SBS Department Newsletter
Spring2, 2024
| |
| Department of Social and Behavioral Sciences
| |
|
The Need to Address the Persistence of Unequal TreatmentIn 1999, Dr. Kevin Schulman and his colleagues published an article in the New England Journal of Medicine, reporting the findings from a study that had been conducted at a medical conference. Some 720 internal medicine physicians had viewed a video of a patient describing their cardiac symptoms and had been asked to make a treatment recommendation. What the physicians did not know was that all of the “patients” were actors and they had described their background and symptoms with identical language. The only thing that differed was that some were black and some were white, some were male and some were female. Stunningly, the study found that when presented with identical symptoms, doctors were less likely to recommend cardiac catheterization (the appropriate next step given the symptoms) for women and blacks compared to men and whites, respectively. The study received considerable media attention, and at the urging of the Congressional Black Caucus, the US Congress provided funding to identify if what happened at a medical conference with fake patients occurs when Americans entered healthcare contexts in the US. This resulted in the landmark report from the Institute of Medicine (now National Academy of Medicine), titled Unequal Treatment, published in 2003, that found that across virtually every therapeutic intervention, blacks and other minorities receive less intensive care and poorer quality care than whites.
I served as a member of the committee that prepared that report, and last year I participated in multiple conferences seeking to assess what progress had been made in the last 20 years. Alas, there is a ton of new research documenting the striking persistence of racial/ethnic inequities in the quality of care. Here are the findings of a 2023 study by Dr. Andrea Enzinger and colleagues. They examined the care that over 318,000 Medicare patients with advanced cancer had received in their waning days of life. It found that African Americans and Latinos were less likely than whites to get opioid medication for their pain and when they received medication, they got lower doses. African American patients were also more likely than others to undergo urine drug tests to identify if they were abusing opioids. And African American males were the most disadvantaged, being the least likely to get opioids and the most likely to get urine tests for opioid abuse.
Implicit bias is likely to be a major contributor to the striking pattern of unequal treatment. And a comprehensive review of the research on implicit bias training and diversity programs by Frank Dobbin and Alexandra Kalev finds that while these programs are useful in raising awareness levels about bias and can lead to more positive attitudes toward diversity, they do very little to reduce implicit bias. However, Professor Patricia Devine, at the University of Wisconsin, has documented that it is possible to get nonblack adults to increase their motivation about addressing implicit bias, implement multiple strategies to reduce it, and to successfully reduce bias, with the reductions still evident three months later. What is the key to what she's doing? Her implicit bias program is a 12-week program, with homework exercises, and success in reducing implicit bias is greater among those who faithfully complete the homework assignments. Her program is not a brief workshop trying to deal with deeply embedded processes of how our brains function. Her research highlights that it takes a long-term commitment and practice to make progress in reducing bias.
Equally important, the problem within the healthcare system, and our social institutions more generally, is not simply a problem of implicit bias. Yes, unconscious bias is real and we need to address it. But we cannot stop there. We need to also focus on the upstream mechanisms of racism within our healthcare system and society, and we need to recommit to dismantling them. But we also need a new appreciation that ALL of us human beings have the potential to treat others differently, based on deeply embedded, often unconscious, assumptions that we hold based on what we learned about various groups from our culture. And we need a “Devine intervention” to overcome the ways our brains normally function so that we can begin to treat every individual that we encounter with the dignity and respect that that person deserves.
David R Williams
Florence Sprague Norman and Laura Smart Norman Professor of Public Health
Chair, Department of Social and Behavioral Sciences
| |
I am interested in refugee health, maternal and child health, reproductive health, substance use, community-based participatory research, and mixed methods.
| |
My research interests include cancer disparities, health equity, social determinants of health, and the intersection of obesity, unhealthy eating, and cancer risk. Through my doctoral studies, I hope to focus on cancer prevention research with an emphasis on implementation science, community engagement, and health promotion.
| |
Congratulations to the SBS staff, faculty, and academic appointees who have reached a key milestone at Harvard in the calendar year 2024:
5 Years
Mary Bassett
Nigel Harriman
Amy Kelly
Beth MacEachran
Trang Nguyen-Dafforn
Ramya Pinnamaneni
Todd Reid
Heidi Smith Pento
10 Years
Jessica Davine
15 years
Jessica Barrett
25 Years
Laura Kubzansky
| |
Climate Change Planning through a Black Feminist Ecological Lens
Thurs, April 4th, 1:00-1:50pm
FXB G11
Join WGH and Dr. Fushcia-Ann Hoover, 2023-2024 Radcliffe-Salata Climate Justice Fellow, for a brief presentation followed by a lunch and learn-style discussion on Black Feminist Ecology! RSVP here!
Discover your Ikigai with Altruism: A Workshop for Finding Personal Fulfillment and Contributing to a Better World
Fri, April 5th, 1-1:50 PM
Kresge 202A
We invite all Harvard ID-holders to join the Lee Kum Sheung Center for Health and Happiness Student Interest Group for “Discover your Ikigai with Altruism: A Workshop for Finding Personal Fulfillment and Contributing to a Better World.” This workshop will be led by Center Student Steering Committee member Sarah Wang, MPH ’25, and lunch will be provided.
Learn more and RSVP here.
Framing public health: Evidence-based strategies for effective communications
Tues, Apr 9, 1:00 - 1:50 pm
Kresge 502 or Zoom
Join Moira O'Neil, Vice President of Research Interpretation at FrameWorks Institute, for a discussion of effective framing strategies for public health change. Lunch will be served. This event is presented in collaboration with the Harvard Chan School's Health Communication Concentration and the Stanford Health Equity Media Fellowship. Moira will share her own perspectives; she does not speak for Harvard.
Building a career in health communication - Insights from industry experts
Tues, Apr 9, 5:30 - 7:00 pm
FXB Atrium
This health communication career panel will feature LaVerne Canady, Moira O'Neil, Katelyn Billings, and Mary O'Reilly. The first hour will feature the panelists reflecting on their careers in health communication and the final 30 minutes will be reserved for networking. Dinner will be served. This event is presented in collaboration with the Harvard Chan School's Health Communication Concentration. Panelists will share their own perspectives; they do not speak for Harvard.
Equity in Policies and Interventions to Advance Social Connection
Wed, April 10th, 1-1:50 PM
FXB G12 or online
Join the Center for Health and Happiness for a seminar led by Dr. Ichiro Kawachi, and the latest installment in our Loneliness and Well-being Seminar Series. Lunch will be provided. Learn more and RSVP here.
SBS DIB Film Screening: Conscience Point
Tues, April 16, 1 pm – 2:30 pm
Kresge 201 or Zoom
All HSPH staff, faculty, and students are invited to join the SBS Diversity, Inclusion, and Belonging Committee in collaboration with the FXB Center for Health & Human Rights for a hybrid screening of the documentary Conscience Point. Participants are welcome to join for all or part of the screening and will have the opportunity to interactively engage with the film content in real-time by responding to reflection questions. Conscience Point tracks the fractured history of one of the wealthiest zip codes in the U.S.: the Hamptons, where the Shinnecock Indian Nation were edged off their land over the course of hundreds of years, pushed onto an impoverished reservation, and condemned to watch their sacred burial grounds destroyed to make way for residential and commercial development.
Lunch will be provided for in-person participants.
Gratitude Unfolded: a Workshop on Integrating the Art of Noticing and Appreciation into the Student Journey
Thurs, April 18th, 1-1:50 PM
Kresge 202B
We invite Harvard students to join the Center for Health and Happiness for this workshop led by Center Student Steering Committee members Suceil Sivsammye, MPH ’24, and Michelle Shah, MPH ’25. Lunch will be provided. Learn more and RSVP here.
The ethics of AI in public health communication
Tues, Apr 23, 1:00 - 1:50 pm
Kresge 502 or Zoom
This event is presented in collaboration with the Harvard Chan School's Health Communication Concentration and the Stanford Health Equity Media Fellowship. Speakers will share their own perspectives; they do not speak for Harvard.
