Marilyn Thomas, PhD, MPH

Asst Professor In Residence
Medicine

Research Interests:
- Structural Racism as a Social Determinant of Health
- Racial Inequities in Accelerated Aging, Cognitive Decline, Mental Illness, and Mortality
- Social Policy, Educational Attainment, and Causal Inference

I am a social epidemiologist investigating the mechanisms by which structural racism contributes to Black–White and other racial inequities in chronic disease risk, premature aging, mental illness, and mortality. My research evaluates policy effects and emphasizes methods for causal inference in the absence of randomization.

In the US, substantial racial differences in health persist despite efforts to reduce overall morbidity and mortality, and to address social determinants of health. Structural racism—the ongoing interactions between macro-level systems and institutions that constrain the opportunities, resources, and power of minoritized racial groups—is considered a fundamental cause of racial disparities in health. Unfortunately, adequate measurement to capture the mechanisms of structural racism remains a considerable challenge in public health research. My work helps to address this gap by measuring and evaluating the policies and processes contributing to structural racism.

My research centers Black experiences (i.e., factors that distinctively characterize Black lives in the US). To date, my research focused on three domains of Black experiences: policing, negative racial sentiment or race-based discrimination, and education. My research on policing addressed two issues—racial patterns in risk of being killed by police and police agency characteristics and policies related to police killings—and introduced innovative approaches that can examine intersectional social and environmental experiences in racism-related epidemiological research and the effectiveness of law enforcement policies that purport to save Black lives. My work has also addressed how experiences of area-level anti-Black bias, interpersonal racial discrimination, and culturally-specific coping strategies influence health, providing evidence that institutional racism contributes to physiologic stress-regulation and accelerated aging, whether perceived or not, and that improved socioeconomic position and racial identify may buffer the biological consequences of racism.

My research has subsequently evolved into a deeper examination of structural racism in higher education, either as public policy or through individual-level educational attainment, as a potential causal driver of Black-White inequities in health. Higher educational attainment offers indirect social and health benefits through access to social privilege and prestige, higher income, healthier behaviors, ability to cope with stressors, and increased utilization of health care. Consequently, education is a strong predictor of cardiometabolic risk, mental illness, dementia, and mortality. Though structural racism is implicated as a fundamental cause of higher education gaps, little to nothing is known about if, and to what extent, uniquely Black college experiences influence health in Black adults. As such, I aim to explore the long-term health effects of education policies that govern Black experiences in institutions of higher learning, specifically Historically Black Colleges and Universities (HBCUs).

As a postdoctoral scholar in the Department of Psychiatry and Behavioral Sciences, I received a K99/R00 Award from the National Institute on Aging to study the impact of HBCUs on late-life cognition in Black adults with Drs. M. Maria Glymour, Rita Hamad, Kirsten Bibbins-Domingo, Justin White, and Christina Mangurian. I also co-lead the SF BUILDing Bridges Program, an NIH funded program to enhance diversity of the biomedical research workforce by transforming the teaching and research environments at San Francisco State University. Last, I am an active participant in the Glymour Research Group (https://glymourgroup.ucsf.edu/team), UCSF PReMIUM Group (https://integration.ucsf.edu/staff), SPHERE Research Group (https://sphere.ucsf.edu/our-research-team), and HEARTS Research Group (https://publichealth.berkeley.edu/research/hearts-research-group/).

Publications: 

School racial composition, effect modification by caring teacher/staff presence, and mid/late-life depressive symptoms: findings from the Study of Healthy Aging among African Americans.

American journal of epidemiology

Mobley TM, Hayes-Larson E, Wu Y, Peterson RL, George KM, Gilsanz P, Glymour MM, Thomas MD, Barnes LL, Whitmer RA, Mayeda ER

Associations of Everyday and Lifetime Experiences of Discrimination With Willingness to Undergo Alzheimer Disease Predictive Testing.

