Social Epidemiologist and Population Health Researcher

Stephanie Koning

Stephanie Koning is an assistant professor in the Department of Health Behavior, Policy, and Administration Sciences in the School of Public Health at University of Nevada, Reno. Her background is in sociology, population health, and policy research. Her research focus areas are biosocial determinants of maternal and child health; structural violence and social stress; and the health implications of migration and displacement. She has led or co-led multiple data collection projects using survey, interview, and ethnographic methods, and uses quantitative analytical techniques from biostatistics, machine learning, and quasi-experimental design. Her work focuses on global health and inequities, particularly in North American and Southeast Asian settings.

CV

REsearch

Joining contextual and person-centered analysis to study violence and displacement

Chronic conflict and displacement carry consequences for personal and social violence. Yet, studying these consequences in individuals and populations are difficult because these situations constantly change and are carried by individuals across time and space. I offer a new approach to conceptualizing and measuring displacement contexts, and the structural violence embedded therein. Myanmar's civil conflict has fueled ongoing displacement to Thailand for over fifty years. Using novel interview data from 520 women living at Thailand's northern border with Myanmar in 2016–17, I uncover clustered life events in women’s personal histories that reveal personal displacement-related contexts that have shifted over time, revealing cascading chains of violence. For instance, women who experienced past military occupation and/or overt military violence reported unexpectedly low perceived past oppression, or everyday violence. They were also more likely to experience ongoing violence in Thailand, characterized by livelihood- and security-based threats related to nativist social sentiment and policing. While past work has either focused on personal violence or violence as socially or spatially structured, this study contributes new insights for studying structural violence as it is personally embodied over time and space.

Koning, S. M. (2019) Displacement Contexts and Violent Landscapes: How conflict and displacement structure women's lives and ongoing threats at the Thai-Myanmar border. Social Science & Medicine, 240, 112557.

Toxically stressful contexts underlie women’s health and reproductive health inequalities

Chronic maternal stress is known to harm health during pregnancy, both for mothers and fetal development. However, less is understood regarding if and when specific stressful life events (SLE’s) pose acute perinatal health risks and how this might contribute to perinatal health disparities. We demonstrate the importance of studying SLE’s jointly as clusters in order to uncover “toxic stressor landscapes,” which resemble chains of risk that emerge in violent social contexts, including racism in the United States. Among U.S. births, we uncover toxic stressor landscapes characterized by acute and/or excessive SLE’s that disproportionately affect Black American families and account for a sizeable proportion of racial inequalities in low birth weight and prematurity.

Koning, S. M., and Ehrenthal, D. B. (2019). Stressor Landscapes, Birth Weight, and Prematurity at the Intersection of Race and Income: Elucidating Birth Contexts through Patterned Life Events. SSM-Population Health, 8, 100460.

Uncovering health-selective migration to understand immigrant health and inequalities

Whether and how health affects migration decisions may help explain the paradoxical Hispanic health advantage observed in the United States. Yet, no existing data exists for easily comparing health between migrants who stay and leave. To investigate this, we compare the health of Mexican migrants leaving the U.S. to those in comparable situations who stay using a dataset we uniquely linked and harmonized. We find voluntary return migrants report more health limitations and stress than those who stay. More accessible healthcare in Mexico may affect decisions to leave the U.S. Unlike most migrant health studies, we also include deported migrants. Among this group, we do not observe similar health selection, as expected.

Diaz, C. J., Koning, S. M., & Martinez-Donate, A. P. (2016). Moving Beyond Salmon Bias: Mexican Return Migration and Health Selection. Demography, 53(6), 2005-2030.