David Rehkopf, ScD
Examining the links between social and economic exposures and cardiovascular risk factors
The first is a project with Prof. Will Dow at UC Berkeley comparing the associations of level of education with risk factors for coronary heart disease in the United States with Costa Rica. Prof. Dow is a principle investigator of a new study population study of health in Costa Rica. Costa Rica is of particular interest to look at in comparison with the United States because despite a much lower overall standard of living, they have achieved levels of health at the same level, or in some cases even beyond that of the United States. In addition, mortality in Costa Rica does not show differences by level of education, while there are strong differences in mortality by level of education in the U.S. So Costa Rica in some ways can serve as a test case for how it is possible to achieve social equity in mortality.
The second project that I have worked on is trying to understand the causes of why people with less resources have a diet which is worse for their health. While important recent work has examined the potential impacts of the availability of health food in the neighborhoods where people live, I am working on a project with Prof. Epel and Prof. Laraia to understand whether poverty affects levels of stress which in turn have a direct effect on the types of foods that people eat. Prior experimental work by Prof. Epel has shown that stressful situations do indeed have a dramatic effect on the types of food choices that individuals make (more calorie dense foods), and we are doing work to examine whether this is also true with stressful events outside of the laboratory.
Finally, while work on describing the complex nature of socioeconomic disparities in health has increased our knowledge of the potential power and prevalence of socioeconomic factors for shaping population health, policy makers and the public have often wondered what actions should be recommended based on this evidence. When health disparities are rooted in long histories, many solutions may be long term, or at least need to be in place many years in order to have an effect. However, in the meantime, it is useful to try and think about what we are currently doing to decrease material deprivation and poverty, and examine whether this has beneficial effects on peoples health. The largest anti-poverty program currently in the United States is the Earned Income Tax Credit, which in 2002 lifted almost 3 million working families out of poverty. This project, working with Prof. Catalano and Prof. Dow, is examining the potential effects of this policy on levels of adolescent obesity in the U.S.
In the fall, I will begin as an Adjunct Assistant Professor in the Department of Epidemiology and Biostatistics at the University of California, San Francisco.