Thursday, Dec 13, 2018
by Erin Wispelwey

Jennifer Hirsch ‘88, a professor at Columbia University’s Mailman School of Public Health and a visiting professor in the Center for Health and Wellbeing this year, is an anthropologist who parses the environmental, social, structural, and political economy drivers of wellbeing. She brings a community perspective to her research on sexual assault on college campuses as well as her work on HIV risk in migrant communities. She is currently co-directing the Sexual Health Initiative to Foster Transformation (SHIFT) research project with Claude Ann Mellins which aims to understand sexual health and violence at Columbia University and Barnard College. In a recent op-ed published in the Hill, Hirsch wrote, “as public health problems go, sexual assault is more like car crashes than measles; there’s no vaccine, no one program that will prevent all assaults. Rather, it will require changes at multiple levels, from individual behavior to the broader environment”—or as she was quoted by Jia Tolentino in the New Yorker, “we have to stop working one penis at a time.”  

I recently had the opportunity to sit down with Professor Hirsch to learn how she interrogates the upstream and contextual level factors that affect health and wellbeing behaviors and outcomes in her academic work as well as how she is working toward advancing justice and amplifying her impact through community organizing. This interview has been condensed and edited for clarity and space.

Erin: You were a Princeton ‘88 grad, how did your time here set you up for your career?

Jennifer: It’s funny to be back at Princeton working on questions of gender and bodies and inequalities because this is where I started working on questions of gender and bodies. I remember taking classes with Elaine Showalter and Natalie Davis and Chris Stansell and learning how to think about gender inequality in relation to people’s bodies. I was just recently cleaning out my mom's garage, and I found all my college papers from Princeton. I've forgotten many of the facts that I learned, but I learned how to write, how to reason, and how to use evidence to make an argument.

Erin: How did you get involved with public health work after Princeton?

Jennifer: After Princeton, I went to Mexico where I volunteered with the Mexico Planned Parenthood affiliate. I was interested in questions about what it means for people’s lives if they are in control of their bodies. I worked with an adolescent pregnancy program, and I wrote a paper about dirty jokes as a system of sex education, which was actually published in Critical Matrix, the Princeton journal of working papers in women’s and gender studies. That was my first academic paper, and the moment I figured out that I wanted to be an anthropologist working in public health. Dirty jokes were not a thing that people in sex-ed were talking about, but to me, it was clearly at the intersection of these two fields.

Erin: When you began the Sexual Health Initiative to Foster Transformation (SHIFT) research project at Columbia University, were there insights that you brought with you from your work in Mexico?

Jennifer: Yes—that context shapes behavior, which is a fundamental insight of both social science and public health. It’s the same broad question about how context shapes individual behavior that I worked on in Mexico, just in a radically different environment. What is it about residential higher education context that creates sexual assault? If we understood more about how this was produced at the community level then we could think about changing the community in addition to just telling individuals to act better.

Erin: Why did you decide to start the SHIFT project? And what was it like doing research on your own campus where you are both a researcher and stakeholder?

Jennifer: I’ve been working as an advocate in New York State trying to improve conditions for farm workers for about 10 years; the last major policy change was more than 20 years ago, giving them access to sanitation so they could wash their hands after going to the bathroom—hardly where we need to be in terms of workers’ rights. Columbia University, however, is an environment where I have a lot more input as a stakeholder in policy. [Sexual assault on campus] seemed like an issue for which the kind of research I know how to do was exactly what the world needed. Although making changes in the campus context is also really complicated—big ships move slowly—I have a different place as an actor and stakeholder, so the possibilities are exciting. Columbia has already made changes in response to our work and that has been fun and gratifying. But I haven’t given up on the farmworkers either!

Erin: You mentioned that Columbia is already making changes. Do you have some generalizable suggestions on how Princeton and other institutions can further study the context of sexual assault here or enact policy or influence cultural changes?

Jennifer: One thing we have clearly seen from SHIFT is the value of ethnographic research. We learned so much from the ethnography that would never emerge doing survey research. If you’re interested in making environmental and institutional changes you need to look at students in an ecological context. It’s much easier to assess many dimensions of the institution that you might want to modify through ethnography. Today, except perhaps in the dark corners, there is a moral consensus in the US that sexual assault is wrong—yet people still don’t report perpetration on surveys. You really can’t understand the scope of the problem if you can’t understand perpetration—and designing prevention programs will then be hard. And yes, this is recommending full employment for anthropologists everywhere.

The importance of space and power emerged out of our work. We're also not the first people to see this—Elizabeth Armstrong has also raised that in her work—but these are the types of questions that every university should be asking: What are the spaces that students spend time in, and who controls those spaces?  

