Nancy Krieger: COVID-19, structural racism, embodied histories, and the two-edged sword of data: structural problems require structural solutions
April 23 @ 12:00 pm - 1:00 pm
On April 23, 2021, Nancy Krieger, Professor of Social Epidemiology, Department of Social and Behavioral Sciences, and Director of the HSPH Interdisciplinary Concentration on Women, Gender, and Health., Harvard T.H. Chan School of Public Health, will present “COVID-19, structural racism, embodied histories, and the two-edged sword of data: structural problems require structural solutions” as part of the Carolina Population Center’s 2020-2021 Interdisciplinary Research Seminar Series.
COVID-19 has pulled the thread, starkly revealing both profound connections – and profound divisions – both within the US and within and between countries worldwide, with risk of infection, illness, and death profoundly and inequitably socially structured. Analyzing and acting to alter the myriad ways in which structural racism systemically generates health inequities, including for COVID-19, requires engaging with the two-edged sword of data. This sword cuts deeply with respect to the profound challenges of conceptualizing, operationalizing, and analyzing the very data deployed – i.e., racialized categories – to document racialized health inequities. In my presentation, I use the example of COVID-19 to dissect the sword’s two edges: (1) the non-use (Edge #1) and (2) problematic use (Edge #2) of data on racialized groups – but the point is data for health justice. Because structural problems require structural solutions, for both data and action for health justice, I conclude with recommendations for a new feasible enforceable institutional mandate for the reporting and analysis of publicly-funded work involving racialized groups and health data. A core requirement is that racialized health data must always be conceptually justified and analyzed in relation to relevant data about racialized societal inequities. A new opportunity arises as US government agencies re-engage with their work, with a stated commitment to racial and economic justice, to move forward with structural measures to sharpen and strengthen the work for health equity.
Nancy Krieger is Professor of Social Epidemiology, Department of Social and Behavioral Sciences, at the Harvard T.H. Chan School of Public Health and Director of the HSPH Interdisciplinary Concentration on Women, Gender, and Health. She has been a member of the School’s faculty since 1995. Dr. Krieger is an internationally recognized social epidemiologist (PhD, Epidemiology, UC Berkeley, 1989), with a background in biochemistry, philosophy of science, and history of public health, plus 30+ years of activism involving social justice, science, and health. In 2004, she became an ISI highly cited scientist, a group comprising “less than one-half of one percent of all publishing researchers, with her ranking reaffirmed in the 2015 update.” In 2013, she received the Wade Hampton Frost Award from the Epidemiology Section of the American Public Health Association, and in 2015, she was awarded the American Cancer Society Clinical Research Professorship. In 2019, Dr. Krieger was ranked as being “in the top 0.01% of scientists based on your impact” for both total career and in 2017 by a new international standardized citations metrics author database, including as #1 among the 90 top scientists listed for 2017 with a primary field of public health and secondary field of epidemiology (https://doi.org/10.1371/journal.pbio.3000384)
Dr. Krieger’s work addresses three topics: (1) conceptual frameworks to understand, analyze, and improve the people’s health, including the ecosocial theory of disease distribution she first proposed in 1994 and its focus on embodiment and equity; (2) etiologic research on societal determinants of population health and health inequities; and (3) methodologic research on improving monitoring of health inequities. In April 2011, Dr. Krieger’s book, Epidemiology and the People’s Health: Theory and Context, was published by Oxford University Press. This book presents the argument for why epidemiologic theory matters. Tracing the history and contours of diverse epidemiologic theories of disease distribution from ancient societies on through the development of — and debates within — contemporary epidemiology worldwide, it considers their implications for improving population health and promoting health equity. She is also editor of Embodying Inequality: Epidemiologic Perspectives (Baywood Press, 2004) and co-editor, with Glen Margo, of AIDS: The Politics of Survival (Baywood Publishers, 1994), and, with Elizabeth Fee, of Women’s Health, Politics, and Power: Essays on Sex/Gender, Medicine, and Public Health (Baywood Publishers, 1994). In 1994 she co-founded, and still chairs, the Spirit of 1848 Caucus of the American Public Health Association, which is concerned with the links between social justice and public health.
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