Dr. Nancy Krieger’s work focuses on social inequalities in health. She is a social epidemiologist, with a background in biochemistry, philosophy of science, history of public health, and involvement as an activist in issues involving social justice, science, and health. Her work involves: (a) etiologic studies of health inequities, (b) methods for improving monitoring of social inequalities in health, and © development of theoretical frameworks, including ecosocial theory, to guide work on understanding and addressing societal determinants of health.

In her current epidemiologic research, she is investigating:

Area-Based Socioeconomic Measures for Health Data

This epidemiologic investigation has demonstrated the utility of using US census tract poverty data for monitoring socioeconomic inequalities in health. It did so by evaluating which area-based measures of socioeconomic position, at which level of geography (census tract, census block group, or ZIP Code), are appropriate for US public health surveillance systems and health research. The goal is to improve capacity for monitoring socioeconomic inequalities in health in the United States. Health data for this project were obtained from public health surveilance systems in 2 states (Massachusetts and Rhode Island), and pertain to: mortality (all-cause and cause-specific), cancer incidence (all sites and site-specific), low birthweight, childhood lead poisoning, sexually transmitted infections, tuberculosis, and non-fatal weapons-related injury. Visit our Public Health Disparities Geocoding Project Monograph website (listed below) for a discussion of our project, plus free access to our publications and a sample data set (Geocoding Project )

Physical and Social Hazards: Jobs, Race, Gender, and Health

This union-based study, led by Dr. Elizabeth Barbeau (PI), will examine how workplace hazards, both physical (e.g., noise, ergonomics) and social (e.g., discrimination, sexual harassment), affect workers’ health at work and at home. The study uses the newly validated “Experiences of Discrimination” (EOD) instrument developed by Krieger to measure self-reported experiences of racial discrimination.

Measuring racial discrimination for health research

This just-completed study, funded separately as a sub-study to the above grant on “Physical and Social Hazards,” was designed to validate the “Experiences of Discrimination” (EOD) instrument designed to measure self-reported experiences of racial discrimination. The validation study was conducted in both English and Spanish among a random sample of African American and Latino/a low-wage workers showed the instrument has good psychometric properties. For access to the instrument and information on how it can be used, see register for access to EOD instrument

Socioeconomic trends in breast cancer incidence

This study is assessing whether the socioeconomic gradient in breast cancer is changing, using US cancer registry data from the past 30 years. Data to test the hypothesis that the incidence of breast cancer is increasing more quickly among less affluent and more working class women (and men), thereby leading to a reduction in the class gradient, will be obtained from 2 cancer registries in California and from the Massachusetts State Cancer Registry, which will be geocoded and analyzed using area-based socioeconomic measures derived from the US census (1970-2000).

Racial/ethnic disparities in breast cancer estrogen receptor status

This study is assessing whether conventional estimates of racial/ethnic disparities in breast cancer estrogen receptor (ER) status for breast tumors are biased by missing data on ER status, a lack of socioeconomic data, and inappropriate modeling assumptions. It employs data from from 2 cancer registries in California, geocoded and analyzed using area-based socioeconomic measures derived from the 2000 US census.

Newly funded studies, just underway, pertain to racial discrimination and risk of chronic disease, and also to changes in socioeconomic gradients in breast cancer following release of the Women’s Health Initiative results regarding hormone therapy.

Dr. Krieger’s is also engaged in study and critique of theories that epidemiologists and others use to explain population patterns of health, disease, and well-being.