Epidemiologist’s lifelong passion serves as inspiration to work with communities
Q&A with Sari Reisner (he/him)
Associate Professor of Epidemiology
Sari Reisner, associate professor of Epidemiology at the University of Michigan School of Public Health, has always been interested in equity and social justice.
He found public health after graduating from Georgetown University, where he was a double major in English and Women’s studies, earning a bachelor’s degree in 2001.
Reisner landed his first job out of college as a grant writer at Whitman Walker, a federally qualified community health center in Washington, DC, that specializes in HIV services and LGBTQIA+ health.
“I wrote grants to fund their mental health, substance use and HIV prevention and care services,” he said. “Little did I know, back when I took that position, just how handy those grant writing skills would be for my future career as a researcher.”
Reisner completed a postdoctoral fellowship in Infectious Disease Epidemiology in 2015 at the Department of Epidemiology at Harvard T.H. Chan School of Public Health, where he earned a Doctor of Science degree in Social and Psychiatric Epidemiology in 2013. He also holds a master’s degree in Gender and Cultural Studies in 2006 from Brandeis University.
His research focuses on understanding and mitigating health inequities for stigmatized and underserved populations, particularly in mental health, HIV prevention and care, and access to healthcare.
Reisner is specialized in LGBTQIA+ population health, with deep expertise in transgender, nonbinary and gender diverse population health. His work utilizes a “participatory population perspective” to work “with” not “on” communities to promote health equity.
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What motivated you to work in public health?
My interest in LGBTQIA+ public health was partly driven by my own experiences as a member of the LGBTQIA+ community as a transgender man—and by the experiences of those around me that I bore witness to. I saw the toxic and health-harming nature of stigma and how being “othered”—facing societal exclusion or marginalization in whatever capacity—can have detrimental effects on health and well-being. I wanted to be part of changing this in public health.
I also learned how many of the vulnerabilities that arise in challenging circumstances are due to external forces—pushing back on the traditional biomedical narrative of “personal responsibility” or “lifestyle choices”—and how people can and do resist oppression experienced in their lives. For example, through community connection, participation and the sense of belongingness. Public health can be part of the solution by identifying and leveraging health-promoting factors instead of searching for the causes of specific diseases. We need to document and understand the ways that the multilevel contexts in which people live, grow and relate to each other, work and play—at the intrapersonal, interpersonal and structural levels—influence health outcomes for different populations both in negative and positive ways.
What parts of public health are the most interesting for you?
Public health is a “team sport” and I love the interdisciplinary nature of public health. I am always interested in learning about and applying methods and approaches from other fields to understand public health problems and identify solutions. I learn so much from the synergies and collaborations that I have with colleagues from other disciplines. It keeps public health fresh and interesting. It also increases innovation and creativity, providing us all with new ideas and opportunities to potentially improve the health and well-being of populations and communities.
Public health is complex. There is no “one size fits all” approach to address the health needs and concerns of all communities. This is why it is so important to collaborate with communities in the research we do. It helps us to identify the specific public health needs of different populations, understand both shared and unique vulnerabilities and resiliencies of across populations for interventions, and increase the relevance and reach of the research we conduct.
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On the topic of resiliencies, how has resilience been a part of your own story?
When I was starting my doctoral work in 2009, the field of LGBTQIA+ health was in its nascence. Doing LGBTQIA+ research was also very stigmatized. For example, one comment I received from a grant reviewer at that time was: “The size of the LGBT population is small. It will not make a significant difference in addressing population health disparities in the US.” A seminal Institute of Medicine report commissioned by the National Institutes on Health on LGBT health research was published in 2011 that identified the need for more research and the unmet needs of LGBT populations, bringing visibility to LGBT health. That report also highlighted transgender people as an underserved population. In 2016, NIH designed sexual and gender minorities a health disparities population. These were defining events and “legitimized” LGBT public health as a field of inquiry.
In 2016, the Lancet did a special issue in transgender health, the first medical journal to do so. I led a systematic review of the global transgender health burden. I was also profiled in that issue. The field has grown exponentially since then. So have the challenges given the contemporary sociopolitical context in which the research is conducted. This includes the unprecedented rise of anti-trans legislation and policies that have been introduced over the last few years stripping transgender rights, including limiting access to healthcare. There were 24 bills introduced in 2020 and 185 bills in 2023 seeking to restrict access to gender-affirming healthcare. There is a lot of work to do.
I remember I met with a mentor of mine at The Fenway Institute at Fenway Health when I was in the process of applying to doctoral programs. Her name was Judith Bradford, a pioneer in LGBT health. We were talking about some of the challenges of doing LGBT research, including the stigma LGBT researchers experienced. She said, “What do you really want to do? If you weren’t held back by the forces around you—by your own fears, by other people or by society in general?” I said, “I want to do transgender health.” She said: “Then that is what you should do. You can make a path and pave the way for others.” In 2017, Bradford passed away from cancer. I’m very grateful to her. She helped me to find the courage to pursue my interests. Mentorship is so important. We can never know the impact we are having for people.
And from that moment you found a home for your work in epidemiology.
Epidemiology is about population health—it’s about people. I love that.
In its traditional definition, the field of epidemiology is about the distribution and determinants of diseases in populations. That is certainly an important part of it. But it’s also about the distribution and determinants of good health—of well-being, thriving and flourishing.
The causes of health inequities are complex and multifactorial—it’s a puzzle. And I’m a big fan of puzzles. Identifying the mechanisms—the modifiable factors that drive health inequities—can help us to know what types of interventions we need for equity and to change their distribution. That is very exciting to me.
Data justice is also an important issue in epidemiology. I believe that we, as epidemiologists, have a responsibility to think critically and engage with the politics of “counting”—to consider who is “counted”, who is not, and why—in terms of the questions we ask in surveys, the research and populations we focus on, and how we analyze categories and data. A practice of critical reflection in practicing epidemiology can not only enhance the science we do, but also ensure we do it justly.
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You spent a lot of time on the East Coast as an assistant professor at Harvard Medical School and in the Department of Epidemiology at the Harvard T.H. Chan School of Public Health and other healthcare centers in Boston. What motivated you to join the Michigan Public Health faculty in January 2024?
I was drawn to Michigan because of its outstanding reputation as a leading public university in the nation and because of the people. The people at the University of Michigan are talented and make major contributions to public health in research, advancing scientific knowledge; in education, preparing the next generation of well-rounded future public health leaders; and practice and service, making the University of Michigan the dynamic institution it is. The students are bright, inquisitive and want to make a difference in the world. And everyone is “down to earth” and incredibly nice!
I wanted to contribute to the exciting work happening at the University of Michigan School of Public Health, and in the Department of Epidemiology, Center for Social Epidemiology and Population Health, and Eisenberg Family Depression Center. The community at the University of Michigan is what attracted me to work here.