- Structural Racism as a Social Determinant of Health
- Racial Inequities in Accelerated Aging, Cognitive Decline, Mental Illness, and Mortality
- Social Policy, Educational Attainment, and Causal Inference
I am a social epidemiologist investigating the mechanisms by which structural racism contributes to Black–White and other racial inequities in chronic disease risk, premature aging, mental illness, and mortality. My research evaluates policy effects and emphasizes methods for causal inference in the absence of randomization.
In the US, substantial racial differences in health persist despite efforts to reduce overall morbidity and mortality, and to address social determinants of health. Structural racism—the ongoing interactions between macro-level systems and institutions that constrain the opportunities, resources, and power of minoritized racial groups—is considered a fundamental cause of racial disparities in health. Unfortunately, adequate measurement to capture the mechanisms of structural racism remains a considerable challenge in public health research. My work helps to address this gap by measuring and evaluating the policies and processes contributing to structural racism.
My research centers Black experiences (i.e., factors that distinctively characterize Black lives in the US). To date, my research focused on three domains of Black experiences: policing, negative racial sentiment or race-based discrimination, and education. My research on policing addressed two issues—racial patterns in risk of being killed by police and police agency characteristics and policies related to police killings—and introduced innovative approaches that can examine intersectional social and environmental experiences in racism-related epidemiological research and the effectiveness of law enforcement policies that purport to save Black lives. My work has also addressed how experiences of area-level anti-Black bias, interpersonal racial discrimination, and culturally-specific coping strategies influence health, providing evidence that institutional racism contributes to physiologic stress-regulation and accelerated aging, whether perceived or not, and that improved socioeconomic position and racial identify may buffer the biological consequences of racism.
My research has subsequently evolved into a deeper examination of structural racism in higher education, either as public policy or through individual-level educational attainment, as a potential causal driver of Black-White inequities in health. Higher educational attainment offers indirect social and health benefits through access to social privilege and prestige, higher income, healthier behaviors, ability to cope with stressors, and increased utilization of health care. Consequently, education is a strong predictor of cardiometabolic risk, mental illness, dementia, and mortality. Though structural racism is implicated as a fundamental cause of higher education gaps, little to nothing is known about if, and to what extent, uniquely Black college experiences influence health in Black adults. As such, I aim to explore the long-term health effects of education policies that govern Black experiences in institutions of higher learning, specifically Historically Black Colleges and Universities (HBCUs).
As a postdoctoral scholar in the Department of Psychiatry and Behavioral Sciences, I received a K99/R00 Award from the National Institute on Aging to study the impact of HBCUs on late-life cognition in Black adults with Drs. M. Maria Glymour, Rita Hamad, Kirsten Bibbins-Domingo, Justin White, and Christina Mangurian. I also co-lead the SF BUILDing Bridges Program, an NIH funded program to enhance diversity of the biomedical research workforce by transforming the teaching and research environments at San Francisco State University. Last, I am an active participant in the Glymour Research Group (https://glymourgroup.ucsf.edu/team), UCSF PReMIUM Group (https://integration.ucsf.edu/staff), SPHERE Research Group (https://sphere.ucsf.edu/our-research-team), and HEARTS Research Group (https://publichealth.berkeley.edu/research/hearts-research-group/).