My current work in this area is in collaboration with Claude Fischer (UC Berkeley, Sociology) on UCNETS, a longitudinal study funded by the National Institute on Aging of how social networks and health affect and are affected by life events among 21 to 30 year-olds and 50 to 70 year-olds in the Bay Area.


2. How do health policies intersect with social life?


A. How will the Affordable Care Act affect

communities and population health?

with Stefan Timmermans


In the coming years, the Affordable Care Act (ACA) is estimated to expand access to health insurance for more than 32 million Americans that are currently uninsured. Existing research linking uninsurance to poorer health outcomes, decreased access to care, lower utilization of preventative care, and lower quality of care suggests that ACA stands to substantially improve the health of the uninsured. What remains unknown is whether and how the already-insured population will be affected by the expansion of insurance beneficiaries. Prompted by an Institute of Medicine (2003) report on the subject, researchers have begun examining "spillover" effects from the uninsured to the insured in health care access, quality, and cost. This research has focused almost exclusively on the economic pathways through which the uninsured might affect the health and health care of the privately insured. Our research addresses several gaps in this literature, including extending the spillover framework to account for the effects of uninsurance in other areas of social life, community mobilization and responses to spillover.

1. Where do global health priorities come from and how do they move around the global system?


My dissertation, titled Invisible Men: Constructing Men who Have Sex with Men as a Global AIDS Priority at UNAIDS and beyond, is a cross-national, mixed-methods study of the global policy response to AIDS, focusing on the exclusion - and then inclusion - of what came to be called “men who have sex with men” (MSM) in that policy response. The study was motivated by a puzzling observation: despite more than two decades of AIDS programs and policy targeting gay and bisexual men in North America and Western Europe, global AIDS policy had long remained silent on the issue of same-sex sexual transmission in places hardest hit by the epidemic, such as sub-Saharan Africa. Then, in the mid-2000s, UNAIDS began to assert MSM as a global priority, breaking sharply from earlier policy regimes which understood MSM as a geographically-bounded problem of the West. Drawing on archival, ethnographic, and original household survey research conducted in Malawi, Invisible Men provides a comprehensive account of the social life of AIDS policy from inception to implementation and speaks to a broader literature on the origins of global norms and policy priorities, processes of diffusion, and social change.

B. How do global AIDS policies targeting same-sex sexual transmission of HIV intersect with LGBT issues and other local sociopolitical and economic concerns?


In a series of ongoing works with Nicole Angotti, Rachel Sullivan Robinson, and Ashley Currier, author ofOut in Africa: LGBT Organizing in Namibia and South Africa, I examine the linkages between global health policies targeting same-sex sexualities and the escalation of political homophobia in sub-Saharan Africa. This work primarily draws on news media data and other government documents in order to show how state actors, their allies, and opponents use homophobic rhetoric to contest global and national regimes of power throughout the 2000s. In a paper with Currier, we find that although HIV policy has provided a much needed “in” for sexual rights promotion in Malawi, changes in attitudes and practices have been largely limited to Malawian civil society elites and a few government officials tasked with addressing AIDS and keeping donor monies flowing. Moreover, we find that growing international pressure to protect the human rights and health of sexual minorities has prompted increasingly oppositional and repressive action from political and religious elites.

Research

My research examines the social relationships, communities, and policy contexts that shape health and health policy with a focus on socially marginalized populations.​  My recent work has addressed the following questions:

3. How do social relationships, communities, and policy contexts shape health?


My interests in health, sexuality, and policy have prompted studies of: