Research > Research Themes > Health and Well-being of Populations

PSC Researchers identified with this theme are listed below.

This is research devoted to understanding the physical and psychological well-being of individuals, but differs from clinical research and medical practice in focusing on population health. Declines in childbearing and advances in clinical medicine, public health, and material wellbeing have created populations—in the US and abroad—that are older and longer-lived than at any time in human history, in spite of serious epidemiological issues. Advances in life expectancy and access to health care are unequally distributed—socially, economically, and geographically. The costs of healthcare in the US constitute an ever-increasing fraction of the economy—more than in other developed nations—and the gap in expenditures on medicine and public health between the developed and less developed worlds is extreme. These are issues in which integrated knowledge from the social sciences is crucial. This includes the study of health care policy; the implementation of health care programs in specific cultural, social, and political contexts; the demographic causes of demand for health services; and the demographic consequences of changes in mortality, morbidity, medicine, public health, economic and social development, and inequality.

This theme reflects core PSC strengths in research on health services and on social stratification. By social stratification, we mean social and geographic differences between groups within populations, primarily by race, ethnicity, gender, and social class. The domain of this signature theme is defined along a continuum: At one end is population-based health services research not explicitly linked to stratification. Aiken has a large research enterprise focused on the relationships among labor markets for nurses, the organization of nursing within hospitals, and outcomes ranging from occupational safety to patient mortality. It has made her highly influential—she routinely ranks among the most influential individuals in medicine, nursing, and health care—in the formulation of policies regarding such matters as nurse-to-patient staffing ratios. Polsky has, conversely, written on physician workforce responses to managed care. Pauly’s Distinguished Investigator Award from the Agency for Healthcare Research and Quality recognizes his significant and long-lasting contribution to the field of health services research and the promotion of evidence-based decision making. Soldo and colleagues show that public policy initiatives to increase health insurance coverage rates in Mexico could lead to higher preventive health-care utilization rates and improvements in population health.

At the other is a set of inquiries into the evolution of stratification systems including the maintenance, definition, and replication of various sub-populations: Katz’s One Nation Divisible: What American Was and What It Is Becoming, articulates the processes behind the enduring inequality between African– and European- Americans; Zuberi’s Thicker Than Blood: How Racial Statistics Lie uses ideas on causation from Smith among others to critique the use of racial categories in social statistics, including population studies; and Kao has written a series of papers, supported by an NICHD R01, on dating and homophily, with implications for our understanding of the maintenance of racial and ethnic identity. There is also a line of research on where groups live relative to one another and the implications for their well-being: Charles’ Won’t You Be My Neighbor? shows how contemporary racial attitudes shape, and are shaped by, the places where we live; Madden’s work on the decline in income segregation as better-off blacks move into neighborhoods with worseoff whites; and Harknett’s work on how local marriage markets affect the quality of marriages.

Most of the work in this theme moves from either end of the continuum to the study of the influence of social stratification on health outcomes. Work by both Armstrong and Jacobs looks at the interaction between provider and patient status characteristics (race and gender) in the provision of effective health care. Allison’s high-profile work, with N. Christakis, in the New England Journal of Medicine, considered the effect of the hospitalization by condition and/or death of a spouse on the mortality of the non-hospitalized spouse, but also gender and race. Elo and J Culhane have projects and papers on race, neighborhood, and various forms of health and well-being; Elo has much related work on schooling differentials in mortality and race-ethnic differentials, including black-white differences in "avoidable mortality," mortality from causes of death for which prevention or medical treatment are important. Jemmott is a national and international authority on scaling clinical interventions, culturally specific to race and ethnic groups, to the population level, especially with reference to sexual health and AIDS prevention. Mandell has pioneered the study of how differences by race, SES characteristics, and state-level rules influence the incidence of psychiatric diagnoses for children, especially of autism; inequality in access to treatment tends to reflect racial and SES differences across populations. Chang’s work is also very much at the confluence of health services research, involving studies of residential segregation, social status stratification, inequality, and the propensity toward obesity.

PSC Research Associates involved in this area of research:
Aiken, Allison, Armstrong, Chang, Charles, Culhane D, Culhane J, Elo, Harknett, Jacobs, Jemmott, Kao, Katz, Madden, Mandell, Pauly, Polsky, Preston, Rosenbaum, Schnittker, Smith, Soldo, Stevenson, Zuberi

PSC Students interested in this research area:
Appiah-Yeboah, Bangha, Chae, Chin, Harhay, Ho, Margolis, Mykyta,Ruther, Saabneh, Schott, Sironi, Steinweg, Stokes, Sullivan, Tesfai, Vala-Haynes