Ariana Mora is a MD-PhD student in epidemiology at Emory University. She is a member of Health Policy Research Scholars Cohort 2021.
Tell us a little bit about yourself and what your research interests are.
I’m an MD-PhD student in Epidemiology. With my combined training across medicine, public health, and health policy, I’m interested in addressing health disparities by understanding affected patient populations and existing systemic limitations. There is a complex interplay between how social structures influence behaviors and health outcomes, and it is difficult to capture that nuance in a meaningful way that allows researchers to quantify these relationships and develop interventions. Overall, I want to help bridge the gaps existing between each of these fields because there are meaningful connections present that we can leverage for sustained change and progress towards health equity.
What’s the story behind why you’re doing what you’re doing?
I grew up without health insurance like many in my community, and I witnessed firsthand the decisions and struggles that were not unique to my family. Without the specific language I have to describe it now, I recognized how multiple structural factors could result in limited economic opportunity, and that this was omnipresent in many of our lives. This in turn affected our individual health and how our communities struggled—and often thrived despite. With the work that I’m doing now, I don’t see impoverished communities that need “saving”—there is so much vitality and richness communities like the ones I grew up in have to offer. With understanding and addressing how upstream policies influence the potential opportunities and decisions individuals can make, I hope that individuals will be less frequently forced to choose between ensuring their immediate needs of survival yet ultimately sacrificing their future health.
Tell us about a project you are currently working on that you are excited about.
There is frequent discourse about how structural factors influence downstream health outcomes, but because there are so many steps between a policy and the individual person it affects, it has been really difficult to quantify the magnitude of the impact of structural factors. Additionally, we tend to think about structural factors that are more closely related to health, since the causal path is a bit clearer. In thinking beyond structural factors like access to healthcare, I had the opportunity to collaborate with the Division of Violence Prevention at CDC to investigating the impact of Minority Depository Institutions (MDI), which are banks that specifically serve that serve racially minoritized and low-to-moderate-income communities historically excluded from traditional banking resources (e.g. access to mortgage loans), on community health outcomes. Using geospatial spillover models, we were able to determine and quantify the impact of MDI as a structural intervention for inequities in wealth and housing opportunity on downstream community health. We found that MDI’s positive financial impact—increased mortgage approval rates—and positive community impact—decreased social vulnerability—extends beyond the census tracts in which the banks reside and have a broader positive community effect. This analytic approach demonstrated a stepwise method to quantify downstream community-wide effects of structural interventions, which I’m excited to apply to other scenarios to better understand these complex systems.
For people unfamiliar with your research area, what is one piece of information you think is important for them to know?
I’ve been talking about structural factors, but I haven’t really defined them, so they may seem like this really inaccessible concept or theoretical idea, but in reality, we all interface with them every single day. Structural factors are these interconnected systems in our society (such as housing, education, employment, civil rights, and healthcare) that have a complex interplay with one another, and when you consider how these systems have interacted and reinforced themselves over time, we can begin to understand how they have reinforced and perpetuated inequality through explicit and implicit policies. What this translates to for people in their day to day lives is that structural factors enable or restrict the range of possible decisions one can make in their lives.
Who is a researcher you admire and why?
I really admire Camara Phyllis Jones, MD, MPH, PhD. I read her Gardner’s Tale very early on in my training, and she has a wonderful way of conceptualizing and communicating these complex ideas of race, racism, and how we all interact and perceive one another. I was able to meet her during a class in the first year of my PhD and it was such an honor. Given she’s also a fellow Wellesley alumna, there’s a lot of pride there too! Non Ministrari sed Ministrare
How do you think HPRS will complement your doctoral training?
Prior to joining HPRS I understood that many of the issues I was interested in addressing were primarily controlled through policy decisions, but the policy world felt so foreign and impregnable to me. I really appreciate how HPRS has given me the tools and the confidence to believe that I can be lending my voice in these spaces and have the potential to drive and inform policy change.
What part(s) of HPRS excite you the most?
I’m most excited about the friendships and collaborations that are possible with other HPRS scholars. I feel so privileged to be a part of this wonderful community since everyone is so passionate and driven in their goals. But most importantly, everyone has been very welcoming and interested in learning from one another and I think that sort of space is so difficult to foster, so I really appreciate everything that the program and staff have done to facilitate that for us!
In the RWJF HPRS program we will work with you to help you think further about using your research to develop policy. If you could use your research to change any policy, what policy would it be?
All of my work is centered around the idea that every person should have the potential and capacity to ensure their health without being limited by financial or logistic to access the resources they need to do so. Certainly this isn’t a straightforward or simple goal to achieve, so what I have to offer is not only based off of the substantial work preceding my own but will necessarily be part of a collaborative effort. I would be thrilled if my research helped support the need for universal healthcare access and potentially informed mechanisms for how we can approach it.
Here’s a fun question to wrap things up. If you could visit any place in the world, where would you choose to go and why?
Ooh, I really like this question! I’d like to visit the Mariana Trench—I grew up near the ocean and have always loved how diverse sea creatures are. Particularly at these deep depths, these animals have some mind-boggling adaptations to the high pressure and low light conditions that they’re practically otherworldly, so hopefully on the way down to the trench I’d be able to see some. Many people are familiar with the anglerfish with its bioluminescent “lure” on top of its head (thank you Finding Nemo), but one that I think is really neat are barreleye fish which have these bright green upward pointing orb-like structures for eyes, which are inside a clear membrane forming a dome around their head like an astronaut helmet—you really have to check out some photos!
