Supporting research, education, and innovation.
My research focuses on how racism -- embedded within policies, systems, and environmental factors -- shapes health and health inequities and community-led interventions to remedy injustices and promote health equity. As structural racism is contextually specific and dynamic, many of my research projects are place-based, with the research questions and approach informed or driven by community priorities. The throughline of my projects is a focus on justice – immigrant, racial, economic, environmental, and climate – recognizing that these factors are intricately connected with health and well-being.
Just as communities are complex ecosystems, my approach to public health research recognizes that the body is complex and physiologic systems are interconnected. Accordingly, the health outcomes of focus in my work reflect an understanding that there are persistent patterns of racial and economic inequities in health and well-being. My work often focuses on community-led health priorities and mechanisms by which living in an unequal world affects health and well-being.
My work addresses two overarching research questions:
What are the mechanisms by which policy, systems, and environmental factors shape inequities for racially minoritized communities?
For community-level interventions designed to mitigate health inequities, under what conditions are these interventions effective in ameliorating inequities?
These questions have culminated in a body of work on structural racism that encompasses four key areas: racialization-related stressors, immigration and immigrant policies, environmental racism, and community-level interventions. I frequently leverage a community-based participatory research approach, where academic and community partners share equal power and ownership over the research agenda, implementation, analysis, dissemination, and translation of research findings. I use qualitative and quantitative methods and often work in multi-disciplinary teams.
Racialization-Related Stressors and Health Inequities
Structural and institutional racism trickle down to shape day-to-day opportunities, experiences, and health for communities of color. There are several well-established tools to ask communities about their experiences with systems of racism and discrimination in their day-to-day life. Many of these tools were developed to understand the experiences of racism of Black/African American communities. I have led several studies that examine the application of these tools to understanding how Latiné communities self-report their experiences of racism and discrimination, and linkages with health outcomes such as cardiovascular risk and mental health.
Racial Inequities in Health Care Experiences and Outcomes
Health care is a site that can reduce or worsen health inequities. It has long been established that racism contributes to the disproportionate burden of chronic and infectious conditions among communities of color in the United States. Health care interventions -- such as medication for hypertension or diabetes or guideline concordant care -- can help to manage conditions that disproportionately burden communities of color. Likewise, racism is embedded in the US health care system, with legacies linked with the history of exploiting Black, Indigenous and other Communities of Color to advance western medicine and historical and ongoing segregation in health care. Several of my projects examine the racial and socioeconomic patterning of guideline concordant medical treatment and find persistent and -- in some cases -- widening racial inequities in guideline concordant medical treatment
Local Government-Issued ID Policy to Improve Access to Health Promoting Resources
In the early 21st century, the federal government passed a set of policies that restrict who can get or renew a state-issued ID, such as a driver’s license. Additionally, several policies, institutional practices, and individual practices increasingly demand a current state-issued ID to access health-promoting resources, such as picking up medication from a pharmacy, seeing a doctor, getting a library card, viewing or applying for housing, opening a bank account, and proving one’s identity to police or immigration officials.
Building on the evidence that government-issued ID policies are health policies, I worked with the Washtenaw ID Project (based in Washtenaw County, Michigan) to evaluate a local government-issued ID policy that sought to improve access to health-promoting resources that are increasingly dependent upon having a current government-issued ID (e.g., driver’s license, state ID).
Immigration & Immigrant Policies and Health for Latino/Latiné Communities
Immigration policies shape the migration patterns, migration options, and legal status of immigrant communities, whereas immigrant policies shape the lived experiences of immigrant communities living in the United States. Exclusionary immigration and immigrant policies are an enduring way in which racism affects the health of immigrant communities. My research examines how 21st Century exclusionary immigration and immigrant policies in the United States shape the health and wellbeing of Latino/Latiné communities across immigrant generations.
Community Health Worker/Promotores Models
Several of my projects examine the ways in which community health worker or promotores models support Latino/Latiné, Black/African American, and Asian and Pacific Islander communities in addressing social, economic, and health needs linked with living in an unequal world. Drawing on the Latin American roots of community health worker models, this work conceptualizes community health worker and promotores models as more than a bridge between systematically and historically excluded communities and powerful public health and health care institutions. Rather, this work conceptualizes and studies the work of community health works through the lens of their expertise as community organizers working in partnership with communities to affirm, assert, and create structural and community conditions for belonging.
Our most recent projects, Community Activation to Transform Local Systems (CATALYST).
COVID-19 Health Inequities
I am a co-founder of the Orange County Health Equity COVID-19 Community-Academic Partnership (OCHEC-CAP). In this partnership, we sought to harness the power of community-based organizations, community responders, and health equity scholars to shape public health policies and practices to reduce COVID-19 inequities affecting low-income communities of color in Orange County, CA.
Our partnership was able to uplift concerns about accessing detailed and timely data that highlighted and tracked racial, socioeconomic, and spatial patterning of COVID-19 cases, hospitalizations, and deaths; and to guide strategies to improve access to COVID-19 testing and vaccination for low-income communities of color in Orange County, CA. Additionally, our partnership supported the bilingual Health Equity Contact Tracing popular education curriculum designed with a community economic development model to equip community responders with the skills and knowledge needed to meet community priorities in the COVID-19 pandemic.
Understanding and Addressing Lead (Pb) Exposures
Initiated in response to resident-driven concerns in Santa Ana, CA, my research focuses on how environmental racism shapes exposures to toxins for low-income communities of color. This research seeks to integrate findings from environmental justice research with community knowledge to inform the development of a multi-level plan to foster a healthier environment.
I am a founding member of a community-academic partnership, ¡Plo-NO Santa Ana! Lead-Free Santa Ana!, which seeks to assess and address high levels of lead (Pb) in the soil in Santa Ana, CA. This research process ensures that community and academic research partners have equal ownership over the research agenda, questions, and knowledge-production process. We have examined the social and spatial distribution of lead and other heavy metals in the soil using soil samples collected with a high spatial resolution throughout Santa Ana, CA.
Our most recent project, Inequities in Childhood Lead Exposures and Academic and Neurodevelopmental Outcomes (I-CLEAN) seeks to understand how exposure to low levels of lead across the life course affect children’s academic and neurological development and brings residents together to develop a vision for healing the land and addressing and preventing lead exposures. The I-CLEAN Study is supported by the National Institute of Environmental Health Sciences.