Yusuf Ransome, DrPH
Graduation Year: 2014
Degree/Concentration: DrPH/Sociomedical Sciences
Current Position: Assistant Professor in Social and Behavioral Sciences, Yale School of Public Health
WHERE DO YOU CURRENTLY WORK AND WHAT TYPE OF WORK DO YOU DO THERE?
I am an Assistant Professor in the Department of Social and Behavioral Science at Yale School of Public Health. I research how psychosocial and economic determinants, at multiple levels, influence racial/ethnic- and geography-related disparities in HIV care continuum indicators, alcohol and other substance use disorders, and youth homelessness. Currently, I focus on two exposures a) social capital/cohesion, and b) religion, faith, and spirituality. In one project, which is funded through a K01 Mentored Research Scientist Development Award from the National Institute of Mental Health (NIMH), I investigate the how distributions of social capital and cohesion in communities are related to disparities in the rates of late HIV diagnosis and viral suppression across the city of Philadelphia, PA.
In my second line of research, I use several large national and international datasets to estimate the causal relationships between religiosity, faith, and spirituality constructs and health and substance use outcomes to identify which measures contribute significantly to reducing racial disparities. Then, I work with faith institutions to contextualize the results and strategize to translate the findings into interventions that can be scaled to the population.
WHAT MADE YOU INTERESTED IN PURSUING THIS WORK? WHY DO YOU ENJOY IT?
Before I developed an academic interest in the social determinants of HIV, I witnessed the conditions that lead to premature death of family and others infected with HIV in the Caribbean. More than 15 years after I migrated to the United States (US), while preparing data for a presentation at Brooklyn College on World AIDS Day, I realized that many of the social and economic conditions associated with the early death of family are also disproportionately affecting racial minority populations in the US. Through these experiences, I committed to research that can reduce HIV-related disparities, especially among the Afro-diaspora. My interest in religion and health developed through my personal relationship with God, and observing many positive effects of religion, faith, and spirituality on multiple (e.g., social, economic) aspects of life. Religion is now undisputed as an important social determinant and I am committed to investigating this topic systematically to improve population health. I enjoy both areas of research because I embrace that its part of my calling and purpose in this life acknowledging that I have been given an important task of contributing to health and longevity of human beings.
HOW HAS THE "SMS LENS" (SEEING PUBLIC HEALTH AS EMBEDDED IN SOCIAL/CULTURAL/ECONOMIC/POLITICAL CONTEXTS) INFLUENCED YOUR PROFESSIONAL ATTITUDES AND APPROACHES IN ADDRESSING ISSUES IN YOUR WORK?
The training I received in SMS is an indispensable part of my research approach today and shapes how I think about interventions. The SMS lens has taught me to interrogate and reflect on how structure and agency plays out in human behaviors and health. This approach has allowed me to question why, for instance, access to biomedical technology to prevent HIV can (and has) widen racial and geographic disparities. Through the SMS lens, I am equipped to approach HIV prevention from a historical, cultural, and political context to problematize assumptions that locate behavior change solely in the individual domain. Specifically, how can one include the legacy of Tuskegee, and racism and discrimination that has influenced mistrust of institutions that provide care? How can one include the legacy of historical and contemporary examples of disinvestment in communities of color, which has limited access to health care and heightened stigma and shaped several other determinants that influence behavior change? On the positive side, how can one include the religious institution, which has played a prominent role in shaping the political, social, and economic discourse of black people in the US and abroad?
HOW HAVE YOU APPLIED THE SKILLS YOU LEARNED IN YOUR SMS COURSES TO YOUR CURRENT WORK?
Building upon the example of structure and agency, I constantly look for intervention points across multiple levels to reduce disparities. It’s well established that individual risk behaviors (e.g., condom use, substance use) cannot fully explain racial disparities in HIV, but rather other higher-level factors such as assortive mixing, delays in testing, access to preventive services, etc. within the community. Before I understood social capital as a concept, I experienced how connections and solidarity (within communities characterized by socioeconomic deprivation) shaped health outcomes. Social capital can be conceptualized, broadly, as collective resources generated through social connections that individuals or groups can access. Social capital can be intentionally generated, and empirical research across some international settings provided examples of how it has been leveraged to reduce the incidence of HIV and HIV-risk behaviors. While I focus on social capital as one possible mechanism, I have used my training to challenge the taken-for-granted assumptions of social capital theories popular in today’s discourse. In my current work, I investigate how race-specific levels of community social capital indicators impact disparities, for which there is limited empirical research, but has several implications for theory. I am also researching other ways to measure social capital that is salient for specific groups and communities, which integrates historical and contemporary nuances. My long-term goal is to develop interventions, informed by this concept, that contribute to reducing HIV disparities in the US based on what I will have learn from this research in Philadelphia.
HOW HAVE YOUR INTERESTS IN PUBLIC HEALTH CHANGED (OR NOT) SINCE YOU WERE AT MAILMAN?
My research interests are the same. However, today I focus also on translating the findings into evidence-based interventions because reducing disparities and improving the lives of marginalized populations is my priority.
WHAT DO YOU FORESEE IN THE NEXT 50 YEARS OF PUBLIC HEALTH?
I first acknowledge that there should never be one answer to this question as everyone’s ideas are valuable. Two things I foresee and plan to integrate in my future work is technology and social business models. Technology is moving very fast and its imperative for public health to keep up and eventually lead. For instance, in the medical field, precision medicine and big-data are dominating public discourse on treating diseases and improving population health. Today, its possible to use an app to read blood-sugar levels, there are electronic-monitored skin patches to aid with smoking cessation, and many others. Funding agencies are soliciting proposals that use technology to integrate social determinants into health care delivery. Soon, many of these technologies mentioned could be scaled. What are potential implications when we have all these data? What if John Snow had GIS software or satellite imagery or apps that monitors a person’s behavior to predict their health outcomes? The next generation of public health students should know about the technologies that exist and how to integrate them appropriately as well as work with other sectors to develop technology that positively impacts population health. Related, there is a movement in the business sector where companies are increasingly operating under social business models, which focuses on serving humanity and not maximizing profits. In the past, public health has typically been at odds with industry which typically prioritized profits over health. Public health may have an opportunity to gain new friends and so the next generation of public health students should understand social business models and stretch their minds of how they can partner with the business sector to improve population health.