Global Health at Princeton

Nancy Krieger is a professor in the Department of Society, Human Development and Health at the Harvard School of Public Health.

ABSTRACT: Taking history seriously – conceptually and analytically – is critical for analyzing causes of and solutions to health inequities. Contemporary research, however, remains largely ahistorical; even the growing interest in lifecourse epidemiology typically translates to decontextualized analyses that are also insufficiently comparative across time, place, and species. In this presentation, I demonstrate the utility of alternative approaches to incorporating history, drawing on new insights from ecological evolutionary developmental biology and also from ecosocial theory, which focuses on how we literally embody, biologically, our societal and ecologic context – across both levels and historical generations – thereby creating population patterns of health, disease, and health inequities. Examples discussed focus on links between racism, class, mortality, body size, and breast cancer, in relation to: (1) the historical contingency of health inequities; (2) haldanes and metrics of change; (3) Jim Crow and infant death rates; and (4) what I term the four histories of the breast cancer estrogen receptor: societal, individual (lifecourse), tumor (cellular), and evolutionary. Together, these examples suggest our science will likely be better served by conceptualizing disease and its biomarkers, along with changing magnitudes of health inequities, as expressions of not innate biology but instead emergent embodied phenotypes, i.e., embodied history.

This lecture is co-sponsored by the Program in Global Health and Health Policy, the Center for Health and Wellbeing and the Woodrow Wilson School of Public and International Affairs.