Courtney Boen

My past, current, and future research projects align with an overarching agenda aimed at uncovering the causes and consequences of population Health Disparities in Aging, with a particular focus on racial and ethnic health inequities. With training in sociology, demography, and public health, my work aims to improve understanding of how macro-level racial and socioeconomic inequality “get under the skin” to affect health and disease risk across the life course, from birth through late life.

I am currently engaged in several projects that examine how structural racism patterns psychosocial stress exposure, promotes chronic activation of bodily physiological stress response systems, and ultimately contributes to disparities in disease emergence and progression. Utilizing a variety of analytic techniques— including quasi-experimental designs, treatment weighting procedures, and longitudinal fixed effects models— this research contributes new causal evidence linking macro-level racial inequality to disparities in micro-level biological processes.

This line of research built on earlier research investigating the social factors producing population health disparities. In one study published in Social Science and Medicine, I used more than twenty years of longitudinal data from the Panel Study of Income Dynamics to examine how Black-White differences in long-term socioeconomic exposures contributed to racial disparities in multiple health outcomes across the life course. This study revealed that long-term SES exerted a lasting influence on trajectories of body mass index and self-rated health and contributed to the life course patterning of Black-White health disparities, net of point-in- time measures of SES. I also documented that Blacks and Whites received differential health returns to increases in SES, suggesting that other factors—such as neighborhood segregation and exposure to stressors including racial discrimination—may restrict Blacks from converting increases in SES into health improvements in the same way as Whites. This paper received a paper award from the American Sociological Association’s Section on Aging and the Life Course.

I was also lead author of another study published in Social Science and Medicine that was among the first studies to examine the effects of the Great Recession on individual health and well-being. Using a quasi-natural experimental design and longitudinal fixed effects models, I showed that household-level wealth shocks experienced during the Great Recession significantly affected the physiological functioning of older adults, such that losses in net worth from the pre- to the post-Recession period were associated with increases in blood pressure and systemic inflammation.

I have also collaborated on studies that assess how exposure to socioeconomic disadvantage in early-life affects biological markers of health—including C-reactive protein and markers of metabolic functioning—from adolescence through old age. Together with collaborators, I have tested theories regarding the life course timing of socioeconomic exposures in order to elucidate how trajectories of socioeconomic well-being relate to biomarker of health and physical functioning. Our work in this area has been published in Biodemography and Social Biology, the American Journal of Preventive Medicine, and The Journals of Gerontology: Social Sciences.

Another strand of research inquiry assesses how access to social relationships and exposure to relationship strain both buffer against social stress exposure and contribute to disparities in health and disease risk across the life course. One study, which was published in the Proceedings of the National Academy of Sciences, used data from four nationally representative data sets to reveal the critical importance of social relationships in predicting markers of metabolic, cardiovascular, and immune function across the life course. This study documented not only the protective health effects of social ties, but also revealed the health risk associated with social relationship stress. Findings from this project received coverage in a number of major news outlets, including The New York Times and The Washington Post. I was lead author of a collaborative study with researchers at the Linberger Comprehensive Cancer Center at UNC-Chapel Hill that examined the associations between social relationship support, physiological inflammation, and mortality among individuals with cancer. A paper based on this study has been accepted and is forthcoming at Cancer Epidemiology, Biomarkers, and Prevention. I also co-authored a related study in the Journal of Aging and Health that showed that embeddedness in social networks was protective against increases in blood pressure in late life.

My current research, related to PARC theme Cognition and Alzheimer’s Disease and Related Dementias (ADRD), builds on my substantive expertise in health disparities, biosocial interactions, life course processes, and psychosocial stress to examine the role of stress exposure in producing racial, ethnic, socioeconomic, and immigrant-native disparities in markers of biological, physical, and cognitive well-being across the life course. Using data that spans from birth through old age, this research aims to generate new knowledge of how social exposures impact biophysiological and cognitive change across the life course and contribute to population disparities in health and mortality.

In 2017, I received a Quartet Pilot Project, Biological Risk, Physical Functioning, and Psychosocial Stress among Older Age Hispanics, funded by the PARC NIA AG012836. Findings from this study improve understanding of the health profile of the aging Hispanic population in the United States and shed new light on social and biological mechanisms and life course processes underlying racial, ethnic, and nativity-status disparities in health from mid- through late-life. By examining how exposure to a diverse set of socioeconomic, stress-related, and behavioral factors across the life course relate to the biological, psychological, and physical functioning of aging Whites, Blacks, and Hispanics, this research provides new knowledge of the social patterning and determinants of population health disparities and informs prevention and intervention efforts aimed at achieving health equity. With these funds, I was able to hire and mentor a grad RA, presented my findings at the Sylvan M. Cohen Annual Retreat and Poster session sponsored by the Institute on Aging (IOA) at Penn, and received subsequent funding from the Penn IOA pilot competition.