About

Jessica Ho is an Associate Professor of Sociology and Demography at Pennsylvania State University. She is a co-funded faculty member at the Social Science Research Institute (SSRI). Her academic background includes a Ph.D. in Demography and Sociology from the University of Pennsylvania, an A.M.. in Demography from the same institution, and a B.A. in Economics and Health and Societies from the University of Pennsylvania. Her expertise lies in the study of aging, health, and mortality. Her major research areas include examining why American life expectancy lags behind other high-income countries, understanding the factors contributing to widening inequalities in mortality across social groups within the United States, and investigating the causes and consequences of the contemporary American drug overdose epidemic. Her work emphasizes the role of health behaviors and socially patterned factors in shaping American mortality. Current projects focus on how American culture, social institutions, and the organization of everyday life influence life expectancy and the impact of the drug overdose epidemic on older adults, families, and intergenerational relationships.

Research topics

• Demography
• Medicine
• Gerontology
• Environmental health
• Geography

Selected publications

• Dynamics and discrepancies in rural–urban village regeneration: A case study of a coastal community in Hong Kong SAR, China

  Journal of Chinese Architecture and Urbanism · 2025-02-17 · 1 citations

  articleOpen access1st authorCorresponding

  Village revitalization has garnered significant attention in urbanized regions such as Hong Kong, where researchers and practitioners are actively responding to the rural revitalization movement inspired by China’s policies to enhance agricultural activities, preserve cultural heritage, and stimulate economic development. This article examines the historical, cultural, and ecological significance of Shui Hau village, a coastal farming, and rural–urban community, alongside the implementation of novel village regeneration initiatives proposed by the authors. The primary aim is to illustrate the mechanisms behind these initiatives, explore the dynamics between stakeholders and researchers, and analyze the dual role of researchers as both trusted outsiders and effective collaborators. These insights are intended to inform future practices and recommend context-specific policy changes. Adopting a case study approach, this article contributes to the growing body of qualitative rural studies in the wider Asian context. Challenges relevant to village regeneration, including land boundaries, the Small House Policy, and planning and conservation regulations under the existing legal framework, are documented. As part of a broader action research initiative, three government-funded projects were proposed and implemented to revitalize cultural values: (i) Rediscovering traditions and rituals through tactical interventions, (ii) restoring the grain store as a farming cooperative, and (iii) transforming the stone house into a living culture cooperative. This retrospective review reveals key dynamics and discrepancies, including intricate land ownership issues, unspecific regulations, loose governance, and mismatches between expectations and actual outcomes. From a practitioner’s perspective, systemic changes at multiple levels are recommended to better engage stakeholders and facilitate more effective countryside regeneration.

  PublisherDOI

• Life expectancy and geographic variation in mortality: an observational comparison study of six high-income Anglophone countries

  BMJ Open · 2024-07-01 · 9 citations

  articleOpen accessSenior authorCorresponding

  OBJECTIVE: To compare life expectancy levels and within-country geographic variation in life expectancy across six high-income Anglophone countries between 1990 and 2018. DESIGN: Demographic analysis using aggregated mortality data. SETTING: Six high-income Anglophone countries (USA, UK, Canada, Australia, Ireland and New Zealand), by sex, including an analysis of subnational geographic inequality in mortality within each country. POPULATION: Data come from the Human Mortality Database, the WHO Mortality Database and the vital statistics agencies of six high-income Anglophone countries. MAIN OUTCOME MEASURES: Life expectancy at birth and age 65; age and cause of death contributions to life expectancy differences between countries; index of dissimilarity for within-country geographic variation in mortality. RESULTS: Among six high-income Anglophone countries, Australia is the clear best performer in life expectancy at birth, leading its peer countries by 1.26-3.95 years for women and by 0.97-4.88 years for men in 2018. While Australians experience lower mortality across the age range, most of their life expectancy advantage accrues between ages 45 and 84. Australia performs particularly well in terms of mortality from external causes (including drug- and alcohol-related deaths), screenable/treatable cancers, cardiovascular disease and influenza/pneumonia and other respiratory diseases compared with other countries. Considering life expectancy differences across geographic regions within each country, Australia tends to experience the lowest levels of inequality, while Ireland, New Zealand and the USA tend to experience the highest levels. CONCLUSIONS: Australia has achieved the highest life expectancy among Anglophone countries and tends to rank well in international comparisons of life expectancy overall. It serves as a potential model for lower-performing countries to follow to reduce premature mortality and inequalities in life expectancy.

