Q&A with Rachel Washburn, Director of Health and Society

Rachel Washburn is an Associate Professor of Sociology and Director of the Health and Society Program at Loyola Marymount University.

What led you to study medical sociology in your doctorate program?

I took a medical sociology course as an undergraduate student at the University of California, Santa Cruz, taught by Monica Casper, a leading scholar in the field. In that course, we learned about social determinants of health and the inequitable burden of disease across populations in the U.S. and elsewhere. I was particularly struck when we learned about how high infant mortality rates are among African Americans compared to other groups in the United States. This seemed so unfair and such a product of social arrangements that disadvantage communities of color in so many other ways. We often think of health as so personal, but it really is a reflection of our living conditions and society at large. This awareness, combined with my existing interest in health, led me to pursue a degree in medical sociology. I hoped that by better understanding how social conditions affect health, I could contribute to reducing health inequalities. Though I ultimately did not end up focusing on social determinants of health in my doctoral work, it continues to be a strong interest of mine and one that I integrate into several of my courses.

Are you still researching the human health harms of pesticide exposure in the U.S. and if so, what are some of your most interesting findings?

Yes. My research on the environmental health sciences began in graduate school. My doctoral work looked at the social dimensions of a technique called human biomonitoring, which is used to measure environmental chemicals in people’s bodily fluids. Part of my work involved researching the history of this technique, when it was developed and why. This led me to the CDC’s work on pesticide toxicology, which was carried out in the mid-twentieth century. At the time, many new chemicals were being synthesized and used in a variety of applications. Among these were pesticides, which were used heavily in the agricultural sector but also in public health programs. Due to concerns about the safety of these chemicals, the CDC launched a program to carry out human studies of the toxicity of pesticides like DDT and parathion. CDC researchers ventured out into orchards, fields, and agricultural communities in several sites across the country to study whether pesticides caused harm to those exposed. To do so, they interviewed people about symptoms and collected blood and urine samples. They also collected adipose tissue from individual undergoing surgery to determine the average American’s exposure to DDT. Based on a narrow definition of harm, the CDC team found that while pesticides might be responsible for transient symptoms like headaches or nausea, these substances were generally safe for the American public. I think what’s most interesting about my findings is that they highlight how our understanding of problems is so fundamentally shaped by the models and frameworks we use to study them. The CDC scientists used models for studying harm that used pesticide poisoning, which involves fairly severe clinical symptoms, as evidence of toxicity. This meant that they did not look at sub-clinical effects of pesticides or the effects of these substances over long periods of time. If they had, they would have discovered that pesticide exposures are responsible for all sorts of health problems, including impaired reproductive function and cancer. This relates to the current covid-19 pandemic in the sense that our public health agencies have been too limited in their thinking about public health risks. They failed to imagine the real threat of a pandemic, which left us unprepared. Ultimately, our lack of preparedness and health system capacity has resulted in preventable illnesses and deaths and real social and economic costs.

What other projects do you have coming up that you’re excited about?

I’m currently continuing to work a collaborative project on qualitative research methods but am also plotting my next big project. This summer, I plan to finish up another manuscript on the history of biomonitoring at the CDC and then hope to do some preliminary groundwork for my next project. I still have not decided what this will look like, but after giving birth to my son in 2019, I have become really interested in the area of reproductive health, specifically the science behind standards for hospital birthing practices.

What is your teaching philosophy, i.e. what is the number one takeaway you’d like every student to receive from your classes, and what issues do you stress the most through the content you present and the style you present it in?

I take teaching really seriously, which is part of why I came LMU. I am very enthusiastic about critical thinking and encouraging students to move beyond their preconceived ideas about society and human nature. I think most students assume that society is organized in ways that reflect some sort of natural order (e.g., women are better at caring and our social hierarchy is inevitable). I really try to challenge my students to think about how things could be different, and the ways that culture and political and economic arrangements play a critical part in shaping our consciousness and sense of possibility. This includes how we think about and act on health and illness.

How do you see the new Health and Society program impacting students, BCLA, and the overall LMU community?

I think the Health and Society program is a fantastic addition to an already great set of curricular offerings at LMU. The goal of the program is to provide rigorous interdisciplinary training in the social foundations of health. We offer courses in all four colleges across campus and aim to show students that health is much more complex than individual lifestyle behaviors. It’s a direct reflection of culture, social arrangements, and power relations. Seeing health in this way enables us to promote health and well-being at a structural level, which is ultimately the most effective and humane approach. I think the covid-19 pandemic vividly demonstrates that health is a collective good. It also shows that health is not equitably distributed across the population. Data showing that poor folks and people of color are being disproportionately impacted by covid-19 highlights the imperative of attending to basic social inequalities as a form of public health.

If you had to pinpoint the 3 greatest challenges related to health and society in the United States right now, what would they be? What would they be globally?

Writing in April 2020, covid-19 obviously stands out as the biggest health challenge in the U.S. and globally. It’s amazing how devastating SARS-CoV-2 has been to our way of life and for all of those (and their loved ones) who have suffered illness and died. This pandemic has reshaped our consciousness, showing how incredibly interconnected we are globally and the inseparability of health and society.

A number of the other major health challenges we face have been brought to light through the covid-19 pandemic. These include our need for a more robust and organized public health infrastructure, our expensive healthcare system that leaves millions without adequate access or adequate care, and inequalities in health, infant mortality, and life expectancy between groups. My hope is that the covid-19 pandemic will create the social and political will to finally address these pressing problems that sociologists and many others have been talking about for decades. For those unfamiliar with the history of healthcare reform, there have been efforts to create a national system for one hundred years. These proposals have been met with various challenges, ranging from the structure of our political system to organized opposition on behalf of doctors, insurance companies, and others. I’m hopeful that we can finally overcome these challenges.

Why is this a good time for a minor like Health and Society to be introduced to LMU students?

The Health and Society minor was conceived in 2017, a few years before the current covid-19 pandemic, and we began enrolling our first students in Fall 2019. At that time, introducing this new minor seemed like an excellent way to provide a coherent program of training in the social foundations of health for students seeking careers in the health sciences, policy, advocacy and beyond. As the pandemic has shown, health is integral to social life and social life is integral to our health. The Health and Society program provides a curriculum that is essential to understanding crises like the covid-19 pandemic. Given our interdisciplinary curriculum, students will not only understand the major drivers of health crises, but also how to formulate solutions.

How do you envision the program changing or growing in the future (global or engaged learning opportunities, internships, could this grow into a major, more interdisciplinary collaboration with other departments or colleges)?

The program has already grown since its inception in 2019. We have expanded our curriculum to include courses in the School of Film and TV and the College of Fine Arts. We offer courses in all four colleges across the University, which is really exciting. This truly gives students the opportunity to engage in interdisciplinary scholarship and the flexibility to focus on areas of particular interest. We currently offer engaged learning courses in several departments, but I hope that we can strengthen our community partnerships to facilitate student engagement and research with off-campus organizations. I also hope to create global immersion courses where students can learn about health practices in other countries, including how other countries organize their healthcare systems. I’ve already laid the groundwork for this sort of course by establishing relationships with colleagues in the U.K. I am also excited about developing a more robust and visible Health and Society community on campus, composed of faculty and students. I definitely think we could expand into a major, with the right institutional support. At the very least, we should be thinking about how we can create a Center that could serve as a hub of activity and collaboration for faculty and students.