Marilyn Thomas, PhD, MPH

Assistant Professor

Research Interests:
- Structural Racism as a Social Determinant of Health
- Racial Inequities in Chronic Disease Risk, Accelerated Aging, Cognitive Decline, Mental Illness, and Mortality
- Social Policy, Educational Attainment, and Causal Inference

I am a social epidemiologist investigating the mechanisms by which structural racism contributes to Black–White and other racial inequities in health. My research evaluates policy effects and emphasizes methods for causal inference in the absence of randomization.

In the US, substantial racial differences in health persist despite efforts to reduce overall morbidity and mortality, and to address social determinants of health. Structural racism—historical and ongoing interactions between macro-level systems and institutions that constrain the opportunities, resources, and power of minoritized racial and ethnic groups—is a fundamental cause of racial inequities in health. Unfortunately, adequate measurement to capture the mechanisms of structural racism remains a considerable challenge in public health research. My work helps to address this gap by measuring and evaluating the policies and processes contributing to structural racism.

My research centers Black experiences (i.e., factors that distinctively characterize Black lives in the US). To date, my research focused on three domains of Black experiences: policing, negative racial sentiment or race-based discrimination, and education. My research on policing addressed two issues—racial patterns in risk of being killed by police and police agency characteristics and policies related to police killings—and introduced innovative approaches that can examine intersectional social and environmental experiences in racism-related epidemiological research and the effectiveness of law enforcement policies that purport to save Black lives. My work has also addressed how experiences of area-level anti-Black bias, interpersonal racial discrimination, and culturally-specific coping strategies influence health, providing evidence that institutional racism contributes to physiologic stress-regulation and accelerated aging, whether perceived or not, and that improved socioeconomic position and racial identify may buffer the biological consequences of racism.

My research has subsequently evolved into a deeper examination of structural racism in higher education, either as public policy or through individual-level educational attainment, as a potential causal driver of Black-White inequities in health. Higher educational attainment offers indirect social and health benefits through access to social privilege and prestige, higher income, healthier behaviors, ability to cope with stressors, and increased utilization of health care. Consequently, education is a strong predictor of cardiometabolic risk, mental illness, dementia, and mortality. Though structural racism is implicated as a fundamental cause of higher education gaps, little to nothing is known about if, and to what extent, uniquely Black college experiences influence health in Black adults. As such, I aim to explore the long-term health effects of education policies that govern Black experiences in institutions of higher learning, specifically Historically Black Colleges and Universities (HBCUs).

In 2022, I received a K99/R00 Award from the National Institute on Aging to study the impact of HBCUs on late-life cognition in Black adults. Also, I am Co-Director of the SF BUILD program, a partnership between UCSF and SF State to enhance diversity of the biomedical research workforce. Last, I am an active participant in the Glymour Research Group (https://glymourgroup.ucsf.edu/team), UCSF PReMIUM Group (https://integration.ucsf.edu/staff), SPHERE Research Group (https://sphere.ucsf.edu/our-research-team), and HEARTS Research Group (https://publichealth.berkeley.edu/research/hearts-research-group/).

Publications
  1. Mobley TM, Hayes-Larson E, Wu Y, Peterson RL, George KM, Gilsanz P, Glymour MM, Thomas MD, Barnes LL, Whitmer RA, Mayeda ER. School racial composition, effect modification by caring teacher/staff presence, and mid/late-life depressive symptoms: findings from the Study of Healthy Aging among African Americans. Volume 193 of Issue 9. American journal of epidemiology 2024. PMID: 38634611


  2. Hill-Jarrett TG, Choi M, Buto PT, Miramontes S, Thomas MD, Yang Y, Kim MH, Sims KD, Glymour MM. Associations of Everyday and Lifetime Experiences of Discrimination With Willingness to Undergo Alzheimer Disease Predictive Testing. Volume 102 of Issue 4. Neurology 2024. PMID: 38266219


  3. Reeves A, Michaels EK, Thomas MD, Okoye U, Price MM, Hasson RE, Chae DH, Allen AM. All Stressors Are Not Equal: The Salience of Racial Discrimination and Appraisal for Blood Pressure in African American Women. Volume 86 of Issue 1. Psychosomatic medicine 2023. PMID: 37774102


  4. Thomas MD, Vittinghoff E, Koester KA, Dahiya P, Riano NS, Cournos F, Dawson L, Olfson M, Pinals DA, Crystal S, Walkup J, Shade S, Mangurian C, Arnold EA. Examining the Impact of State-Level Factors on HIV Testing for Medicaid Enrollees with Schizophrenia. Journal of acquired immune deficiency syndromes (1999) 2023. PMID: 37229531


