Featured Researcher: Marcella Alsan
Marcella Alsan’s route to a career researching inequality in healthcare and its possible solutions began when she was a Harvard undergraduate majoring in cognitive neuroscience. During a class on the history of medicine and public health in America, she heard for the first time about the Tuskegee experiment, the infamous effort of the US Public Health Service to learn about syphilis by withholding available treatment for the venereal disease from hundreds of Black men.
“The way medical doctors doubled down on the deception was really distressing,” Alsan recalled recently. “I would have loved to complement the historical work with quantitative analysis then, but I didn’t have the tool kit.”
“Getting the tool kit” happened in subsequent work when her adviser, Nathan Nunn, was studying the effect of slavery on mistrust in Africa, which, she said, “led to my understanding that these deeply rooted inequities could be examined using modern econometric methods.” The Ebola epidemic in West Africa also shaped her research interests, as she read with dismay how communities that held burials for family members were portrayed, as if they had no reason to lack confidence in the advice of public health officials.
Alsan added a master’s in public health from Harvard and an MD from Loyola University Chicago to her undergraduate degree, then returned to Harvard for doctoral studies in economics. There, a chance encounter with Claudia Goldin, who recently was named a Nobel laureate in economics, “just changed the trajectory of my career.” Responding to Goldin’s question, Alsan said she was considering the long-term effects of the tsetse fly on the trajectory of poverty in Africa as a possible dissertation topic. Alsan recalled Goldin’s enthusiastic support and encouragement for the project.
More important, Alsan said, was Goldin’s recognition and appreciation for the complexity of her life at that time. “She saw my duality as both a mother and a scholar, and she embraced both of them.”
Fully armed with the tool kit and the experience of working with Goldin, David Cutler, and other leading economists, she returned, with coauthor Marianne Wanamaker, to the Tuskegee experiment, documenting how the 1972 disclosure of that horrific deception led to deep distrust of the medical community among Black men, and their consequent shunning of hospitals and distrust of the medical system.
That led eventually to studies that found that healthcare services encouraged by trusted individuals were more readily accepted, not just in the United States but also in India during the COVID-19 pandemic. Moreover, the trusted individuals may even be non-experts, depending on the situation.
Following a professorship in medicine at Stanford University, Alsan became a professor of public policy at Harvard Kennedy School, where she runs the Health Inequality Lab at the Malcolm Wiener Center for Social Policy. She was named a MacArthur Fellow in 2021 and is using the fellowship to help support projects related to the health of incarcerated people.
When she is not working, Alsan enjoys watching cooking shows and taking walks with her family and dogs.