We’re also very interested in working comparatively. Ironically, if the thing you’re most interested in is context, you can’t see that very clearly if there is no variation. For example, how do the urban and rural contexts differ? There are ways in which the urban context might produce certain vulnerabilities but also be protective against other vulnerabilities, and then there may be further variability for different groups. The next frontier for us, I hope, is for the Columbia to be the first of a larger set of case studies.

Erin: Through ethnography, participant observation, and the survey questions you asked in SHIFT, people may have had different opportunities to describe the sexual encounters they were involved in, how do these methods help unveil the problem of sexual misconduct on campus?

Jennifer: We wrote a paper about the reasons that people don't label things as sexual assault and don't report them. The iceberg metaphor fits well here. What universities know is the tip of the iceberg because that is what is reported. Then they do survey research and they know a little bit more because if you ask people behaviorally-specific questions, people will give a little bit more information. But there are experiences that people don't want to really think about as assault or situations when they've assaulted somebody else where they don’t label their actions as assault. However, when recounting the encounter in an ethnographic interview, they will tell you details in a way that they would never tell you on a survey. Some of it has to do with labeling, but I think some of it just has to do with the kinds of information that are accessible in our ethnographic research versus what comes out in a survey.

Erin:  Can you talk a little bit about working in teams—what do you bring as an anthropologist to these interdisciplinary teams and what are those collaborations like?

Jennifer: I bring a way of thinking about the social drivers of health inequalities. Frequently, people will think, “you're an anthropologist, you do qualitative methods,” but anthropology is a whole mode of inquiry. Yes, I bring a set of methodological tools, but I also bring a way of thinking about the world, of seeing how individuals are situated in communities and a way of surfacing and examining social forces. This ensures that you're not just looking at what people can do better but at how we can build societies where everyone can do better. I also have a deep grounding in gender studies with three decades of knowledge through work in sexual health, HIV, and gender.

The first part of bringing the SHIFT team together was reaching out to my friend and colleague, Claude Ann Mellins. When we assembled the research team we wanted one of everybody: somebody who works in substance use, somebody who works in LGBTQ health, and we brought people together with many different areas of expertise—that's the great fun of working at a world-class research university.

Erin: How would you think about designing and approaching relational health—of which sexual health is a part—prior to college?

Jennifer:  A quarter of the students in our survey had experienced some form of unwanted sexual contact before they got to college. When I was on the New York City task force to reimagine health education, the recommendations were clear that it should start in kindergarten. And what does this mean in kindergarten? The kindergarten curriculum would be about how you keep your body in your own space—Louis C.K. clearly never got that memo. Let's teach kindergarteners to keep their bodies in their own space and not chase people around the playground and kiss them or shrug this off as boys will be boys and girls are girls—that is rape culture. It’s important to teach people to be reflexive about certain gender and cultural norms. You wouldn't say that to a second grader, but as gender identities emerge people need to start thinking critically about power.  It's not just about what it is to be a boy or a girl or a queer person, but, how does power fit into that, and why is it not okay to dominate other people's bodies? Those are sort of fundamental questions that are super appropriate to deal with in the terms of stealing someone's sandwich in the lunchroom or bullying at any age. So these conversations about consent, bodies, space, and power don't even necessarily need to be about sex. It's just about how you treat other human beings in the world. We also have a new paper about how students actually do consent, which was written up in Teen Vogue and I recently wrote an op-ed in the Hill on why the next step for #MeToo is better sex education.

Erin: You’re writing a book based on the SHIFT ethnography. How is your writing process different working on a trade book versus your previous academic book or peer-reviewed articles?

Jennifer: You mean how do I make it not boring?! I'm working on the book with Shamus Khan. We have a contract with Norton and the manuscript is due in January. He's a delightful person to work with and we're very close friends. Part of writing it is figuring out what our joint voice is going to sound like together. One of the reasons for writing a trade book is to reach more people than another academic paper would, so I try to imagine two readers: someone sitting in a coffee shop who wants to understand the problem; and a young person who is thinking, “what is university going to be like, and how can I be prepared for what I'm going to face?”

Erin: Are you teaching a course next semester? What else are you working on while at Princeton?

I'm teaching an undergraduate seminar in the spring called Gender and Public Health: Disparities, Pathways, and Policies which I'm super excited about.

I am also working on a whole bunch of papers from SHIFT, combining the survey research with the ethnography on topics such as mental health and alcohol—some of which is in the book, but a lot of which is not. We have enough data that we could be writing for years.

I have also continued to co-direct the Columbia Population Research Center, which is a big university-wide center that's funded by NIH and by the Office of the Provost, and I have a small part in an NIH grant-funded project with the Rakai Health Sciences project in Uganda which is a longitudinal population-based surveillance looking at social factors and HIV.

Erin: From your bio, it seems like you have five different areas of research and they are all interconnected. How do you approach new areas to research and decide what to work on?

