Courtney Boen, Research Associate at the Population Studies Center and Assistant Professor of Sociology, sat down with us to speak about her journey to graduate school and current projects at Penn.
What brought you to Penn? When I was on the job market and interviewing, I remember leaving Penn thinking that I had met with so many people that I thought were trailblazers in their own fields. Even if they weren’t demographers or didn’t study health or racial inequality the same way I did, I admired them as scholars. They asked me really critical, poignant questions about my own work that I hadn’t necessarily considered. I was amazed by both the intellectual capacity of so many of the people here, but also the diversity. How they thought about the world varied so much, and I was excited by that.
How did you discover your field of study? I have a Master’s in Public Health, and before going back to graduate school I worked in public health for about 5 years at the state and local level in Massachusetts. Most of my time spent there was working as a policy analyst focused on how to develop policy solutions to reduce racial health disparities in the city of Boston. It was very on the ground, dealing with local budgets and thinking about local intervention.
I remember so saliently sitting in a meeting when I was at the health commission in Boston. I was part of this group that was reviewing the annual health of Boston report that included health indicators of the city and the general health of the city. We were talking about infant mortality rates, and our health commissioner put up a slide that showed that black women with a college degree or higher had higher rates of infant mortality than white high school drop outs. They had worse infant mortality rates—even if they got prenatal care, didn’t smoke, had health insurance, or had advanced degrees—than white women who never got prenatal care or who smoked during pregnancy. I remember being so disturbed by that. I realized that we as a society had a lot of work to do to understand how the lived experiences of black women throughout the life course—their exposure to racism, their exposure to stress, their racialized identities, their interfacing with social institutions—impacted their health in such a way that produced such stark health inequities. That’s sort of what lead me intellectually back to Sociology and to Demography. I was really struck and motivated by this injustice.
When I went back to graduate school I went back with that question always being the motivating one. Why is it that we espouse people that they have so much control over their own health and yet people who are doing everything right are still not able to live their most healthy and productive lives solely because of racism? When I went to UNC Chapel Hill I got training at the Carolina Population Center, and that’s where I realized the utility of understanding population processes and population health. The techniques and the ways in which demographers ask and answer questions was relevant to the questions I had in mind.
"What is unique about pop centers is that they bring together people with different theoretical orientations to answer questions in new and exciting ways."
Do you feel like it influenced your research? I would say so. What is unique about pop centers is that they bring together people with different theoretical orientations to answer questions in new and exciting ways. I worked and collaborated with folks as a demography student that I wouldn’t have otherwise. My questions are about population health inequality, and you can’t understand racism, health, population trends and policy without the type of intellectual diversity that I found at UNC’s Carolina Population Center. I think that’s where a population center is useful.
It seems as though in the past the media generally has not addressed a lot of the racial disparities when it comes to health, but recently we have seen more articles about pregnancy and racism. Even Serena Williams, one of the greatest athletes of all time, talked about her difficulties after giving birth. Yes exactly. Pro Publica put out these series of reports about high levels of maternal mortality. There was one story that I thought was incredibly powerful about one woman who was a researcher at the Center for Disease Control studying infant mortality, and she died due to preventable and treatable complications following child birth. This basically shows that you can’t be immune to your social conditions. I think it just hits you in a different way anytime we hear about infant or maternal mortality because our reaction is that no one should have to deal with or think about these things.
How important have mentors been in your career trajectory? My experience as a mentor is so much informed by the mentors that I had. I was incredibly lucky to have fabulous mentors. I had co-chairs for my dissertation, and they were like “The Odd Couple.” They don’t study the same thing; one is an ethnographer who studies race and education and the other is a demographer who writes methods books on mortality trends. I think my mentality has always been to find the benefits of each, and, in this case, find the best way that they could each contribute to my growth. One of them was a more traditional mentor; she would read and critique anything I sent her. My other chair was a collaborator and trained me in a very “let’s-work-through-these-problems-together” way. I try to take that with me. I’m also conscious of how I give feedback and how I can support students as people, parents and partners and all the other things that they are, and how can I involve them in my projects so that they get experience.
