In Harvard Magazine:
Two years ago the New England Journal of Medicine published a commentary titled “Class—The Ignored Determinant of the Nation’s Health.” Its authors, a policy analyst and an academic physician, wrote: “[P]eople in lower classes die younger and are less healthy than people in higher classes. They behave in ways that ultimately damage their health and that take their lives prematurely (by smoking more, having poorer eating habits, and exercising less). They also have less health insurance coverage, live in worse neighborhoods, and are exposed to more environmental hazards. Beyond that, however, there is something about lower socioeconomic status itself that increases the risk of premature death.”
For 20 years, that “something” about being poor and getting sick has preoccupied Nancy Krieger ’80, Ph.D., professor of society, human development, and health at the Harvard School of Public Health. It has also preoccupied her older brother, James Krieger ’78, M.D., chief of the epidemiology, planning, and evaluation unit at Public Health-Seattle and King County, his local public-health authority. Independent of each other, the Krieger siblings have transformed that fixation into the leading edge of public-health theory and practice. Nancy’s hypotheses and methods are called, by many colleagues, the most brilliant contributions to social epidemiology in a generation. Jim’s on-the-ground innovations are the envy of local health departments across the country. Sister and brother have set a standard for what public health can and should be in the United States; both are trying to steer the profession back to its roots in social justice. That few beyond their respective fields have heard of the Kriegers says as much about their modesty as about the battered profile of public health in America.