Duke Research Blog

Following the people and events that make up the research community at Duke.

Author: Lydia Goff

Who Gets Sick and Why?

During his presentation as part of the Chautauqua lecture series, Duke sociologist Dr. Tyson Brown explained his research exploring the ways racial inequalities affect a person’s health later in life. His project mainly looks at the Baby Boomer generation, Americans born between 1946 and 1964.

With incredible increases in life expectancy, from 47 years in 1900 to 79 today, elderly people are beginning to form a larger percentage of the population. However among black people, the average life expectancy is three and a half years shorter.

“Many of you probably do not think that three and half years is a lot,” Brown said. “But imagine how much less time that is with your family and loved ones. In the end, I think all of us agree we want those extra three and a half years.”

Not only does the black population in America have shorter lives on average but they also tend to have sicker lives with higher blood pressures, greater chances of stroke, and higher probability of diabetes. In total, the number of deaths that would be prevented if African-American people had the same life expectancy as white people is 880,000 over a nine-year span. Now, the question Brown has challenged himself with is “Why does this discrepancy occur?”

Brown said he first concluded that health habits and behaviors do not create this life expectancy gap because white and black people have similar rates of smoking, drinking, and illegal drug use. He then decided to explore socioeconomic status. He discovered that as education increases, mortality decreases. And as income increases, self-rated health increases. He said that for every dollar a white person makes, a black person makes 59 cents.

This inequality in income points to the possible cause for the racial inequality in health, he said.  Additionally, in terms of wealth instead of income, a black person has 6 cents compared to the white person’s dollar. Possibly even more concerning than this inconsistency is the fact that it has gotten worse, not better, over time. Before the 2006 recession, blacks had 10-12 cents of wealth for every white person’s dollar.

Brown believes that this financial stress forms one of many stressors in black lives including chronic stressors, everyday discrimination, traumatic events, and neighborhood disorder which affect their health.

Over time, these stressors create something called physiological dysregulation, otherwise known as wear and tear, through repeated activation of  the stress response, he said. Recognition of the prevalence of these stressors in black lives has lead to Brown’s next focus on the extent of the effect of stressors on health. For his data, he uses the Health and Retirement Study and self-rated health (proven to predict mortality better than physician evaluations). For his methods, he employs structural equation modeling. Racial inequalities in socioeconomic resources, stressors and biomarkers of physiological dysregulation collectively explain 87% of the health gap with any number of causes capable of filling the remaining percentage.

Brown said his next steps include using longitudinal and macro-level data on structural inequality to understand how social inequalities “get under the skin” over a person’s lifetime. He suggests that the next steps for society, organizations, and the government to decrease this racial discrepancy rest in changing economic policy, increasing wages, guaranteeing work, and reducing residential segregation.

Post by Lydia Goff

Global Health Research from Zika to Economics

Brazil, Kenya and China: this week, the sixth annual Global Health Research Showcase proved that Global Health majors truly represent global interests.

This past summer, Duke PhD student Tulika Singh explored complementary diagnosis techniques for Zika virus pregnant women in Vitoria, Brazil. Zika is difficult to diagnose “because the PCR-based test can only tell if you’ve had Zika virus within about ten days of the infection,” Singh said. “That’s a big problem for enrolling pregnant women into our study on Zika transmission and maternal immunity.”

To combat this issue, Singh and her thesis advisor Sallie Permar trained collaborators to use the whole virion ELISA (WVE) laboratory technique which may reveal if an individual has been exposed to Zika. ELISA detects Zika through testing for the antibodies that most likely would have been produced during a Zika infection. Singh’s work allows the research team to better assess whether women have been exposed to Zika virus during pregnancy, and will ultimately guide Zika vaccine design. 

Master of Science in Global Health candidate Carissa Novak examined why some HPV positive women in Western Kenya are not seeking preventive measures against cervical cancer. All the women diagnosed with HPV were referred to the Country Hospital but only “33 to 42 percent actually sought treatment” leading to Novak’s main research question, “Why did so few women seek treatment?” To answer this question, she sent out quantitative questionnaires to 100 women and then followed up by interviewing 20 of them. She surveyed and interviewed both women who had and had not sought treatment. Her results showed that transportation and cost hinder treatment acquirement and that the women who did seek treatment were often directed to by a health worker or actively trying to prevent cervical cancer. Novak believes that increasing women’s trust and understanding of the health care system will assist in improving the percentage who seek treatment.

In Kunshan, China, Brian Grasso evaluated the development of Kunshan’s health system in relation to its economic development. “Kunshan is now China’s richest county-level city and it used to be a small farm town…My main take away was that economic growth has strengthened Kunshan’s health systems while also creating new health challenges,” Grasso said. What are some of these new health challenges? Some of them include air pollution, increased stress in manufacturing jobs and more car accidents. Grasso determines that other developing health systems should learn from Kunshan that without proper regulations poor health can result in the midst of progress.

Post by Lydia Goff

New Blogger Lydia Goff: Freshman with a Passion for Science Communication

Hey! My name is Lydia Goff. I am a first-year at Duke and plan to double major in English and biology in order to pursue a career in science writing. I was born in Waukesha, Wisconsin but raised primarily in the Charlotte area. My junior year of high school I transitioned from homeschool to Gaston Day School where I developed my interest in scientific research. Neither of my parents attended college so my primary teachers were books. Homeschooling instilled my love of reading which grew into an interest in writing, but it also limited my resources.

I had no exposure to scientific research until my junior year at Gaston Day when I became involved in the International Genetically Engineered Machine (iGEM) team. We worked on genetically engineering E. coli K12 so that it would die if accidentally released into the environment through a process called a kill switch. Particularly in developing countries with restricted supplies, improper disposal of genetically engineered bacteria can lead to water supply contamination. Working with my team and amazing faculty mentor showed me not only how interesting scientific research is, but also the global benefits.

A smiling woman

Lydia Goff in front of Baldwin Auditorium.

In iGEM, I ended up taking the lead in communications. Many of my teammates could understand and perform scientific procedures with a remarkable skill but struggled to communicate their ideas. I love being able to discuss the passions of others. These interactions allow me to continuously learn and to help others express themselves. Until that leadership role in iGEM, I was unsure about a major. I enjoyed writing and reading but also the STEM world. My interests bounced from calculus to creative writing to genetic engineering to art history. As I got older and the “What do you want to major in?” question became increasingly relevant, the idea of choosing one subject to focus on was painful. I did not want to stop learning about genetic engineering and neuroscience and astronomy in order to become a writer. For me, science writing and this blog represent the opportunity to never stop learning. They allow me to bounce around from lecture to laboratory and meet experts in a variety of fields, to discover the inspirations and implications of their research, and to express their ideas and discoveries to any curious person.

Post by Lydia Goff

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