Assistant professor in the department of epidemiology and biostatistics at the University of California San Francisco. A social epidemiologist with experience in research and evaluation on topics including health equity, education equity, civic engagement, youth, and the environment. Full publication list available on Google Scholar: https://scholar.google.com/citations?user=4ngSFIUAAAAJ&hl=en.
This study examined the role of demographics, civic beliefs, and the impact of the COVID‐19 pande... more This study examined the role of demographics, civic beliefs, and the impact of the COVID‐19 pandemic in association with distinct forms of civic participation. College students were recruited across 10 institutions of higher education to complete an online survey. Bivariate, multivariable linear, and logistic regressions were performed. Findings indicated that participants from traditionally marginalized backgrounds were more likely to engage in systemchallenging forms of civic participation and community engagement than those from more privileged backgrounds. Participants who rated high in critical reflection, viewed racism as a key issue, and were heavily impacted by the COVID‐19 pandemic were also more likely to engage in system‐challenging forms of civic participation. Participants who endorsed beliefs supporting current systems of power were more likely to report they intended to vote. Results highlight implications for antiracist activism, community engagement, and traditional political civic behaviors.
Revue D Epidemiologie Et De Sante Publique, Oct 1, 2021
BACKGROUND We conducted a community-based participatory environmental health study in three towns... more BACKGROUND We conducted a community-based participatory environmental health study in three towns: two in the heart of Marseille's industrial zone (Fos-sur-Mer and Port-Saint-Louis-du-Rhône), and one on the periphery located about 30 km away (Saint-Martin-de-Crau). METHODS We first conducted a cross-sectional survey of a random sample of residents in each of the three towns. We asked study participants to self-report a wide variety of health issues (Port-Saint-Louis: n = 272, Fos-sur-Mer: n = 543, Saint-Martin-de-Crau: n = 439). We then conducted focus groups with residents and other stakeholders to share preliminary data in order to propose areas of reflection and collaboratively produce contextually-situated knowledge of their health and environment. We directly standardized the prevalences (by age and gender) to the French metropolitan population to make our results more comparable. RESULTS Study participants who lived closer to the core industrial zone (residents of Fos-sur-Mer and Port-Saint-Louis-du-Rhone) had higher prevalences of eye irritation, nose and throat problems, chronic skin problems and headaches than people who lived further away (residents of Saint-Martin-de-Crau). Residents also offered diverse qualitative insights about their environment and health experiences. DISCUSSION We observed elevated prevalences of diseases that affected residents across the industrial zone (Fos-sur-Mer and Port-Saint-Louis-du-Rhône) compared to those living outside (Saint-Martin-de-Crau), and qualitative evidence of how residents made sense of their health experiences strengthening an understanding of their own empirical observations which helps to produce knowledge about health in an industrial context. The results of the workshops show an important benefit from the co-production of local knowledge. CONCLUSION We encourage future researchers to do in-depth, community-based research to comprehensively describe the health of residents in other heavily polluted zones, product local knowledge and to help identify policy solutions, engender trust among the local people, and identify opportunities for intervention.
