On Science, Identity and Rigor

Hey! I’m glad you’re here. You probably read through my bio but the TL;DR version: My name is Tiffany Green. I’m an economist and population health scientist who spends her time trying to unpack racial/ethnic disparities in reproductive health. I’m also black (not African American, thank you very much) and a second-generation Jamaican immigrant on my dad’s side. I’m also a wife, mama, friend and side-eye master. (Was that short enough?)

I thought a lot about what my first blog post would be and as I walked outside today, occasionally trying to avoid neighbors who oddly seem to want to congregate in the middle of a global pandemic, it hit me. I needed to talk about the intersections between identity and science.

I happen to have lots of opinions about this, given that I’ve had to spend a lot of time establishing and coming to terms with my professional identity. Given that I’m an economist who works in health and plays with psychologists and demographers and health services researchers, you learn to cope with skepticism and develop a thick skin. On one hand, many of my fellow economists kind of don’t know what to make of me, given that I’ve been interested in the demand for infant feeding and prenatal care, and not say, labor market outcomes (even though we all have the same training!). On the other hand, folks outside of economics in public health are usually glad I’m around, but are surprised I’m down for the cause. “You’re so..nice for an economist” is the usual refrain. Thanks..I think?

But I digress. As an economics grad student, I remember being taught that our ability to be ‘objective’ social scientists was a point of pride. That somehow, being apolitical and making no judgements made you a better scientist. This kind of threw salt in the game, but I’m not a macroeconomist and that’s none of my business. 

One of the things that has become clear to me over the years is that my identity as a black economist certainly does matter to how I see the world and the questions I ask. For example, neoclassical economics models suggest that even if some employers discriminate (e.g., against black workers), discrimination will eventually disappear through the magic of competition. That’s of course not true, and differences in human capital (e.g., education and skills) don’t explain the persistence of discrimination, which is obvious to just about every black person I know, economist or not. Not taking into account how race actually works in our theoretical models and frameworks limits our ability to say things about how the real world operates. And that’s why the black economists I know tend to approach the study of race and discrimination in labor markets very differently than the white economists that make up the majority of the field—and why you should listen to them. Not because it’s some ‘politically correct, social justice warrior’ thing to do (if you use these terms derisively, you might be someone who has a problem treating folks with basic human dignity and may want to seek help). But because they make the science better and that’s what we should all want. 

So when I think about why differences in education also don’t explain why the most educated black women have worse birth outcomes—including low birth weight, preterm birth and infant mortality—than the least educated white women I’m thinking about the various reasons why, including differential returns to education in the labor market (read: more education, less money), neighborhood environments, discrimination and more. Because I know the science but my lived experience as a black mother makes all of this hit real different. 

On the other hand, when I’m talking to most public health people about breastfeeding, their prior is that we should be doing everything in our power to make sure that all women* breastfeed. Breastfeeding good, formula not ideal. And they assume I feel the same. 

Now, I think breastfeeding is a perfectly good way to feed babies. (Full disclosure: I’ve done it myself twice and am still doing it!) Ideally, we’d have a world where anyone who wanted to breastfeed had the resources to do so. But as an economist, I know good and well that US family policies (or the lack thereof) make it difficult to continue breastfeeding once parents return to work. (Hello constraints!) And these barriers are differentially felt by folks with jobs that don’t offer flexible schedules or clean, private rooms for pumping, which also takes up quite a bit of time in one’s day. I’ve personally spent a lot of hours I could have been working on new articles on pumping!

Side note (but related): I once met with a government bureaucrat some years ago who will remain nameless. We happened to start talking about breastfeeding, and he mentioned that one of his employees, a new mother, wanted additional leave time so that she could breastfeed. The discussion is paraphrased here:

Me: Did you give her more time off?

Him: No.

Me: I guess you didn’t want her to breastfeed!

For some reason, I wasn’t invited back. *shrugs*

Back to the subject at hand, there’s the thornier question of whether breastfeeding is causally related to better health outcomes. This is where my economist brain takes over again. I know that in developed countries such as the United States (where I’m going to confine my discussion), most, if not all of the effects we see of breastfeeding for full-term babies can be attributed to family-level characteristics, not to breastfeeding itself. We call this unobserved heterogeneity (aka omitted variable bias). For example, more educated, higher income women who breastfeed also have the resources to purchase goods and services and environments that contribute to better health and educational outcomes. This makes us attribute the health and educational benefits of breastfeeding, when what we’re really seeing is the effects of all the aforementioned resources. Switching to breastfeeding certainly would not save millions of babies in the US—including black children.** 

Long story short: I think we need to: 1) learn more about the molecular properties of breastmilk to better understand what impacts it might have 2) address larger issue of inequitable leave laws and 3) interrogate why black women are more likely to be encouraged to formula feed. But again, the way I see and approach these issues is as an empiricist and mother who all too intimately understands the costs of breastfeeding. 

I know I’ve gone on for quite bit here. But my point is that my identities—as an economist, a black woman, a 2nd gen immigrant and a mother matter to my science. They don’t make me less objective, they allow me to see problems from different angles and come up with better answers. And that is a good thing. 

*women aren’t the only ones who nurse or give birth for that matter

**For preterm babies, breastfeeding does help to protect against a very serious, life-threatening intestinal disorder, necrotizing enterocolitis.