Neurology

Hill-Jarrett TG, Choi M, Buto PT, Miramontes S, Thomas MD, Yang Y, Kim MH, Sims KD, Glymour MM

All Stressors Aren't Equal: The Salience of Racial Discrimination and Appraisal for Blood Pressure in African American Women.

Psychosomatic medicine

Reeves A, Michaels EK, Thomas MD, Okoye U, Price MM, Hasson RE, Chae DH, Allen AM

Examining the Impact of State-Level Factors on HIV Testing for Medicaid Enrollees with Schizophrenia.

Journal of acquired immune deficiency syndromes (1999)

Thomas MD, Vittinghoff E, Koester KA, Dahiya P, Riano NS, Cournos F, Dawson L, Olfson M, Pinals DA, Crystal S, Walkup J, Shade S, Mangurian C, Arnold EA

Black Mothers' Concern for Their Children as a Measure of Vicarious Racism-Related Vigilance and Allostatic Load.

Journal of health and social behavior

Daniels KP, D Thomas M, Chae DH, Allen AM

Gender Composition in Biomedical Research Grant Submissions and Grant Review Panels Before Versus During the COVID-19 Pandemic

Journal of Women's Health

Danielle Roubinov, Kent A Griffith, Nicole L Simone, Sindy Escobar Alvarez, Marilyn Thomas, Christina Mangurian, Reshma Jagsi

Characteristics and Trends in HIV Testing Among Medicaid Enrollees Diagnosed as Having Schizophrenia.

Psychiatric services (Washington, D.C.)

Walkup J, Thomas MD, Vittinghoff E, Hermida R, Crystal S, Arnold EA, Dahiya P, Olfson M, Cournos F, Dawson L, Dilley J, Bazazi A, Mangurian C

The impact of attending historically Black colleges and universities on cognitive decline in Black adults: A longitudinal analysis in the KHANDLE and STAR cohorts.

Alzheimer's & dementia : the journal of the Alzheimer's Association

Thomas MD, Calmasini C, Khela H, Mobley TM, Mayeda ER, Mangurian C, Barnes LL, Gilsanz P, Whitmer RA, Glymour MM

Field Visit Contact Rate by Mobile Crisis Teams as a Crisis System Performance Metric

Psychiatr Serv

Goldman ML, Ponce AN, Thomas M, Felder S, Wu S, Loewy R, Mangurian C

CRANIUM: a quasi-experimental study to improve metabolic screening and HIV testing in community mental health clinics compared to usual care

BMC psychiatry

Hwong AR, Chagwedera DN, Thomas M, Niu G, Quan J, Vittinghoff E, Schillinger D, Newcomer JW, Gonzalez A, Essock S, Mangurian C

Mental Health Implications of Abortion Restrictions for Historically Marginalized Populations

New England Journal of Medicine

Ogbu-Nwobodo L, Shim RS, Vinson SY, Fitelson EM, Biggs MA, McLemore MR, Thomas M, Godzich M, Mangurian C

Breast Cancer Screening Rates Among Medicaid Beneficiaries With Schizophrenia

Psychiatric Services

Hwong AR, Vittinghoff E, Thomas M, Hermida R, Walkup J, Crystal S, Olfson M, Mangurian C

Postsecondary Education and Late-life Cognitive Outcomes Among Black and White Participants in the Project Talent Aging Study: Can Early-life Cognitive Skills Account for Educational Differences in Late-life Cognition?

Alzheimer disease and associated disorders

Thomas MD, Calmasini C, Seblova D, Lapham S, Peters K, Prescott CA, Mangurian C, Glymour MM, Manly JJ

Superwoman Schema, Racial Identity, and Cellular Aging among African American Women.

The Gerontologist

Thomas MD, Mendez RM, Zhang Y, Wang Y, Sohail S, Chae DH, Márquez-Magaña L, Sellers R, Woods-Giscombe CL, Allen AM

Occupation and Educational Attainment Characteristics Associated With COVID-19 Mortality by Race and Ethnicity in California.