Frontiers in rehabilitation sciences, Apr 28, 2023
Long COVID disproportionately affects premenopausal women, but relatively few studies have examin... more Long COVID disproportionately affects premenopausal women, but relatively few studies have examined Long COVID's impact on female reproductive health. We conduct a review of the literature documenting the female reproductive health impacts of Long COVID which may include disruptions to the menstrual cycle, gonadal function, ovarian sufficiency, menopause, and fertility, as well as symptom exacerbation around menstruation. Given limited research, we also review the reproductive health impacts of overlapping and associated illnesses including myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), postural orthostatic tachycardia syndrome (POTS), connective tissue disorders like Ehlers-Danlos syndrome (EDS), and endometriosis, as these illnesses may help to elucidate reproductive health conditions in Long COVID. These associated illnesses, whose patients are 70%–80% women, have increased rates of dysmenorrhea, amenorrhea, oligomenorrhea, dyspareunia, endometriosis, infertility, vulvodynia, intermenstrual bleeding, ovarian cysts, uterine fibroids and bleeding, pelvic congestion syndrome, gynecological surgeries, and adverse pregnancy complications such as preeclampsia, maternal mortality, and premature birth. Additionally, in Long COVID and associated illnesses, symptoms can be impacted by the menstrual cycle, pregnancy, and menopause. We propose priorities for future research and reproductive healthcare in Long COVID based on a review of the literature. These include screening Long COVID patients for comorbid and associated conditions; studying the impacts of the menstrual cycle, pregnancy, and menopause on symptoms and illness progression; uncovering the role of sex differences and sex hormones in Long COVID and associated illnesses; and addressing historical research and healthcare inequities that have contributed to detrimental knowledge gaps for this patient population.
The global COVID-19 pandemic’s social, economic, and health consequences are far-reaching, and th... more The global COVID-19 pandemic’s social, economic, and health consequences are far-reaching, and the pandemic’s disproportionate impact, coupled with movements against systemic racism, have exposed deep structural challenges in our society. As citizens and policymakers respond to these challenges, American democracy and societies worldwide are at a crossroads. In How Democracies Die, Levitsky and Ziblatt (2018) asserted that “American democracy depends on us – the citizens of the United States. No single political leader can end a democracy; no single leader can rescue one, either” (p. 230). Can we meet this challenge of shared civic responsibilities in a highly polarized polity? Do our schools and other core institutions have the capacity and the will to inspire our children and young adults’ civility and civic purpose? Can we revive civic trust as the majority of our citizens lose confidence in our governing institutions? Will the next generation of American citizens be ready to exercise their voting rights and free speech? Will inequalities in civic engagement widen in the context of growing economic inequality? Is deliberative democracy fading in the American polity? These issues are at the core of the design, practice, and future of democratic practices in the United States and beyond. The papers in this special issue raise the saliency and the relevance of these issues while suggesting steps that civic actors – whether teachers, researchers, students, parents, taxpayers, or other members of the public – can and do take to encourage greater democratic living. The worrisome state of American democracy calls for a systematic examination of civic education and civic capacity, the foundational pillars of democratic life. Mounk (2018) found that only one-third of millennials (versus two-thirds of those born in the 1930s and 1940s) thought living in a democratic society was very important. Studies (e.g., CCSSO, 2018) show curricula are narrowing due to high stakes accountability, often excluding or marginalizing civics education. Schools can play an important role in increasing civic engagement generally and decreasing gaps in civic engagement that exist (Levinson, 2012), but civic opportunities are often inequitably distributed within schools (Kahne & Middaugh, 2008). In a political context shifting toward ideological polarization (Feldman et al., 2018) and populism (Roth, 2017) and away from transparent and public accountability around the globe, including in democracies, there is increasing interest in reaffirming democratic practices. In the US, part of the rationale for public schools has been to prepare people to be democratic citizens, both historically (Dewey, 1916) and currently (Gould et al., 2011). Given the longstanding commitment to civic education and the current urgency, this special issue offers a comprehensive, current understanding of the state of the field. Collectively, this special issue integrates theoretical and empirical work on civic education, civic capacity, and democratic practices. We view civic education as a set of learning goals shaped by the framework of liberal democracy (e.g., Dewey, 1916; Gutmann, 1987). Particular attention is given to the concepts and practice of action civics, a type of guided experiential civics education (Ballard et al., 2016; Cohen et al., 2018; Pope et al., 2011). Strengthening civic education will contribute to vibrant civic capacity, a concept commonly promoted by political scientists (e.g., Henig et al., 1999; Orr &
The COVID-19 pandemic has had wide-ranging impacts on college-going emerging adults and their com... more The COVID-19 pandemic has had wide-ranging impacts on college-going emerging adults and their communities, which may prompt them to engage civically. Using spring 2020 survey data from a national sample of college students aged 18–22 ( N = 707), we document the prevalence of pandemic-related civic engagement as well as differences in engagement by sociopolitical perspectives. The majority of participants (70.4%) reported engaging civically at least once, most commonly online (e.g., sharing information about COVID-19 on social media, volunteering virtually). Results showed differences in civic engagement by communal orientation and the candidate participants intended to vote for in the 2020 presidential election, but not by political party affiliation. Qualitative data provide insight into different motivations for pandemic-related civic engagement. We conclude that emerging adult college students’ pandemic-related civic engagement is partially motivated by their sociopolitical perspectives and discuss implications for future work examining emerging adult civic engagement more broadly.
