A new member of the YSPH faculty explores the intersection between social policies and health outcomes.
Danya E. Keene, an assistant professor in the Department of Chronic Disease Epidemiology at the Yale School of Public Health, explores how factors such as neighborhoods, housing and place can negatively affect an individual’s health. Additionally, her work looks at how stigma associated with certain areas or addresses can perpetuate health disparities and limit future opportunities. Recently, a study she authored found that racial health inequalities coupled with broader economic trends increased the risk of home foreclosure for African Americans.
Dr. Keene joined the School of Public Health faculty in 2013.
What are your research interests?
DK: In the broadest sense, my work is focused on understanding how social inequalities can get under the skin and produce health inequalities, with the hopes that a better understanding of these processes will lead to greater health equity. Underneath this broad umbrella, I am particularly interested in how social policies and macro-level forces affect health by structuring access to homes and communities. For example, my work has explored topics such as housing affordability, residential stability, attachment to place, community cohesion and exposure to stigma that may vary according to one’s place of residence.
What is a specific example of this? What did you find?
DK: Some of my recent work examines the interconnectedness between mortgage strain and health. As one part of this study, I conducted in-depth qualitative interviews among working class African-American homeowners. I found that many participants experienced mortgage strain as result of a health-related event that triggered the collapse of a fragile household budget.
Like many middle and working-class African Americans, participants experienced poor health and disability at relatively young ages. Additionally, resulting from a long and ongoing history of structural racism and discriminatory housing policies, they often lacked access to safety nets that could buffer the consequences of illness. In a nutshell, this project really shows how a web of social inequalities can intersect to interfere with the quintessential American Dream of homeownership.
You also study “spatial stigma.” What is this?
DK: Spatial stigma refers to the idea that marginalized places can carry negative symbolic meanings that have implications for the well-being of their residents. For example, in one study I interviewed African-Americans in Chicago who had relocated to eastern Iowa from public-housing developments and other high-poverty neighborhoods. These participants described experiencing discrimination that was related not just to race and class, but also to negative stereotypes that people held about their former neighborhoods. Participants also described a number of ways that this discrimination limited their opportunities and created tremendous amounts of stress.
Most of the literature on how place affects well-being focuses on the things that are wrong with disadvantaged communities. In contrast, the concept of spatial stigma turns our attention to broader sociocultural processes that exist outside of these communities.
What are some of the places where you have studied spatial stigma?
DK: In addition to the Iowa study, I am looking at experiences of spatial stigma among young adults in Detroit.
Does this influence health? How so?
DK: The connection between spatial stigma and health is fairly understudied, but there are a number of likely pathways. For example, a neighborhood’s reputation can affect what kinds of resources and opportunities end up in that neighborhood. At the interpersonal levels, individuals who reside in stigmatized locales may face discrimination when others view them negatively because of where they live. These experiences of discrimination can be health demoting in and of themselves. Additionally, they can affect access to resources that are important to health. For example, there is evidence suggesting that employers discriminate in the hiring process against addresses from disadvantaged areas.
Also, I think when people aren’t able to take pride in where they live, it is harder to build a strong community; a community where people can come together and advocate for their collective needs and rights. I firmly believe strong communities are important to health.
What drew you to this type of research?
DK: My original interest in urban inequality stems in part from my experience as a fifth grade teacher in a very disadvantaged section of Baltimore. As I got to know my students and their families, I observed first hand the social production of health inequality.
What are your long-term research goals?
DK: In the broadest sense, my long-term research goals involve working to extend knowledge about the structural determinants of health, to interventions and policy changes that can reduce inequalities.
What are your interests and pursuits outside of Yale?
DK: These days, my main interests, Nadia (age 4) and Emmett (age 1.5), keep me pretty busy.