Dr. Natalie Slopen joined the SBS Department in January 2021 as an Assistant Professor. Previously a faculty member at the University of Maryland School of Public Health, she received her ScD in Social Epidemiology at Harvard Chan and her postdoctoral fellowship training at the Center on the Developing Child at Harvard University. Dr. Slopen’s research primarily focuses on the early life origins of health and health disparities, and her studies aim to identify modifiable risk and protective factors that can be targeted by interventions.
Could you tell us about your research background and your current projects?
I first got involved in research during my undergraduate training in psychology. From this introduction, I learned that I loved research and slowly found my way to public health. During my doctoral training I focused on psychiatric epidemiology, and as I became increasingly aware of the strong connections between mental and physical health my research interests broadened.
My research spans two general areas. The first domain focuses on how early life experiences and environments become embedded to influence physical and mental health over the life course. One project is a 5-year study funded by the National Heart Lung and Blood Institute to conduct a follow-up of the Bucharest Early Intervention Project, a randomized trial to study the benefits of early foster care for infants in institutional care in Romania. This study’s participants are now young adults, and we will examine the long-term impacts of institutional rearing and early foster care for cardiometabolic health and behaviors in early adulthood. I am also working on several projects to investigate the impacts of housing assistance programs for child health, in collaboration with two colleagues from my time at the University of Maryland. In another project, I am working with a team to develop a new measurement tool to efficiently assess both stressors and resources in the lives of parents with young children. My second research area focuses on social and contextual influences on common chronic disease and psychiatric health outcomes among adults, such as affective disorders and cardiovascular disease risk factors and outcomes, including sleep. Within this line of research, I am collaborating on a variety of projects using data from large population-based cohort studies.
I look forward to developing new projects and building collaborations at Harvard Chan, both within SBS and across the University, particularly related to my research on modifiable factors that can promote healthy child development and prevent the emergence of health disparities.
How, if at all, has the COVID-19 pandemic changed your research?
The COVID-19 pandemic has not led to a significant change in the direction of my research program. However, the pandemic has amplified many of the social risk factors that I consider in my studies, as it has widened existing social and economic disparities and disproportionately affected poor children, children in immigrant families, and women. It feels more important than ever to prioritize studies that can directly inform strategies to promote child and family wellbeing using upstream, population-based programs and policies that can have a broad impact.
How has the field of social epidemiology evolved over the past decade?
There are so many ways to answer this question given that social epidemiology is such a broad and interdisciplinary field! Four significant changes stand out to me. First, there is increased attention to rigor and causal inference, with more researchers using natural experiment designs, administrative data linkages, and advanced epidemiologic methods to address confounding. Social epidemiology has moved beyond the descriptive phase of documenting patterns and associations to make more definitive statements regarding cause and effect, resulting in more persuasive and informative evidence for intervention. Second, when I began my doctoral training, “life course epidemiology” was on the periphery, and there was much less research on the role of childhood experiences for diseases that typically begin later in life. Over the past decade, there has been increased recognition of the early life origins of health and health disparities. For example, organizations such as the National Institutes of Aging and National Heart Lung and Blood Institutes now include a life course approach within their priority areas, recognizing that social conditions in early life have implications for health across the entire lifespan. Third, there has been a large increase in the availability of population-based cohort studies that collect biological measures of future disease risk. This data has made it possible for social epidemiologists to significantly advance understanding of the biological mechanisms that connect social disadvantages and stressors to health outcomes; however, there is still a lot to be learned in this area. Finally, relative to a decade ago, there is increased focus on the role of structural racism for understanding widely documented racial disparities in health. Building on earlier findings that interpersonal experiences of discrimination negatively affect health, there is a greater emphasis on the societal structures that perpetuate racial injustice and reinforce health disparities (e.g., policing and mass incarceration; novel measures of residential context, and racism ingrained within educational and healthcare systems and settings).
In a recent study published by the Development and Psychopathology, you and others analyze the connection between stressful life events and inflammation among adolescents who have a history of early institutional rearing. What was your biggest takeaway in this study?
This study reported results from a longitudinal follow-up of a randomized controlled trial of early foster for young children in institutional care in Romania. In this particular study, we wanted to understand whether stressful life events during adolescence and low-grade inflammation varied based on whether the child was randomized to early foster care or continued with care as usual. Low-grade inflammation is an important outcome, as it is prospectively associated with both physical and mental health outcomes. We found that adolescents with prolonged institutional care showed an association between stressful life events and inflammation that was not evident among those who received early foster care or were never in institutional care. Our results extend on prior studies by showing a stress-sensitizing effect of early neglect due to institutional rearing for inflammation in adolescence. The most important aspect of this study is that it provides experimental evidence that early placement into family care can buffer against heightened inflammation in response to later stressful events. This finding tells us that early interventions can have a lasting positive impact on biological responses to stress, with potential implications for chronic diseases later in life.
Do you have any advice to prospective and current students who have an interest in social epidemiology?
Follow your interests! Given that social epidemiology is such a broad and interdisciplinary field, you will have infinite choices in terms of topics to work on, people or organizations to collaborate with, and research methodologies to learn. For current students in particular, I recommend that you take courses across various departments because many of the most impactful social epidemiology studies bridge disciplines, drawing on theories and methods from other fields. Interdisciplinary (or multi-disciplinary) approaches are central to developing innovative research ideas and designing effective public health programs.
Lastly, how can the SBS community learn more about your research? Do you have any upcoming research projects planned?
I am very excited to engage with the SBS community and have many upcoming research projects planned. I especially look forward to finding ways to involve students in my research. For now, the SBS community can learn more about my research interests by looking up my publications on Google Scholar or Pubmed, and I will set up a personal webpage with summaries of my current projects and links to publications during the spring term.
-Interview by Daniel Choi