PURPOSE The purpose of this study is to document young adults' perceived stress and anxiety i... more PURPOSE The purpose of this study is to document young adults' perceived stress and anxiety in a diverse sample of college students across the U.S. during the COVID-19 pandemic. METHODS We recruited, via Instagram, a sample of full-time college students aged 18-22 from across the U.S. We surveyed them in April (baseline; N = 707; mean age = 20.0, SD = 1.3) and July (follow-up) 2020. This study presents overall levels of perceived stress and general anxiety symptoms and inequalities across each of these outcomes by gender, sexual orientation, race/ethnicity, and household income. We also explore potential explanations for these health issues by analyzing baseline qualitative data. RESULTS All students, on average, were suffering from perceived stress and anxiety, with especially high levels in April. We also identified inequalities in college student mental well-being, particularly by gender identity and sexual orientation. Women reported worse well-being compared with men; transgender and gender diverse and sexual minority youths reported worse outcomes than their cisgender, heterosexual peers at both time points. Qualitative data illustrate how the COVID-19 pandemic has generated educational, economic, and environmental stressors that are affecting college students' well-being. CONCLUSIONS As colleges and universities think about how to manage and mitigate the infectious disease dimensions of COVID-19 among their student populations, they must also consider who is most at risk for increased stress and anxiety during the pandemic.
This study examined the role of demographics, civic beliefs, and the impact of the COVID‐19 pande... more This study examined the role of demographics, civic beliefs, and the impact of the COVID‐19 pandemic in association with distinct forms of civic participation. College students were recruited across 10 institutions of higher education to complete an online survey. Bivariate, multivariable linear, and logistic regressions were performed. Findings indicated that participants from traditionally marginalized backgrounds were more likely to engage in systemchallenging forms of civic participation and community engagement than those from more privileged backgrounds. Participants who rated high in critical reflection, viewed racism as a key issue, and were heavily impacted by the COVID‐19 pandemic were also more likely to engage in system‐challenging forms of civic participation. Participants who endorsed beliefs supporting current systems of power were more likely to report they intended to vote. Results highlight implications for antiracist activism, community engagement, and traditional political civic behaviors.
Revue D Epidemiologie Et De Sante Publique, Oct 1, 2021
BACKGROUND We conducted a community-based participatory environmental health study in three towns... more BACKGROUND We conducted a community-based participatory environmental health study in three towns: two in the heart of Marseille's industrial zone (Fos-sur-Mer and Port-Saint-Louis-du-Rhône), and one on the periphery located about 30 km away (Saint-Martin-de-Crau). METHODS We first conducted a cross-sectional survey of a random sample of residents in each of the three towns. We asked study participants to self-report a wide variety of health issues (Port-Saint-Louis: n = 272, Fos-sur-Mer: n = 543, Saint-Martin-de-Crau: n = 439). We then conducted focus groups with residents and other stakeholders to share preliminary data in order to propose areas of reflection and collaboratively produce contextually-situated knowledge of their health and environment. We directly standardized the prevalences (by age and gender) to the French metropolitan population to make our results more comparable. RESULTS Study participants who lived closer to the core industrial zone (residents of Fos-sur-Mer and Port-Saint-Louis-du-Rhone) had higher prevalences of eye irritation, nose and throat problems, chronic skin problems and headaches than people who lived further away (residents of Saint-Martin-de-Crau). Residents also offered diverse qualitative insights about their environment and health experiences. DISCUSSION We observed elevated prevalences of diseases that affected residents across the industrial zone (Fos-sur-Mer and Port-Saint-Louis-du-Rhône) compared to those living outside (Saint-Martin-de-Crau), and qualitative evidence of how residents made sense of their health experiences strengthening an understanding of their own empirical observations which helps to produce knowledge about health in an industrial context. The results of the workshops show an important benefit from the co-production of local knowledge. CONCLUSION We encourage future researchers to do in-depth, community-based research to comprehensively describe the health of residents in other heavily polluted zones, product local knowledge and to help identify policy solutions, engender trust among the local people, and identify opportunities for intervention.
