Anusha Vable, ScD, MPH
Associate Professor
Family Community Medicine
School of Medicine

We employ methods from basic linear regression with interaction terms; to sophisticated approaches for identifying causal effects from epidemiology and econometrics; to sequence analysis, an approach that originated in genetics but has extensions in social science to identify common patterns in variables that unfold over time. Our research focuses on socioeconomic exposures (particularly education, but also occupation and income) and diseases associated with aging (particularly cognitive aging, but also heart disease and diabetes); I have received several R01 and R01-equivalent grants as PI or mPI to support these goals. Methodologically, VabLab has two areas of expertise that may be especially important for equity researchers: [1] Quantile regression: a method to evaluate how exposures impact the entire outcome distribution (vs. the mean, which is typically evaluated). This is important for equity research because the most structurally minoritized individuals are typically in the tails of the outcome distribution. [2] Sequence analysis is a powerful and underutilized method to characterize variables that occur over time or over the lifecourse. Our team has been using sequence analysis to understand educational trajectories from age 14 – 48; employment trajectories from ages 18 – 65; air pollution trajectories from 2000 – 2010; state-level abortion access trajectories from 1970 – 2014, Earned Income Tax Credit trajectories from ages 22 - 48, etc., and how these exposures predict subsequent health outcomes. Sequence analysis is descriptive, not causal, but I argue that for most exposures that cumulate over the lifecourse, we are in the descriptive phase, not the causal phase. Substantively, our team evaluates if socioeconomic exposures and policies are racist / discriminatory (widen inequities) or anti-racist / anti-discriminatory (narrow inequities). We have found that the Korean War GI Bill, which subsidized college education for qualifying veterans, predicted smaller socioeconomic disparities in markers of mental, physical and cognitive health among veterans compared to non-veterans. Similarly, in work led by postdoc Dr. Aayush Khadka, we found that Vietnam War GI Bill eligibility shifted and reshaped the blood pressure distribution to one of lower CVD risk and reduced childhood socioeconomic disparities in blood pressure. We have also found that structurally marginalized groups (women, racial minoritized people, and those from lower socioeconomic backgrounds) seem to benefit more from each year of education than structurally advantaged groups (e.g. high socioeconomic status White men). Our work to date suggests programs and policies to increase educational attainment could be powerful mechanism to reduce racial and socioeconomic health inequities; these consistent findings inform our social change work. Our social change work, informed by our substantive work, focuses on building the evidence base for the state of California to invest in the public education system at 3 levels: [1] Early childhood (0 - 5 years): we know this period is critical and we know it’s a market failure; if it’s a market failure, it’s the government’s responsibility to fix this; they are the only ones who can. [2] K-12 education in California has been underfunded for decades: uneven distribution of buses, nurses, and guidance counselors; they have to fundraise for basic programming like physical education, music, and arts. Especially important for equity is decoupling the funding for public education from property taxes; that is, we need to create a system where the size of your house doesn’t determine the quality of your public education options. [3] Higher education: tuition at UCs and CSU systems used to be free; similarly, the reason 48,000 UC employees went on strike in 2022 has the same root cause: underfunding by the state. To make up for the budgetary shortfall caused by underinvestment by the state, our public universities are squeezing students with ballooning tuition payments and squeezing low-wage workers with barely livable wages in order to stay solvent. Higher education at public universities can become accessible to the public again if the state decides to prioritize it.

The State of California is under-investing in our kids. We know that education is the primary mechanism for opportunity and social mobility in this country, therefore it is vital that we convince the state to adequately fund the education system. I am not talking about a one-time investment, but a massive and systemic course-correction.