Do you have any advice in particular for graduate students looking to get involved in a research project? I think one of the challenges and rewards of being a graduate student is that you are in charge. As an undergraduate it’s a lot of top down guidance, whereas, in graduate school, the student has control. The questions you need to ask are: What’s the career I want? And, how do I get there? And try to collaborate. The worst thing a person can say to you about working on their project is no. Alternatively, anyone can ask a faculty member to be on their project. As a grad student I wanted a higher level of buy in from a faculty member and I needed more guidance that I knew I wasn’t going to get unless they were a co-author, so I asked them to join me on a project. It eventually turned into my first lead-author paper.
What projects are you working on now? Right now, I am working on getting my dissertation published. The focus of my dissertation is examining how racial inequality in the United States patterns individual stress exposure in ways that harm health; or, in other words, how does racialized stress get under the skin to effect health as people age. I looked at racialized stress in different domains of social life and how exposure to these stressors across the life course impacted trajectories of health. For example, how does racism pattern exposure to the criminal justice system in the form of police stops and searches, arrests, incarceration? And, how do these experiences serve as health-harming stressors throughout life?
Another paper I’m finishing looks at how cumulative stress exposure from childhood through late life impacts racial health disparities at old age. The black-white health disparities that we see in people ages 55+ are the result of their cumulative stress exposure throughout their life course. I’m really trying to study and think of this problem as “death by a thousand cuts”—the constant assaults that happen as a result of living in a racially stratified society that produce divergent trajectories of health as people age. There are a number of related projects that I’m trying to get out the door and still working on.
I got funding through the Quartet Pilot Competition to expand some of that work by looking into the health of older aged Hispanic populations in the United States to try and understand the long standing finding of the Hispanic Mortality Paradox. The Hispanic Mortality Paradox refers to the epidemiological finding that Hispanics and Latinos in the United States live longer despite having lower socioeconomic status. You would expect them to have outcomes that are similar to African Americans and in fact they are outliving whites. We have a project looking at the biological profiles of older age Hispanics. I’m examining how they are exposed to various stressors across the life course and some of the factors that are protecting their health as they age.
"At the core we are trying to understand what aspects of wealth are seemingly most protective against poor health as people get older."
I have a project where were looking at how the racial wealth gap and racial differences in wealth portfolios impact health outcomes as people age. Wealth is incredibly racially stratified in the US because it’s a product of historical legacies of racism but also contemporary racial inequality in the lending and housing markets, and we are trying to understand how that impacts population health. There are a couple economists at Duke and the New School that have been getting a lot of press recently because they are proposing strategies for how to build wealth in communities of color. They’ve outlined policy solutions like baby bonds for low income families, where we give bonds to kids at birth as a way to build wealth so that everyone becomes a “trust fund baby”. At the core we are trying to understand what aspects of wealth are seemingly most protective against poor health as people get older. Is it housing? Is it Savings? What is it? This can inform policy.
How have professional organizations been valuable to you? The two that I’m most active in are the ASA (American Sociological Association) and PAA (Population Association of America). I’m just starting to get more involved. I was asked to be on the ballot for the Medical Sociology section, so I’m going to be potentially a section member. As a graduate student, I used professional organizations as an opportunity to share my work and to network with people, and I continue to use conference deadlines as paper deadlines.
How do you navigate networking situations with scholars from disparate fields of study? I think part of being in an NIH-Funded Population Studies Center is that all of us are inherently interested in social problems that cross disciplinary boundaries in one way or another. Talking about infant mortality rates without cloaking that conversation in all sorts of disciplinary jargon makes it easier for people to understand that problem or question. I think population scholars are generally motivated by questions of population problems, social justice, and social equity that cross disciplinary boundaries.
Is there anything you're looking forward to in the coming year? I’m presenting at PAA this year! I have two presentations, and I’m excited about going to Denver. I’m also excited to teach my class again this semester. I taught a freshman seminar about social inequality and health. I had a really diverse group of students in terms of where they’re from and their majors. At this point I’m not questioning that the class is working but, rather, how to tweak it to make it better.
What is a piece of advice you would give someone in training to be a population researcher? One thing that I found extremely helpful is to ask: What does your 10 year plan look like? Where are yougoing to be in 5 years? And work backwards from there. When you’re in the grind of graduate school it’s easy to lose sight of what brought you to school in the first place and why you’re doing what you’re doing and how to actually get there. Start from your goal and work backwards.