Frontiers in rehabilitation sciences, Apr 28, 2023
Long COVID disproportionately affects premenopausal women, but relatively few studies have examin... more Long COVID disproportionately affects premenopausal women, but relatively few studies have examined Long COVID's impact on female reproductive health. We conduct a review of the literature documenting the female reproductive health impacts of Long COVID which may include disruptions to the menstrual cycle, gonadal function, ovarian sufficiency, menopause, and fertility, as well as symptom exacerbation around menstruation. Given limited research, we also review the reproductive health impacts of overlapping and associated illnesses including myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), postural orthostatic tachycardia syndrome (POTS), connective tissue disorders like Ehlers-Danlos syndrome (EDS), and endometriosis, as these illnesses may help to elucidate reproductive health conditions in Long COVID. These associated illnesses, whose patients are 70%–80% women, have increased rates of dysmenorrhea, amenorrhea, oligomenorrhea, dyspareunia, endometriosis, infertility, vulvodynia, intermenstrual bleeding, ovarian cysts, uterine fibroids and bleeding, pelvic congestion syndrome, gynecological surgeries, and adverse pregnancy complications such as preeclampsia, maternal mortality, and premature birth. Additionally, in Long COVID and associated illnesses, symptoms can be impacted by the menstrual cycle, pregnancy, and menopause. We propose priorities for future research and reproductive healthcare in Long COVID based on a review of the literature. These include screening Long COVID patients for comorbid and associated conditions; studying the impacts of the menstrual cycle, pregnancy, and menopause on symptoms and illness progression; uncovering the role of sex differences and sex hormones in Long COVID and associated illnesses; and addressing historical research and healthcare inequities that have contributed to detrimental knowledge gaps for this patient population.
The global COVID-19 pandemic’s social, economic, and health consequences are far-reaching, and th... more The global COVID-19 pandemic’s social, economic, and health consequences are far-reaching, and the pandemic’s disproportionate impact, coupled with movements against systemic racism, have exposed deep structural challenges in our society. As citizens and policymakers respond to these challenges, American democracy and societies worldwide are at a crossroads. In How Democracies Die, Levitsky and Ziblatt (2018) asserted that “American democracy depends on us – the citizens of the United States. No single political leader can end a democracy; no single leader can rescue one, either” (p. 230). Can we meet this challenge of shared civic responsibilities in a highly polarized polity? Do our schools and other core institutions have the capacity and the will to inspire our children and young adults’ civility and civic purpose? Can we revive civic trust as the majority of our citizens lose confidence in our governing institutions? Will the next generation of American citizens be ready to exercise their voting rights and free speech? Will inequalities in civic engagement widen in the context of growing economic inequality? Is deliberative democracy fading in the American polity? These issues are at the core of the design, practice, and future of democratic practices in the United States and beyond. The papers in this special issue raise the saliency and the relevance of these issues while suggesting steps that civic actors – whether teachers, researchers, students, parents, taxpayers, or other members of the public – can and do take to encourage greater democratic living. The worrisome state of American democracy calls for a systematic examination of civic education and civic capacity, the foundational pillars of democratic life. Mounk (2018) found that only one-third of millennials (versus two-thirds of those born in the 1930s and 1940s) thought living in a democratic society was very important. Studies (e.g., CCSSO, 2018) show curricula are narrowing due to high stakes accountability, often excluding or marginalizing civics education. Schools can play an important role in increasing civic engagement generally and decreasing