  PublisherOA PDFDOI

• Inequalities in life expectancy and cardiometabolic disease mortality across and within high-income countries

  Cell Metabolism · 2024-02-01 · 4 citations

  articleOpen access1st authorCorresponding
  PublisherOA PDFDOI

• Life Course Patterns of Prescription Drug Use in the United States

  Demography · 2023-09-20 · 14 citations

  articleOpen access1st authorCorresponding

  Prescription drug use has reached historic highs in the United States-a trend linked to increases in medicalization, institutional factors relating to the health care and pharmaceutical industries, and population aging and growing burdens of chronic disease. Despite the high and rising prevalence of use, no estimates exist of the total number of years Americans can expect to spend taking prescription drugs over their lifetimes. This study provides the first estimates of life course patterns of prescription drug use using data from the 1996-2019 Medical Expenditure Panel Surveys, the Human Mortality Database, and the National Center for Health Statistics. Newborns in 2019 could be expected to take prescription drugs for roughly half their lives: 47.54 years for women and 36.84 years for men. The number of years individuals can expect to take five or more drugs increased substantially. Americans also experienced particularly dramatic increases in years spent taking statins, antihypertensives, and antidepressants. There are also important differences in prescription drug use by race and ethnicity: non-Hispanic Whites take the most, Hispanics take the least, and non-Hispanic Blacks fall in between these extremes. Americans are taking drugs over a wide and expanding swathe of the life course, a testament to the centrality of prescription drugs in Americans' lives today.

  PublisherOA PDFDOI

• Psychomotor and visual skills underlying position specialization in 1352 elite youth baseball players

  PLoS ONE · 2023-01-19 · 6 citations

  articleOpen access1st authorCorresponding

  Baseball is an international sport with participation from tens of thousands of people worldwide. In the United States, the Prospect Development Pipeline (PDP) is a collaborative effort between Major League Baseball and USA Baseball to establish a developmental pipeline leading to the professional draft. Players participating in the PDP undergo comprehensive evaluations that measure athletic performance, speed-of-processing, visual function, and on-field talent. The present study evaluated data from 1352 elite junior male PDP participants (aged 14 to 21) who signed informed consent, collected between 2017 and 2020, to identify latent abilities and their association with player specialization. Data were first subjected to Exploratory Factor Analysis (EFA) to reduce the 22 measured variables to a smaller set of latent abilities. The resulting factors were evaluated using multiple linear regression to predict each factor using age, height, weight, and position. EFA revealed a combination of physical and psychomotor skills accounting for 52% of the overall variance that grouped into four abilities: grip strength, functional vision, explosiveness, and rapid decision-making. Regression analyses demonstrated that these skills are associated with position assignments, controlling for age, weight, and height, and revealed that outfielders are the most explosive, infielders perform best on psychomotor measures, and catchers perform best on functional vision tests (ps < 0.001). These findings indicate skills that contribute to player specialization, providing new information about the developmental trajectory of junior elite baseball athletes that can be used for scouting and player development.

  PublisherDOI

• The Relationship Between Multimorbidity and Types of Chronic Diseases and Self-Rated Memory

  Research on Aging · 2022-04-07 · 4 citations

  articleOpen accessSenior author

  This study explores the impact of multimorbidity and types of chronic diseases on self-rated memory in older adults in the United States. Data were drawn from the 2011 wave of the National Health and Aging Trends Study (NHATS, N = 6,481). Logistic regressions were used to examine the associations between multimorbidity and types of chronic diseases and fair/poor self-rated memory. Compared to respondents with no or one chronic disease, respondents with multimorbidity showed 35% higher odds of reporting fair/poor self-rated memory. Also, stroke, osteoporosis, and arthritis were identified as increasing the odds of reporting fair/poor self-rated memory by 41%, 20%, and 30%, respectively. Demonstrating the importance of both multimorbidity and types of chronic diseases in self-reporting of memory, our findings suggest the need to educate older adults with multimorbidity and certain types of diseases regarding negative self-rated memory and its consequences.

