Race, class and gender have long been known as the “Holy Trinity” of social divisions in the United States. But why and how these factors lead to disparities in health is still not clear, much less the question of whether such inequalities are inevitable.
Sociologist Tyson Brown wants to get at those questions. The new assistant professor from Vanderbilt University is heralding an innovative approach called intersectionality in an attempt to understand the joint health consequences of social factors.
The sociologist’s research shows the effects of social factors interact in a way that is more complicated than previously believed, but they also point to public policies that could, despite generations of historical imbalances, still alleviate differences in outcomes.
In recent studies of health disparities, Brown is using both critical, intersectional frameworks and advanced quantitative approaches to show how race, class and gender not only contribute to gaps in health outcomes, but also their simultaneous and multiplicative effects.
“The conventional sociological approach to studying the social stratification of health has been to examine how an individual’s position in a single status affects well-being,” Brown said. However, such unidimensional approaches do not adequately capture within-group heterogeneity or racial and gender differences in health returns to socioeconomic resources.
“For example, social scientists studying racial inequality in health infrequently consider how it varies by gender or socioeconomic status, and vice versa,” Brown said. “Examining inequalities along these single lines masks their joint consequences. Individually, each has a direct effect, but together there is an important additional synergetic impact.”
Multidimensional studies have been the exception rather than the rule due to conceptual and methodological challenges. But Brown and others are able to get into the weeds of large, nationally representative data sets to identify the patterns and explanations for the intersecting health consequences of race, class, and gender.
“We take an intersectional and biopsychosocial approach to examine how unequal exposure to chronic stress, discrimination, incarceration, and poor neighborhoods are key mechanisms through which inequality ‘gets under the skin.’”
Brown’s research combines two of Duke’s strategic priorities: quantitative analysis of large data sets and study of the impact of social inequalities. In addition to his teaching and research, Brown joins psychology professor Gary Bennett as the new co-director of the Center for Biobehavioral Health Disparities Research, which brings together faculty from across the university interested in the topic. He is co-investigator on a $3.4 million National Institutes of Health grant awarded to the center to study the effects of stress, discrimination, coping style and genetics on health and longevity among older African Americans and their families.
Brown said he’s excited to work with an interdisciplinary group of faculty members at the center who can bring a variety of approaches. His own sociological training is valuable because “it highlights the importance of social context.”
“Sociological research helps us understand how social factors shape exposure to an array of risks that have harmful effects on health. It also points to stark group differences in access to health-promoting factors such as education, financial resources, safe neighborhoods, and quality health care.”
While many of these inequalities appear to increase over the course of peoples’ lives and persistent across generations, Brown said the evidence shows that none of them are set in stone. “Social and economic policy is health policy,” Brown said, adding that “reducing social inequalities in many areas of life, including education, jobs, wealth, neighborhoods, incarceration and exposure to toxic stress would go a long way toward eliminating health disparities and improving population health.”
“Health disparities are not inevitable and they fluctuate over time. Given that social and economic policies have contributed to health disparities, it stands to reason that that they can also play a key role in ameliorating them. For example, there’s evidence that civil rights legislation narrowed key racial disparities in health.”
Brown is no stranger to Duke, having served a NIH postdoctoral research fellowship here from 2008 to 2010. “My department is dynamic, and I’m fortunate to have excellent colleagues. Furthermore, we have a a vibrant graduate program with a strong record of placing graduate students in good jobs in the academy. I find that I thrive when I’m in such an environment.”
He is currently teaching a graduate course on “Race, Gender, Class and Health,” that includes not only sociology graduate students but those from across the university, including global health and nursing. He said he enjoys the mix of experiences the students bring.
At home in Durham near the Durham/Orange County line, he and his wife make heavy use of the nearby Eno River, where their toddler daughter plays and their 60-pound chocolate golden doodle dog runs with energy.