gaps in civic engagement that exist (Levinson, 2012), but civic opportunities are often inequitably distributed within schools (Kahne & Middaugh, 2008). In a political context shifting toward ideological polarization (Feldman et al., 2018) and populism (Roth, 2017) and away from transparent and public accountability around the globe, including in democracies, there is increasing interest in reaffirming democratic practices. In the US, part of the rationale for public schools has been to prepare people to be democratic citizens, both historically (Dewey, 1916) and currently (Gould et al., 2011). Given the longstanding commitment to civic education and the current urgency, this special issue offers a comprehensive, current understanding of the state of the field. Collectively, this special issue integrates theoretical and empirical work on civic education, civic capacity, and democratic practices. We view civic education as a set of learning goals shaped by the framework of liberal democracy (e.g., Dewey, 1916; Gutmann, 1987). Particular attention is given to the concepts and practice of action civics, a type of guided experiential civics education (Ballard et al., 2016; Cohen et al., 2018; Pope et al., 2011). Strengthening civic education will contribute to vibrant civic capacity, a concept commonly promoted by political scientists (e.g., Henig et al., 1999; Orr &
The COVID-19 pandemic has had wide-ranging impacts on college-going emerging adults and their com... more The COVID-19 pandemic has had wide-ranging impacts on college-going emerging adults and their communities, which may prompt them to engage civically. Using spring 2020 survey data from a national sample of college students aged 18–22 ( N = 707), we document the prevalence of pandemic-related civic engagement as well as differences in engagement by sociopolitical perspectives. The majority of participants (70.4%) reported engaging civically at least once, most commonly online (e.g., sharing information about COVID-19 on social media, volunteering virtually). Results showed differences in civic engagement by communal orientation and the candidate participants intended to vote for in the 2020 presidential election, but not by political party affiliation. Qualitative data provide insight into different motivations for pandemic-related civic engagement. We conclude that emerging adult college students’ pandemic-related civic engagement is partially motivated by their sociopolitical perspectives and discuss implications for future work examining emerging adult civic engagement more broadly.
PURPOSE The purpose of this study is to document young adults' perceived stress and anxiety i... more PURPOSE The purpose of this study is to document young adults' perceived stress and anxiety in a diverse sample of college students across the U.S. during the COVID-19 pandemic. METHODS We recruited, via Instagram, a sample of full-time college students aged 18-22 from across the U.S. We surveyed them in April (baseline; N = 707; mean age = 20.0, SD = 1.3) and July (follow-up) 2020. This study presents overall levels of perceived stress and general anxiety symptoms and inequalities across each of these outcomes by gender, sexual orientation, race/ethnicity, and household income. We also explore potential explanations for these health issues by analyzing baseline qualitative data. RESULTS All students, on average, were suffering from perceived stress and anxiety, with especially high levels in April. We also identified inequalities in college student mental well-being, particularly by gender identity and sexual orientation. Women reported worse well-being compared with men; transgender and gender diverse and sexual minority youths reported worse outcomes than their cisgender, heterosexual peers at both time points. Qualitative data illustrate how the COVID-19 pandemic has generated educational, economic, and environmental stressors that are affecting college students' well-being. CONCLUSIONS As colleges and universities think about how to manage and mitigate the infectious disease dimensions of COVID-19 among their student populations, they must also consider who is most at risk for increased stress and anxiety during the pandemic.
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Papers by Alison Cohen