My research uses medical sociology as a lens to understand social inequalities in the United States, and I am particularly interested in sexual and reproductive health and healthcare as a site where gender, SES, racial, and geographic inequalities are created and sustained. Sexual and reproductive healthcare is unique in its entanglement in cultural ideas about gender – making it the ideal sociological case for interrogating how the “social” comes to influence the ideals of medical objectivity. In particular, I focus on the structural, institutional, and cultural mechanisms that underlie differing outcomes.
I leverage a range of primarily quantitative methods and data sources, including secondary survey data and electronic health records, and I use statistical techniques such as structural equation modeling, multilevel modeling, longitudinal data analysis, and advanced missing data techniques.
Gender, Health & Inequalities
Dissertation Work
My dissertation addresses what I see as a key gap in medical sociology – the role of health policy. Even as sociological focus has increasingly turned toward “upstream” explanations for health inequities, investigations of the consequences of public policies have been largely left to economists. Nevertheless, public policies have the potential to meaningfully impact the health inequities that are of interest to sociologists.
I combine in-depth interviews, the Optum Clinformatics® Data Mart Database − a national electronic medical records system, and the National Institute of Reproductive Health’s Local Reproductive Freedom Index to investigate healthcare policy’s association with inequities. For instance, one chapter draws upon 38 in-depth interviews with women living in Indiana to argue that for the consideration of deservingness as a dynamic status that may or may not translate into access to public assistance. My findings illustrate how moments of deservingness can translate into longer-term access to social assistance when these moments align with particular policy, personal and bureaucratic contexts using the case of pregnancy-based access to Medicaid. Other chapters draw upon the electronic medical record data to examine how local-level reproductive freedom shapes inequities in contraception utilization and preventative care.
Abortion
In a related line of research, my coauthors and I investigate the cultural forces that inhibit or enable abortion access. People who need abortion services must draw upon social and economic resources to obtain them. In a paper in Science Advances using interviews and the General Social Survey, Sarah Cowan, Tricia Bruce, Brea Perry, Bridget Ritz, Stuart Perrett and I examine the willingness of Americans who deem abortion immoral to help a close friend or family member seeking an abortion. We find that a substantial minority of Americans morally opposed to abortion would engage in “discordant benevolence”: providing help when doing so conflicts with personal values. We find that those who see abortion as morally wrong can nevertheless play a role in the social support process surrounding abortion access.
In a second stream of research on abortion, I focus on the role of physicians in abortion access. In a first-authored paper in Social Science & Medicine – Population Health, my co-authors, Sarah Cowan, Jenny Higgins, Nicholas Schmuhl, Cynthie Wautlet, and I examine physician’s ability to refer patients to abortion care as a barrier to abortion access using a survey of physicians. We find that around half of physicians willing to consult in abortion care are unable to refer patients because of a lack of knowledge. This research exposes how the institutional exclusion of abortion from standard medical training inhibits individual access to care.
Gender Inequalities & Covid-19
In a separate project published in Socius, my co-authors, Jessica Calarco, Emily Meanwell and Amy Knopf, was motivated by the observation that mothers have shouldered a disproportionate share of the childcare duties during the pandemic. Consequently, we ask how mothers account for these unequal parenting responsibilities. Through interviews and surveys (Pandemic Parenting National Survey [PPNS]) with 55 mothers and 14 fathers in different-sex, pre-pandemic dual-earner couples, we found that mothers (and fathers) justified unequal parenting arrangements based on gendered structural and cultural conditions that made mothers’ disproportionate labor seem “practical” and “natural.” These findings help explain why many mothers have not reentered the workforce, why fathers’ involvement at home waned as the pandemic progressed, and why the pandemic led to growing preferences for inegalitarian divisions of domestic and paid labor.
Disability Status, Health & Inequalities
Disability is a critical axis of inequality garnering increased scholarly attention. Through my collaboration on a longitudinal project of college students on the autism spectrum, my co-authors and I highlight the challenges that students with disabilities experience.
Working with data from a unique survey of the experiences of college students with autism and neurotypical students in Indiana, Jane McLeod and I tested whether autism symptomology was independently associated with multiple educational and social outcomes including course failure, academic difficulties, lower friendship quality and social exclusion. We found that autism symptomology was associated with these outcomes independent of an autism diagnosis, and found evidence of intersectional inequalities as symptomology had a greater negative effect among women than men. We also found that autism symptoms were associated with greater negative social outcomes for students without a diagnosis. This paper can be found at the Journal of Autism and Developmental Disorders.
In another paper published in Social Science & Medicine – Population Health, my co-authors and I use the longitudinal data from 2020 and 2021 to demonstrate that college students with disabilities were more likely to experience declines in their physical health, mental health, and educational aspirations over the first year of the pandemic compared to students without disabilities because of differential exposure to financial and illness stressors.
Broader Inequalities & Health
In a related project, I examine the question of whether inequities in access to vaccination have successfully been addressed, even as the numeric rate of sociodemographic disparities in adolescent vaccination initiation rates for the HPV, Tdap, and MenACWY vaccines has declined in the US. I synthesize research on the resource barriers that inhibit vaccination alongside research on vaccine hesitancy where parents actively refuse vaccination. To do so, I classify the primary reason why teens are unvaccinated in the National Immunization Survey-Teen 2012-2022 into three categories: resource failure, agentic refusal, and other reasons. I use three non-exclusive subsamples of teens who are unvaccinated against the HPV, MenACWY , and Tdap vaccines to examine the relative importance of resource failure reasons and agentic refusal reasons for non-vaccination across time and teens’ sociodemographic characteristics. Results indicate that resource failure reasons continue to explain a substantial portion of the reasons why teens are unvaccinated and disproportionately affect racially/ethnically and economically marginalized teens. Thus, even as sociodemographic inequalities in rates of vaccination have declined, inequities in access remain consequential. This paper was published in PLOS ONE.