Environment, Women, and Children: Experiences from the Fukushima nuclear disaster
Wed, April 24th, 1:00-1:50pm
FXB G12 (Zoom option available)
Anti-Black Racism and Transphobia in Sports + Fitness
Thurs, May 2nd, 1:00-1:50pm
Join WGH and Justice Roe Williams, Ilya Parker, and Dr. Roc Rochon for a discussion and Q&A: With the Olympics approaching, it is a crucial time to reflect on what types of bodies are welcome to participate in sports vs. those that are not, how structural barriers and discrimination shape sports culture, and what public health and social justice implications this engenders. RSVP here!
| |
|
SPHERE Director Rita Hamad and SPHERE Statistician Daniel Collin: Finalists, 2023 Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Research Impact Award, Robert Wood Johnson Foundation Healthy Eating Research Program / Nutrition & Obesity Policy Research and Evaluation Network.
| |
| Beyer L, Slopen N, Chen J. Wealth, Health, and Childhood Physical Abuse: A Longitudinal Study of Older Americans. SHSSM National Conference for Physician Scholars in the Social Sciences and Humanities. Oral Presentation | Chapel Hill, NC | April 14, 2024
Howard, J. Long COVID and Work. Co-sponsored by the Center for Work, Health and Well-being and the Harvard Education and Research Center. Seminar | Harvard Chan School, FXB G12 and Zoom | April 1, 2024 at 1:10-1:50 pm.
Hamad, R. Invited panelist. “Interrupting Intergenerational Poverty: New Research and Recommendations for Policy and Practice.” Institute for Research on Poverty, University of Wisconsin-Madison. March 2024.
Hamad, R. Invited speaker. “Safety Net Policies to Address Pandemic-Era Health Inequities: Impacts and Challenges.” Center for Health Equity, University of California San Francisco. May 2024
Kentucky Conference on Health Communication
Oral Presentation | Lexington, KY | Apr. 6, 2024
Top Four Papers in Health Communication, International Communication Association
Oral Presentation | Gold Coast, Australia | Jun. 22, 2024
Krieger N. Introduction and Radical History of International Women’s Day, for “International Women’s Day, Intersectionality, and Health Justice” celebration, organized by the Interdisciplinary Concentration on Women, Gender, and Health, Harvard T.H. Chan School of Public Health, Boston, MA, March 8, 2024.
Krieger N. Embodied truths, scientific integrity, & health justice: rhetoric, racism, and reality. Invited presentation for the Boston Public Health Commission (BPHC) BPHC Center for Public Health Science Technology and Innovation Conference, Boston, MA, March 11, 2024.
Krieger N. Invited panelist: “Economic systems conversation with NASEM Roundtable on Population Health Improvement.” March 18, 2024 (webinar/webcast).
Kubzansky, LD. Integrating Psychosocial Factors with Omics Science
Social to Biological Research Collaborative, University College London
Guest seminar | London, UK | March 12, 2024
12th Annual Roma Conference. Harvard University’s Barker Center. April 5, 2024.
Peters SE. The Measurement of Wellbeing from Work
26 Trowbridge St in Cambridge, MA and Zoom | April 12, 2024, 9:00 am - 12:30 pm.
| |
| Kim MH, Frøslev T, White JS, Glymour MM, Ilango S, Sørensen HT, Hamad R. “Mediating pathways between neighborhood disadvantage and cardiovascular risk: Quasi-experimental evidence from a Danish refugee dispersal policy.” American Journal of Epidemiology. In press.
Clark, D., Kikut-Stein, A., Jesch, E., Hornik, R.
Should Communication Campaigns Promoting Vaccination Address Misinformation Beliefs? Implications from a Nationally Representative Longitudinal Survey Study Among U.S. Adults.
Journal of Health Communication, in press
Krieger N. Epidemiology and The People’s Health: Theory and Context. 2nd edition. New York: Oxford University Press, 2024.
Qureshi F, Guimond A-J, Tsao E, Delaney S, Boehm JK, Kubzansky LD.
Journal of Adolescent Health | In press
Motta, M., Liu, Y. & Yarnell, A. “Influencing the influencers:” a field experimental approach to promoting effective mental health communication on TikTok. Sci Rep 14, 5864 (2024)
| |
|
|
|
|
