RESEARCH AWARD
Chloe Bird ’86 Minds the Gap BY HILLARY HEMPSTEAD
Chloe Bird ’86 was in graduate school when it was first understood that the incidence of heart disease among women was exceeding that of men. “It was 1988 when the data showed that in every year from 1985 to 2012, more women than men died of cardiovascular disease,” says Bird, a senior sociologist at the RAND Corporation. She’s talking from her sunny Southern California home, occasionally breaking from conversation to wrangle two attention-hungry labradoodles. Bird explains that cardiovascular mortality among men dropped due to the successful use of statins, which can reduce and control high cholesterol among people who have not previously had a heart attack. Gains in the treatment of men were achieved more rapidly because the focus was on heart disease in men, who tend to die younger than women. Diagnosis and treatment lagged in women. As an applied sociologist, Bird has spent her career studying and affecting policy change related to some of society’s most intractable problems, including disparities in health and health care, homelessness, and adolescent smoking behavior. For research addressing women’s health and determinants of differences in men’s and women’s health and health care—particularly her work to improve the evidence base and inform policy and practice—she was recognized in 2020 by the American Sociological Association with its William Foote Whyte Award for notable contributions to sociological practice and public sociology. Bird was already interested in the ways in which research 14
informed health care by the time she signed up for sociology courses in college. She began to see how collecting and analyzing data could make for better policies. “Chloe asks questions in ways that other people don’t think to ask them,” says Professor Emeritus of Sociology James Leo Walsh, recalling his former student’s gift for inquiry. “She listens and listens—and listens—and takes time to thoughtfully put together the meaning of the answers she gets. She’s also a hard-nosed data cruncher and makes sure the facts underscore what she’s reporting, but she has an imagination that makes the data live and real.” Bird pursued a degree at the University of Illinois at UrbanaChampaign with the intention of conducting research that could contribute to better public policy, but she was quickly informed that most people who studied sociology at the graduate level weren’t going to do that. “The professor who recruited me said that most sociologists weren’t
doing work that informs policy, and that sociologists did not usually do intervention research or experiments,” says Bird. The professor told her that sociologists measure gaps and disparities and then identify what’s contributing to them. When Bird entered graduate school, going into sociology wasn’t a likely path to inform policy to address social problems, even though it was an excellent path to studying them. “At that time, there was a challenge in the field as to whether research to inform policy was social science or activism.” But even with all of this study, Bird saw that some of society’s biggest issues—economic inequality, sexism, and racism— weren’t significantly changing for the better. She wanted to affect change rather than simply identify problems, and she saw a path for this through applied sociology. She credits her postdoctoral experience at the Health Institute, a joint program of the New England Medical Center and
Harvard School of Public Health, and her time on the faculty at the Department of Community Health at Brown Medical School, for opening a world in which research on gaps in health and health care could lead to action. There she saw that research provides the evidence base for effective policies at many levels, ranging from clinical practice to national policies that impact health and health care. In 2000, when she and her late husband, physician-sociologist Allen Fremont, entered the job market, both were offered positions in Santa Monica at RAND Corporation, a nonprofit research organization that develops solutions to public policy challenges. At RAND she was involved in a project led by Fremont that examined sex, racial, ethnic, and socioeconomic differences in quality of care for cardiovascular disease and diabetes. Bird recalls that when doing the research, looking for sex differences was almost an afterthought. But in doing so, they found that women were more likely to have unmet health care needs. “Even after accounting for age, women have worse outcomes than men following a heart attack and are less likely to survive,” says Bird. “Women are also more likely to die from a silent heart attack—one for which there weren’t early warning signs or prior diagnosis.” When the number of women’s cardiovascular deaths fell below that of men’s a few years ago, she notes it wasn’t due to women’s outcomes improving to match those of men, but rather an increase in men’s cardiovascular disease mortality. “[The medical field] is still not as aggressive and effective in giving women statins,” says Bird. “There’s a lingering bias that men have heart disease and that women are protected. “I followed this work for 20 years to ask—what are we doing about these gaps?”
LAURA FAY BERTON-BOTFELD
Thought Process