Jennifer: I think it’s all really one big bucket of the social drivers of health disparities. I’m interested in investigating the big drivers that create health inequalities and how we can pull out threads to create change. There is not going to be a day you wake up and make gender equality happen. However, there is going to be a day where you wake up and you are part of a group of people that changes a law or modifies an institution to bring more justice into the world—so articulating what I call the meso-level factors, the modifiable institutional crystallizations of inequality, that you can change is critical. I bring this same optic to different health challenges and then work with others who are experts in that topic. That is what is fun about doing team-based research, you get to collaborate with lots of people that know different things than you do.

Erin:  Global health is sometimes seen as something foreign, but there are also global health challenges right here in the U.S.  What have been some things that you've learned from your experience working in Mexico and elsewhere that you wish were more integral to health approaches here?

Jennifer: There are a lot of countries that do better at acting on social determinants of health. We have deep problems with social inequality. Social inequality leads to bad health outcomes. It's hard to isolate a specific program once you pull at that thread.

I have a lot to say about politics. I went into being a knowledge producer thinking that that was going to make the world a better place. And then a lot of us woke up when “W” was president. There were so many instances where policy was made, that didn’t just not take evidence into account, but was directly in contradiction to evidence! In these instances, lack of information is not the barrier to the world being a better place.

In doctoral training, we spend a lot of time teaching students to produce good information and close to zero time teaching them how to do anything useful with that information. And I feel like anybody who's interested in knowledge production has a moral obligation to engage with the question—how do you get from a good answer to a good policy?  

Learning about community organizing has been really transformational in terms of helping me see and engage in the processes that lead to policy change. I think Princeton is a place where undergraduates interested in affecting change could be asking the question “under what circumstances does research affect policy?” and there are a lot of people at the Woodrow Wilson School that know how to do that well.

Erin: Can you tell me a bit about your community organizing?

Jennifer: This has really been an extracurricular thing. When we moved to New York, I joined a temple that has a strong program in congregation-based community organizing and we got training in the Saul Alinsky model of community organizing—telling your story and building power through relationships. My first involvement in a successful state-level legislative advocacy campaign was life-changing. I worked on marriage equality in New York state and I worked on the domestic workers’ bill of rights in New York state. Neither of these is central to my research agenda, but I think that learning to bend the arc of history towards justice instead of waiting for someone else to do it was an awesome feeling.

As a professor, you can shape the way your students think and you can shift the way your colleagues think and through collective action with community organizations, you can change the way policymakers think. But it's a very slow process. I also had the pleasure of participating in the OpEd voices writing fellowship and through doing that and then through writing this book [on SHIFT], I feel like it's just a different way to engage in making change in the world.

Erin:   Do you have any advice to students interested in careers counteracting social determinants of health? What questions, perspectives, and experiences should they explore at Princeton or after Princeton?

Jennifer: I have a college kid and so I think a lot about that—I have a surfeit of advice: Learn a language. If you only speak English, that's not enough. If you're not going to learn a language in your coursework, then take advantage of the summer and do an immersion program. I would never be where I am now if I hadn't been bilingual. Also, get out of your space. Go see the world, whether that's through Princeton or through something after Princeton before you just go right to grad school or do something else. I see students at Columbia who have been grinding since pretty much since seventh grade. I think it’s important to take a break and be in some other place that's not so “grindy”.

I think you also find meaning being part of something bigger than yourself—whether that is an advocacy group or some other organized form of political action or a religious organization. Living your own atomized individual life is a pretty empty project. One example of this for me is being on the board of Jews for Racial and Economic Justice. We went and disrupted a Trump fundraiser at The Plaza very early in his campaign when nobody believed that he was even a serious candidate for president.

Erin: One thing I read was that it's not necessarily the information, but relationships that you remember after college. Were there people that stuck with you?

Jennifer:  The generosity of faculty was extraordinary along with their accessibility and their care for my intellectual development. I remember Natalie Davis writing to me at some point when I was in graduate school to see how I was doing and she is a rockstar. I went to Christine Stansell’s 70th birthday lunch last year. She was my undergraduate JP and thesis advisor, and we remain very close. To have access to faculty like that and have them actually pay attention to my work and really read it—I won't say it was pearls before swine because I knew at the moment how amazing it was, but those relationships were hugely important.

Part of the education here is the opportunity to talk with faculty. At Princeton, faculty are really accessible to students and so talking with them in office hours is part of the package. I know some students don’t feel comfortable walking into office hours and just chatting. I think that’s a way in which privilege and inequalities replicate themselves and I don't know how to crack that nut but it was such a valuable part of my experience.

Thank you for your time, Professor Hirsch. We look forward to the release of your book next year and collaborating with you this year!