JAMA network open

Matthay EC, Duchowny KA, Riley AR, Thomas MD, Chen YH, Bibbins-Domingo K, Glymour MM

Lessons Learned From a New Reverse-Integration Model to Improve Primary Care Screening in Community Mental Health Settings.

Psychiatric services (Washington, D.C.)

Mangurian C, Thomas MD, Mitsuishi F, Goldman LE, Niu G, Handley MA, Riano NS, Hwong A, Essock S, Dilley J, Newcomer JW, Schillinger D

Hepatitis C Screening Among Medicaid Patients With Schizophrenia, 2002-2012.

Schizophrenia bulletin open

Thomas MD, Vittinghoff E, Crystal S, Walkup J, Olfson M, Khalili M, Dahiya P, Keenan W, Cournos F, Mangurian C

A descriptive analysis of 2020 California Occupational Safety and Health Administration covid-19-related complaints.

SSM - population health

Thomas MD, Matthay EC, Duchowny KA, Riley AR, Khela H, Chen YH, Bibbins-Domingo K, Glymour MM

Geospatial Distributions of Lead Levels Found in Human Hair and Preterm Birth in San Francisco Neighborhoods.

International journal of environmental research and public health

Okorie CN, Thomas MD, Méndez RM, Di Giuseppe EC, Roberts NS, Márquez-Magaña L

An investigation of quantitative methods for assessing intersectionality in health research: A systematic review

SSM Popul Health

Guan A, Thomas M, Vittinghoff E, Bowleg L, Mangurian C, Wesson P

Racial Discrimination and Telomere Length in Midlife African American Women: Interactions of Educational Attainment and Employment Status.

Annals of behavioral medicine : a publication of the Society of Behavioral Medicine

Thomas MD, Sohail S, Mendez RM, Márquez-Magaña L, Allen AM

US law enforcement policy predictors of race-specific police fatalities during 2015-16.

PloS one

Thomas MD, Reeves AN, Jewell NP, Michaels EK, Allen AM

Accuracy of Primary Care Medical Home Designation in a Specialty Mental Health Clinic

Psychiatr Q

Garcia ME, Goldman EL, Thomas M, Chan S, Mitsuishi F, Schillinger D, Mangurian C

Whites' County-Level Racial Bias, COVID-19 Rates, and Racial Inequities in the United States.

International journal of environmental research and public health

Thomas MD, Michaels EK, Darling-Hammond S, Nguyen TT, Glymour MM, Vittinghoff E

After "The China Virus" Went Viral: Racially Charged Coronavirus Coverage and Trends in Bias Against Asian Americans.

Health education & behavior : the official publication of the Society for Public Health Education

Darling-Hammond S, Michaels EK, Allen AM, Chae DH, Thomas MD, Nguyen TT, Mujahid MM, Johnson RC

Peer Specialists in Community Mental Health: Ongoing Challenges of Inclusion

Psychiatric Services

Jones N, Niu G, Thomas M, Riano NS, Hinshaw SP, Mangurian C

Everyday Racial Discrimination and Hypertension among Midlife African American Women: Disentangling the Role of Active Coping Dispositions versus Active Coping Behaviors.

International journal of environmental research and public health

Michaels EK, Reeves AN, Thomas MD, Price MM, Hasson RE, Chae DH, Allen AM

Racial discrimination, educational attainment, and biological dysregulation among midlife African American women.

Psychoneuroendocrinology

Allen AM, Thomas MD, Michaels EK, Reeves AN, Okoye U, Price MM, Hasson RE, Syme SL, Chae DH

Relative Roles of Race Versus Socioeconomic Position in Studies of Health Inequalities: A Matter of Interpretation.

Annual review of public health

Nuru-Jeter AM, Michaels EK, Thomas MD, Reeves AN, Thorpe RJ, LaVeist TA