano, R., Karasek, D., Gemmill, A., Falconi, A., Goodman, J., Magganas, A., Hartig, T. 2014; 108: 237-242


    Much medical literature attributes persistently high rates of very low birthweight (VLBW) to "dysregulated" gestation. We offer the alternative view that natural selection conserved well-regulated, though nonconscious, decisional biology that protects the reproductive fitness of women by spontaneously aborting gestations that would otherwise yield frail infants, particularly small males. Modern obstetric practice, however, converts some fraction of these erstwhile spontaneous abortions into live births of very small infants. We further propose that the nonconscious decisional biology of gestation exhibits preferences also seen in consciously made decisions. We hypothesize that the incidence of VLBW among male infants should vary with the population's self-reported intentions to assume financial risk. We apply time-series modeling to monthly birth counts by sex and weight from the Swedish Medical Birth Registry between January 1993 and December 2010. We gauge risk aversion with monthly data from the Micro Index of the Swedish Consumer Tendency Survey (MISCT). Consistent with our argument that nonconscious decisional biology shares risk aversion with conscious decisions, we find that the incidence of VLBW among male infants in Sweden varies with the population's self-reported intentions to assume financial risk. We find increases above expected odds of a very low weight infant among males born 1 month after increases above expected levels of self-reported risk aversion in the Swedish population. We offer this finding as support for the argument that persistently high rates of VLBW arise, at least in part, from a combination of medical interventions and mechanisms conserved by natural selection to protect reproductive fitness.

    View details for DOI 10.1016/j.socscimed.2014.01.050

    View details for Web of Science ID 000336109700027

    View details for PubMedID 24593927

  • No evidence of programmed late-life mortality in the Finnish famine cohort JOURNAL OF DEVELOPMENTAL ORIGINS OF HEALTH AND DISEASE Saxton, K., Falconi, A., Goldman-Mellor, S., Catalano, R. 2013; 4 (1): 30-34


    The developmental origins hypothesis suggests that morbidity and premature mortality arise, in part, from adverse exposures in utero and early in development. Evidence suggests a connection between early nutritional deficits and adult morbidity; however, the effects on mortality have been less well studied and previous studies provide conflicting results. We extracted Finnish birth cohort death rates from the Human Mortality Database. Our test asks whether men or women born during the 1867-1868 Great Finnish Famine exhibited death rates in old age different from expected, based on death rates among Finnish cohorts born 1818-1866. We found no support for the argument that exposure to the Finnish famine in utero induced excess mortality from age 60 to 89 in either men or women. Our results suggest that the Finnish famine did not induce, via epigenetic changes or any other mechanism, premature mortality in older age among exposed individuals.

    View details for DOI 10.1017/S2040174412000517

    View details for Web of Science ID 000312998700003

    View details for PubMedID 25080180