Research

My research program is driven by a general interest in understanding how and why early life environments shape patterns of human biology and health.

RESEARCH THEMES

Developmental plasticity, evolution, and health

The focus of this research is on understanding the short and long term effects of maternal stress in the perinatal period, as indexed by various psychological indicators and maternal cortisol levels, on offspring health and well-being. This research is important because it shifts attention away from only focusing on health behaviors in adulthood and instead highlights how early life environmental experience can have important impacts on health in adulthood. Most recently we have been trying to understand how timing and duration of stress experience across developmental periods may differentially affect offspring phenotype, as well as how similar physiological systems are programmed in other species.

A subset of this work addresses how developmental plasticity and evolutionary biology can inform the design of public health interventions to improve maternal and child health. As an example, my colleagues and I argued in a recent EMPH piece that short-term macronutrient interventions in pregnancy are unlikely to result in large impacts on offspring phenotype since offspring have evolved to be sensitive to long term signals of maternal environmental experience. Consequently nutritional interventions need to be longer in duration and/or target critical periods of maternal development in order to have increased efficacy. More recently I argued that fetal sensitivity to psychosocial stress could contribute to the development of low birth weight among children conceived through Assisted Reproductive Technologies. The implications of this work is that mental health support should be offered alongside ART therapies and could help to improve outcomes.

Select publications in this area are highlighted below:

Minority health and health inequities

Human biology methods can be used to better understand how social inequalities create health inequalities within and between socially defined ethnic groups. As an example, during my dissertation research I documented that maternal experience of ethnic discrimination predicts variation in stress physiology of offspring. Since stress physiology influences the functioning of many other physiological systems important for health, this research suggests that individuals may be predisposed to poor health due to ethnic discrimination experienced by their mothers. Consistent with this, my collaborators and I recently found that indigenous Māori women who reported discrimination experience before or during pregnancy subsequently gave birth to infants an average of one week earlier and more than 200 grams lighter when compared to Māori women who did not report a similar discrimination experience. We  published an article reporting that discrimination experience in this cohort is also associated with shorter telomere length in children at four years of age.

Collaborators and I have also published articles exploring the impact of early trauma and discrimination on Native American health in the United States. For example, we reported that early life trauma, when combined with subsequent development of post traumatic stress disorder, was associated with significantly higher allostatic load in adulthood among a sample of American Indian adults from reservation communities in the Northern Plains. In addition, racial discrimination experience in adulthood was associated with higher blood pressure in the same cohort. Using data from individuals from tribal communities in both the Southwest and Northern Plains, we were the first to report that individual as well as paternal experience of Native American residential boarding experience is associated with significantly poorer health in adulthood.

Finally, I am interested in contributing to theory around understanding how social inequalities create health inequalities. As an example, I co-authored several papers describing how acculturative stress can impact maternal and child health. In addition, in 2019 I co-authored a manuscript with a Dartmouth student that described the biological pathways through which historical trauma could affect health. Building on previous work, we argue that both within- and between- generation effects of trauma could contribute to the development of poor health through impacts on stress physiology systems and the epigenome.

Select publications in this area are highlighted below:

Social factors shaping maternal health and well-being

Building off of a longstanding interest in the impacts of maternal well-being on offspring growth and development, my most recent projects focus on understanding social and cultural factors that shape maternal well-being in pregnancy, childbirth, and the postpartum period. Recognizing the impacts of the COVID-19 pandemic on maternity care and delivery experiences, Dr. Theresa Gildner (Postdoctoral fellow at Dartmouth College) and I launched the COVID-19 and Reproductive Effects (CARE) study. We have published and currently have in review a series of articles that consider how the pandemic has shaped women’s experiences in prenatal care and delivery, and consequent impacts on maternal mental health and ultimately on offspring health as well.

One article, reviewed in the New York Times, explored the relationship between childbirth fear and preterm birth. We argue that childbirth fear is a presently underappreciated source of anxiety for pregnant people in the United States, and that the COVID-19 pandemic exacerbated these fears. There were socioeconomic and racial inequities in the experience of childbirth fear, suggesting that this may be a presently underappreciated contributor to adverse birth outcomes.

Select publications in this area are highlighted below: