Research

Body weight as a dimension of inequality in the United States

Amid rising concern about the ongoing obesity ‘epidemic’, body weight has emerged as key criterion by which we assess individuals’ health and wellbeing. Yet, categorizing and labeling people as ‘overweight’ or ‘obese’ on the basis of their weight has contributed to the growing stigmatization and devaluation of many children, adolescents, and adults. The health and social consequences of this marginalization are profound, fueled by a narrow perspective on what it means to be ‘healthy’ and ‘fit’ in the modern world. Seeking to better understand uncertainty in the study of obesity and weight-related health, my dissertation used a mixed-methods approach to examine the many contexts in which body weight is defined or constructed as a health risk. This work was supported by a UNC Summer Research Fellowship and a Royster Dissertation Completion Fellowship. The first chapter from my dissertation was published in Social Science & Medicine, and others are being revised for Demography and the Journal of Health & Social Behavior.

Definition and conceptualization of health and the social determinants of population health

Critical sociological theory on the social construction and subjectivity in our definitions and conceptualizations of health is invaluable for advancing clinical, biomedical, and population health research. In a highly-cited paper published in Social Theory & Health, I argue for a more holistic – and less diagnostic – approach to body mass index in research and clinical practice. In a similar vein, my paper in Medical Humanities demonstrates how the biological reification of race in biomedical research contradicts scientists’ personal desires for greater racial health equity; rather, greater awareness of the social determinants of racial variation in biomedical studies would further efforts to recognize race as a social construct. I also have a paper on the issues in conflating the language and assumptions of unhealthiness versus riskiness in the use of the body mass index and obesity in research, published in Sociology of Health & Illness. A more recent publication, also in Sociology of Health & Illness, considers the promises and perils of adopting “social determinants of health” (SDoH) as a diagnostic category in medicine, emphasizing how the many meanings and uses of SDoH lead to very different conclusions about who is responsible for improving population health and by which mechanisms.

Empirical examinations of measurement in population health research

I use theoretical critiques of the conceptualization and definition of health to inform empirical examinations of measurement and modeling in population health research. Working with Dr. Ken Bollen, I have modeled measurement error in the reliability and tested different models for trajectories of self-rated health, with papers published in Social Science Research and Demography. Similarly, I am first author on a paper published in Social Science & Medicine, developing and testing a model of “latent” despair and its association with substance use and suicidality in midlife. In this analysis, our findings demonstrate the validity of despair as a complex, multidimensional construct with emotional, cognitive, behavioral, and biosomatic indicators. However, we demonstrate that the association between latent despair and key behavioral precursors to so-called “deaths of despair” from substance abuse and suicide varies considerably, indicative of heterogeneity in the etiology of these causes of death and their precursors.

Distal and proximate determinants of health and mortality in the United States

I maintain that inequalities in health are a clear and unambiguous outcome of social inequality, across multiple socioeconomic and demographic axes. I have examined educational variation in the association between central obesity and premature mortality, finding that the relative harmfulness of obesity is higher among college-educated adults relative to their less-educated peers, likely owing to a lack of competing risks. This work has been awarded by IPUMS and IAPHS, both of which recognized the paper as an example of outstanding student research, and was published in Social Science Research. I have also collaborated with Dr. Robert Hummer, to document racial/ethnic and nativity disparities in the health of older U.S. adults for a National Academy of Sciences report, as well as to study the association between individuals’ employment and occupations and working-age mortality in recent years. Building off recent interest in rising U.S. “working-class” mortality, our project finds that adults in various service, manual labor, and even some “white-collar” occupations – as well as those not at work – are at significantly elevated risks for drug-related deaths. This work was also recognized by IPUMS and was published in Preventive Medicine.  Other projects have examined the contribution of specific causes of death in early life to racial differences in life expectancy (in Demography), geographic variation in early life mortality (in Demographic Research), and the role of financial loss as a mediator of educational attainment and harmful health behaviors (in SSM-Population Health). Finally, I was first author on a contribution to the Annual Review of Sociology, wherein Dr. Hummer and I provide a critical overview of what the intersection of social inequality, biodemography, and emerging threats to population health portends for the future of life expectancy in the United States.

Prior to my starting graduate school, I was involved in education and adolescent research at NORC at the University of Chicago, serving as a contributing author on studies published in the Journal of Marriage and Family as well as Teachers College Record.

A full list of my published research can be found on my Google Scholar profile.