  PublisherOA PDFDOI

• The rising burden of Alzheimer's disease mortality in rural America

  SSM - Population Health · 2022-02-24 · 41 citations

  articleOpen access1st authorCorresponding

  Since the 1990s, there has been a striking urban-rural divergence in life expectancy within the United States, with metropolitan areas achieving strong life expectancy increases and nonmetropolitan areas experiencing stagnation or actual declines in life expectancy. While Alzheimer's disease and related dementias (ADRD) are likely to pose a particular challenge in nonmetropolitan areas, we know relatively little about the level of ADRD mortality in nonmetropolitan areas, how it has changed over time, and whether it is contributing to metropolitan/nonmetropolitan life expectancy gaps. This study finds that ADRD mortality has risen more rapidly in nonmetropolitan areas than in all other metro areas (large central metros, suburbs, and medium/small cities) between 1999 and 2019. While death rates from ADRD were nearly identical in large central metros and nonmetros in 1999, a clear metro/nonmetro gradient has emerged and widened substantially over the past two decades. Today, nonmetros now experience the highest levels of ADRD mortality, while large central metros have the lowest levels. These metro/nonmetro gaps in ADRD differ substantially by region, with the largest gaps observed in the Middle Atlantic and South Atlantic. The contribution of ADRD to metro/nonmetro differences life expectancy at age 65 is now considerable in many regions, reaching up to 30% for women and 13% for men. In several regions, ADRD's contribution to female life expectancy gaps is on par with or exceeds the contributions of other leading causes of death such as heart disease, cancer, and chronic lower respiratory diseases. The rising burden of Alzheimer's disease mortality is likely to pose a substantial challenge in rural areas of the United States which are aging rapidly, experiencing adverse mortality trends, and increasingly disadvantaged in terms of socioeconomic resources and health care infrastructure.

  PublisherDOI

• Smoking and the widening inequality in life expectancy between metropolitan and nonmetropolitan areas of the United States

  Frontiers in Public Health · 2022-09-07 · 7 citations

  articleOpen accessSenior author

  Background: Geographic inequality in US mortality has increased rapidly over the last 25 years, particularly between metropolitan and nonmetropolitan areas. These gaps are sizeable and rival life expectancy differences between the US and other high-income countries. This study determines the contribution of smoking, a key contributor to premature mortality in the US, to geographic inequality in mortality over the past quarter century. Methods: We used death certificate and census data covering the entire US population aged 50+ between Jan 1, 1990 and Dec 31, 2019. We categorized counties into 40 geographic areas cross-classified by region and metropolitan category. We estimated life expectancy at age 50 and the index of dissimilarity for mortality, a measure of inequality in mortality, with and without smoking for these areas in 1990-1992 and 2017-2019. We estimated the changes in life expectancy levels and percent change in inequality in mortality due to smoking between these periods. Results: We find that the gap in life expectany between metros and nonmetros increased by 2.17 years for men and 2.77 years for women. Changes in smoking-related deaths are responsible for 19% and 22% of those increases, respectively. Among the 40 geographic areas, increases in life expectancy driven by changes in smoking ranged from 0.91 to 2.34 years for men while, for women, smoking-related changes ranged from a 0.61-year decline to a 0.45-year improvement. The most favorable trends in years of life lost to smoking tended to be concentrated in large central metros in the South and Midwest, while the least favorable trends occurred in nonmetros in these same regions. Smoking contributed to increases in mortality inequality for men aged 70+, with the contribution ranging from 8 to 24%, and for women aged 50-84, ranging from 14 to 44%. Conclusions: Mortality attributable to smoking is declining fastest in large cities and coastal areas and more slowly in nonmetropolitan areas of the US. Increasing geographic inequalities in mortality are partly due to these geographic divergences in smoking patterns over the past several decades. Policies addressing smoking in non-metropolitan areas may reduce geographic inequality in mortality and contribute to future gains in life expectancy.

