Name: Prof. Dr. Catherine Cubbin
Affiliations: Steve Hicks School of Social Work, The University of Texas at Austin, 405 W. 25th Street, Austin, TX 78705, USA
Interests: Social epidemiology; social inequalities in health; neighborhood environments and health; conceptualization and measurement of socioeconomic status/position

“Social Inequities in Cardiovascular Disease Risk Factors at Multiple Levels Persist Among Mothers in Texas”
by Catherine Cubbin, Quynh Nhu (Natasha) B. La Frinere-Sandoval and Elizabeth M. Widen
Int. J. Environ. Res. Public Health 2025, 22(3), 404; https://doi.org/10.3390/ijerph22030404
Available online: https://www.mdpi.com/1660-4601/22/3/404

1. Congratulations on your recent publication! Could you briefly introduce yourself and your current research focus?
I am a social epidemiologist and a professor in the Steve Hicks School of Social Work at the University of Texas at Austin, USA. I’ve been there almost 20 years now. I would say I'm primarily focused on two areas of research right now.
The first is really related to the recent publication, but I would describe it broadly as being social inequalities and maternal and infant health, specifically in Texas—that's really where my focus is at the moment. I've published maybe six studies on the topic in recent years, and my interest is in the downstream effects of residential segregation, specifically how segregation has an impact on neighborhood environments and then how those neighborhood environments make it harder or easier to be healthy. Within that work, I’m also interested in how these neighborhood environments might impact people differently based on their own characteristics, such as their own race/ethnicity, or socioeconomic status, those sorts of things. The other area of work that I'm mainly working on is part of an interdisciplinary team. We have a grant from the National Institutes of Health to investigate how urban planning decisions and zoning have evolved historically in Austin, TX, and how that has had an impact on the city, in terms of the locations of sources that create air pollution and then also within that work, we're interested in the components of that air pollution. So not all air pollution is the same, right? And we think that some sources might create more hazardous types of air pollution. The health outcome in our study is neighborhood-level disparities in asthma.  And while there's a piece of it that's just looking at Austin, we're also interested in looking at neighborhood environments in relation to air pollution across the whole state.
I'm one of the Co-investigators, but it's a team that includes a professor in architecture, the principal investigator is a physician scientist, and pediatrician, and we also have a biostatistician and an environmental engineer on the team, among others.

2. What inspired you to focus on disentangling the links between individual-level and social determinants of health inequalities in your research?
I really appreciate that question. I was in Graduate School in the 1990s, and at that time, I would say, with regards to the epidemiology field, there was a renewed interest in moving away from proximate determinants of health. There was a lot of work being done on social determinants, or what we might refer to as upstream causes versus downstream causes, and I was in the middle of learning about all these things at that time.
At the same time, there were some advances in methods, including multi-level modeling, which is also called mixed effects modeling or hierarchical linear modeling. These statistical advances were being made that allowed us to investigate neighborhood-level influences on individual-level health outcomes.
Data sources in the US were also being routinely geo-coded. So, you could actually identify where an individual survey respondent was living and merge in data sources about their neighborhoods and perform multi-level studies. Some of the first studies in health were coming out at that time, and from a conceptual standpoint as well as a methods standpoint, it was very interesting to me.
I was also doing a fellowship at the National Center for Health Statistics, where I had access to all this amazing data and great scientists who were able to mentor me on how to conduct these neighborhood effect studies, as we call them. So, I've continued that work for almost 30 years now. I don't really focus on a particular health outcome; rather, I have examined neighborhood effects across the life course.  At the same time, as a poor graduate and undergraduate student, I was living in neighborhoods that really did make it quite hard to make healthy choices.
I had my scientific interest, but also my lived experience in neighborhoods where you couldn't find fresh produce that was affordable and neighborhoods that were, you know, pretty unsafe just to be out and about, and where I didn't know my neighbors. There wasn't a lot of social cohesion in the places where I lived.  So, in summary, I think those are the two pieces that I would say inspired my focus: scientific curiosity and lived experience.

3. Which understudied social determinants of health do you consider critical for future investigations in rapidly urbanizing contexts?
I think it really is context-dependent, so I'll just stick to the US context, which is what I know and what I study. Concepts such as social cohesion, even though they’ve been studied quite a bit, I don't know if we've studied them enough. Like, how do we keep communities connected, especially thinking of the US context and many other countries where a lot of immigrants are moving to urbanizing areas, who might have language and other barriers? So, I think it becomes really challenging when that’s part of urbanization.
Also, sort of related to the study I mentioned, I think we really need to understand more about how urban planning decisions impact people's lives and people's communities. Thinking of questions such as: how do you make sure everyone has mobility? How do you create walkable spaces? How do you prevent the negative impacts of gentrification and segregation? Those sorts of things, I don't know if we really know enough, and it requires partnerships between local governments, academics, and community-based organizations to really get a better handle on it.
And I think maybe two other areas. First, we absolutely need to know more about climate change-related exposures, in urban or urbanizing areas, thinking of heat, especially heat islands, as well as air pollution, and not just for a city as a whole. We really need to understand intra-city differences at a neighborhood level.
The other thing that I've been thinking about a little bit is the concept of smart cities and cities becoming much more technologically advanced. Trying to figure out what that means for digital inequities and trying to understand differential impacts on people who might not have the same kind of access to those technologies.

4. How do you envision emerging technologies (e.g., geospatial tools, AI) shaping the measurement of health determinants in the next decade?
It makes me think of a couple of things reading that question, and I want to acknowledge that this is not my expertise. I’m very new to AI, to using it, and to understanding it. Of course, it's rapidly evolving, and it's certainly going to be something that we need to be paying attention to. I've been very impressed by what climate scientists and some of the environmental engineers have already been doing with AI and geospatial tools to create these very sophisticated models to understand heat, climate change, and air pollution measurement at hyperlocal levels. So, I think we can look to some of our colleagues in other disciplines, and certainly we're going to be able to analyze data so much more quickly as AI develops more. I think we can probably do a lot more with simulation, and there is already some great research in the public health area.
I think that's an area where we're going to be able to do more, rather than collecting primary data longitudinally and following people over time. We can simulate types of things that might have an impact on health, and my area—health inequities.
In my area of work, one of the key limitations to neighborhood effects research is that we often need to rely on census data, such as poverty concentration or racial/ethnic composition, to provide a proxy for what's happening in terms of how neighborhoods impact health. Rather than being able to study the actual mechanisms. It has to do with data availability. If you're going to be looking at thousands and thousands of neighborhoods, you only really have access to census data to be able to easily look at all those places at once.
But I think as more and more tools become available, we're going to be able to integrate what the actual mechanisms of the neighborhood effects are to study those directly. So, I think that's a really exciting area for what I work in. And I think there's going to be more sensors and wearable technologies, which of course also come with issues of privacy and surveillance; there are always positives along with ethical challenges to these technologies.

5. From an author’s perspective, what unique strengths distinguish IJERPH from other journals?
I have published a fair amount in the International Journal of Environmental Research and Public Health.  It's always been a really smooth and efficient process working with the editorial team. The communication is always really clear. I feel like the papers get reviewed quickly, and I generally get great reviewer comments. And then you do things like this interview and follow up with ways to get your work out to more people and disseminate it more. And while I don't always take advantage of those resources, I still appreciate that the journal does that.  Finally, I really appreciate getting invitations to special issues with the article processing charges waived. That's a huge benefit, because not everybody has access to those types of resources.