• Food Insecurity, Memory, and Dementia Among US Adults Aged 50 Years and Older.
  JAMA network open 2023 Qian H, Khadka A, Martinez SM, Singh S, Brenowitz WD, Zeki Al Hazzouri A, Hill-Jarrett TG, Glymour MM, Vable AM
• Associations of Food Insecurity and Memory Function Among Middle to Older-Aged Adults in the Health and Retirement Study.
  JAMA network open 2023 Lu P, Kezios K, Jawadekar N, Swift S, Vable A, Zeki Al Hazzouri A
• Childhood Residential Mobility and Mental and Physical Health in Later Life: Findings From the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study.
  Journal of applied gerontology : the official journal of the Southern Gerontological Society 2023 Yen IH, Bennett A, Allen S, Vable A, Long DL, Brooks M, Ream RK, Crowe M, Howard VJ
• Lifecourse Educational Trajectories and Hypertension in Midlife: An Application of Sequence Analysis.
  The journals of gerontology. Series A, Biological sciences and medical sciences 2022 Duarte CD, Wannier SR, Cohen AK, Glymour MM, Ream RK, Yen IH, Vable AM
• Code Review as a Simple Trick to Enhance Reproducibility, Accelerate Learning, and Improve the Quality of Your Team's Research.
  American journal of epidemiology 2021 Vable AM, Diehl SF, Glymour MM
• Vable et al. Respond to "Code Review-A Step Toward Reproducibility".
  American journal of epidemiology 2021 Vable AM, Diehl SF, Glymour MM
• Understanding the benefits of different types and timing of education for mental health: A sequence analysis approach.
  The journals of gerontology. Series B, Psychological sciences and social sciences 2021 Vable AM, Duarte CDP, Wannier SR, Chan-Golston AM, Cohen AK, Glymour MM, Ream RK, Yen IH
• Does the Type and Timing of Educational Attainment Influence Physical Health? A Novel Application of Sequence Analysis.
  American journal of epidemiology 2020 Vable AM, Duarte CD, Cohen AK, Glymour MM, Ream RK, Yen IH
• Short-term effects of the earned income tax credit on mental health and health behaviors.
  Preventive medicine 2020 Collin DF, Shields-Zeeman LS, Batra A, Vable AM, Rehkopf DH, Machen L, Hamad R
• Homelessness, housing instability, and abortion outcomes at an urban abortion clinic in the United States.
  American journal of obstetrics and gynecology 2020 Orlando MS, Vable AM, Holt K, Wingo E, Newmann S, Shapiro BJ, Borne D, Drey EA, Seidman D
• Is it possible to overcome the 'long arm' of childhood socioeconomic disadvantage through upward socioeconomic mobility?
  Journal of public health (Oxford, England) 2019 Vable AM, Gilsanz P, Kawachi I
• Quality and quantity: The association of state-level educational policies with later life cardiovascular disease.
  Preventive medicine 2019 Hamad R, Nguyen TT, Glymour MM, Vable A, Manly JJ, Rehkopf DH
• Differential associations between state-level educational quality and cardiovascular health by race: Early-life exposures and late-life health.
  SSM - population health 2019 Vable AM, Nguyen TT, Rehkopf D, Glymour MM, Hamad R
• Military Service, Childhood Socio-Economic Status, and Late-Life Lung Function: Korean War Era Military Service Associated with Smaller Disparities.
  Military medicine 2018 Vable AM, Kiang MV, Basu S, Rudolph KE, Kawachi I, Subramanian SV, Glymour MM
• Trends for Reported Discrimination in Health Care in a National Sample of Older Adults with Chronic Conditions.
  Journal of general internal medicine 2017 Nguyen TT, Vable AM, Glymour MM, Nuru-Jeter A
• Discrimination in health care and biomarkers of cardiometabolic risk in U.S. adults
  Social Science and Medicine Population Health 2017 Nguyen TT, Vable AM, Glymour MM, Nuru-Jeter A
• Are There Spillover Effects from the GI Bill? The Mental Health of Wives of Korean War Veterans.
  PloS one 2016 Vable AM, Kawachi I, Canning D, Glymour MM, Jimenez MP, Subramanian SV
• Can social policy influence socioeconomic disparities? Korean War GI Bill eligibility and markers of depression.
  Annals of epidemiology 2015 Vable AM, Canning D, Glymour MM, Kawachi I, Jimenez MP, Subramanian SV
• Does the "widowhood effect" precede spousal bereavement? Results from a nationally representative sample of older adults.
  The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry 2014 Vable AM, Subramanian SV, Rist PM, Glymour MM
• Outcomes of the Botswana national HIV/AIDS treatment programme from 2002 to 2010: a longitudinal analysis.
  The Lancet. Global health 2013 Farahani M, Vable A, Lebelonyane R, Seipone K, Anderson M, Avalos A, Chadborn T, Tilahun H, Roumis D, Moeti T, Musuka G, Busang L, Gaolathe T, Malefho KC, Marlink R
• Short- and long-term associations between widowhood and mortality in the United States: longitudinal analyses.
  Journal of public health (Oxford, England) 2013 Moon JR, Glymour MM, Vable AM, Liu SY, Subramanian SV
• Combating Obesity at Community Health Centers (COACH): a quality improvement collaborative for weight management programs.
  Journal of health care for the poor and underserved 2013 Wilkes AE, John PM, Vable AM, Campbell A, Heuer L, Schaefer C, Vinci L, Drum ML, Chin MH, Quinn MT, Burnet DL
• Undergoing transformation to the patient centered medical home in safety net health centers: perspectives from the front lines.
  Ethnicity & disease 2013 Quinn MT, Gunter KE, Nocon RS, Lewis SE, Vable AM, Tang H, Park SY, Casalino LP, Huang ES, Birnberg J, Burnet DL, Summerfelt WT, Chin MH
• Patient-centered medical home characteristics and staff morale in safety net clinics.
  Archives of internal medicine 2012 Lewis SE, Nocon RS, Tang H, Park SY, Vable AM, Casalino LP, Huang ES, Quinn MT, Burnet DL, Summerfelt WT, Birnberg JM, Chin MH
• Development of a safety net medical home scale for clinics.
  Journal of general internal medicine 2011 Birnberg JM, Drum ML, Huang ES, Casalino LP, Lewis SE, Vable AM, Tang H, Quinn MT, Burnet DL, Summerfelt T, Chin MH
• Implications of the new definition of diabetes for health disparities.
  Journal of the National Medical Association 2011 Vable AM, Drum ML, Tang H, Chin MH, Lindau ST, Huang ES
• Sexuality among middle-aged and older adults with diagnosed and undiagnosed diabetes: a national, population-based study.
  Diabetes care 2010 Lindau ST, Tang H, Gomero A, Vable A, Huang ES, Drum ML, Qato DM, Chin MH