  PublisherDOI

• Causes of America’s Lagging Life Expectancy: An International Comparative Perspective

  The Journals of Gerontology Series B · 2021-07-05 · 151 citations

  articleOpen access1st authorCorresponding

  OBJECTIVES: This study assesses how American life expectancy compares to other high-income countries and identifies key age groups and causes of death responsible for the U.S. life expectancy shortfall. METHODS: Data from the Human Mortality Database, World Health Organization Mortality Database, and vital statistics agencies for 18 high-income countries are used to examine trends in U.S. life expectancy gaps and how American age-specific death rates compare to other countries. Decomposition is used to estimate the contribution of 19 age groups and 16 causes to the U.S. life expectancy shortfall. RESULTS: In 2018, life expectancy for American men and women was 5.18 and 5.82 years lower than the world leaders and 3.60 and 3.48 years lower than the average of the comparison countries. Americans aged 25-29 experience death rates nearly 3 times higher than their counterparts. Together, injuries (drug overdose, firearm-related deaths, motor vehicle accidents, homicide), circulatory diseases, and mental disorders/nervous system diseases (including Alzheimer's disease) account for 86% and 67% of American men's and women's life expectancy shortfall, respectively. DISCUSSION: American life expectancy has fallen far behind its peer countries. The U.S.'s worsening mortality at the prime adult ages and eroding old-age mortality advantage drive its deteriorating performance in international comparisons.

  PublisherOA PDFDOI

• Immigration and improvements in American life expectancy

  SSM - Population Health · 2021-09-01 · 32 citations

  articleOpen accessSenior author

  Despite the immigrant mortality advantage and the increasing share of the population born abroad, relatively little is known about how immigration has impacted trends in US life expectancy. How immigrants contribute to national life expectancy trends is of increasing interest, particularly in the context of an unprecedented stagnation in American mortality. We find that immigration increases US life expectancy by 1.5 years for men and 1.4 years for women. Over half of these contributions occur at the prime working ages of 25-64. The difference between foreign-born and US-born mortality has grown substantially since 1990, with the ratio of US-born to foreign-born mortality rates nearly doubling by 2017. In that year, foreign-born life expectancy reached 81.4 and 85.7 years for men and women, respectively-7.0 and 6.2 years higher than their US-origin counterparts. These life expectancy levels are remarkable by most standards. Foreign-born male life expectancy exceeds that of Swiss men, the world leaders in male life expectancy. Life expectancy for foreign-born women is close to that of Japanese women, the world leaders in female life expectancy. The widening mortality difference between the US-born and foreign-born populations, coupled with an increase in the share of the population born abroad, has been responsible for much of the increase in national life expectancy in recent years. Between 2007 and 2017, foreign-born men and women were responsible for 44% and 60% of national life expectancy improvements. Between 2010 and 2017, immigrants experienced gains while the US-born experienced declines in life expectancy. Thus, nearly all of the post-2010 mortality stagnation is due to adverse trends among the US-born. Without immigrants and their children, national life expectancy in 2017 would be reduced to its 2003 levels. These findings demonstrate that immigration acts to bolster American life expectancy, with particularly valuable contributions at the prime working ages.

  PublisherDOI

Recent grants

• Health and Well-Being after Large Scale Shocks

  NIH · $182k · 2015–2017

• Health and Well-Being after Large Scale Shocks

  NIH · $720k · 2017–2021

Frequent coauthors

• Yujin Franco

  University of Southern California

  9 shared

• Duncan Thomas

  Duke University

  9 shared

• Elizabeth Frankenberg

  University of North Carolina at Chapel Hill

  9 shared

• Arun S. Hendi

  6 shared

• Pekka Martikainen

  University of Helsinki

  6 shared

• Samuel H. Preston

  Nelson Marlborough Institute of Technology

  6 shared

• Colin Mathers

  Ospedale Cristo Re

  5 shared

• Irma T. Elo

  University of Pennsylvania

  5 shared