  5. Daniels KP, D Thomas M, Chae DH, Allen AM. Black Mothers' Concern for Their Children as a Measure of Vicarious Racism-Related Vigilance and Allostatic Load. Volume 64 of Issue 4. Journal of health and social behavior 2023. PMID: 37332176


  6. Danielle Roubinov, Kent A Griffith, Nicole L Simone, Sindy Escobar Alvarez, Marilyn Thomas, Christina Mangurian, Reshma Jagsi. Gender Composition in Biomedical Research Grant Submissions and Grant Review Panels Before Versus During the COVID-19 Pandemic Journal of Women's Health 2023. PMID:


  7. Walkup J, Thomas MD, Vittinghoff E, Hermida R, Crystal S, Arnold EA, Dahiya P, Olfson M, Cournos F, Dawson L, Dilley J, Bazazi A, Mangurian C. Characteristics and Trends in HIV Testing Among Medicaid Enrollees Diagnosed as Having Schizophrenia. Psychiatric services (Washington, D.C.) 2023. PMID: 36852552


  8. Thomas MD, Calmasini C, Khela H, Mobley TM, Mayeda ER, Mangurian C, Barnes LL, Gilsanz P, Whitmer RA, Glymour MM. The impact of attending historically Black colleges and universities on cognitive decline in Black adults: A longitudinal analysis in the KHANDLE and STAR cohorts. Volume 19 of Issue 8. Alzheimer's & dementia : the journal of the Alzheimer's Association 2023. PMID: 36800287


  9. Goldman ML, Ponce AN, Thomas M, Felder S, Wu S, Loewy R, Mangurian C. Field Visit Contact Rate by Mobile Crisis Teams as a Crisis System Performance Metric Psychiatr Serv 2022. PMID:


  10. Hwong AR, Chagwedera DN, Thomas M, Niu G, Quan J, Vittinghoff E, Schillinger D, Newcomer JW, Gonzalez A, Essock S, Mangurian C. CRANIUM: a quasi-experimental study to improve metabolic screening and HIV testing in community mental health clinics compared to usual care BMC psychiatry 2022. PMID:


  11. Ogbu-Nwobodo L, Shim RS, Vinson SY, Fitelson EM, Biggs MA, McLemore MR, Thomas M, Godzich M, Mangurian C. Mental Health Implications of Abortion Restrictions for Historically Marginalized Populations New England Journal of Medicine 2022. PMID:


  12. Hwong AR, Vittinghoff E, Thomas M, Hermida R, Walkup J, Crystal S, Olfson M, Mangurian C. Breast Cancer Screening Rates Among Medicaid Beneficiaries With Schizophrenia Psychiatric Services 2022. PMID:


  13. Thomas MD, Calmasini C, Seblova D, Lapham S, Peters K, Prescott CA, Mangurian C, Glymour MM, Manly JJ. Postsecondary Education and Late-life Cognitive Outcomes Among Black and White Participants in the Project Talent Aging Study: Can Early-life Cognitive Skills Account for Educational Differences in Late-life Cognition? Volume 36 of Issue 3. Alzheimer disease and associated disorders 2022. PMID: 35791067


  14. Thomas MD, Mendez RM, Zhang Y, Wang Y, Sohail S, Chae DH, Márquez-Magaña L, Sellers R, Woods-Giscombé CL, Allen AM. Superwoman Schema, Racial Identity, and Cellular Aging Among African American Women. Volume 62 of Issue 5. The Gerontologist 2022. PMID: 35084030


  15. Matthay EC, Duchowny KA, Riley AR, Thomas MD, Chen YH, Bibbins-Domingo K, Glymour MM. Occupation and Educational Attainment Characteristics Associated With COVID-19 Mortality by Race and Ethnicity in California. 2022. PMID: 35452107


  16. Mangurian C, Thomas MD, Mitsuishi F, Goldman LE, Niu G, Handley MA, Riano NS, Hwong A, Essock S, Dilley J, Newcomer JW, Schillinger D. Lessons Learned From a New Reverse-Integration Model to Improve Primary Care Screening in Community Mental Health Settings. 2022. PMID: 35138129


  17. Thomas MD, Vittinghoff E, Crystal S, Walkup J, Olfson M, Khalili M, Dahiya P, Keenan W, Cournos F, Mangurian C. Hepatitis C Screening Among Medicaid Patients With Schizophrenia, 2002-2012. 2022. PMID: 35059641


  18. Thomas MD, Matthay EC, Duchowny KA, Riley AR, Khela H, Chen YH, Bibbins-Domingo K, Glymour MM. A descriptive analysis of 2020 California Occupational Safety and Health Administration covid-19-related complaints. 2021. PMID: 34977326


  19. Okorie CN, Thomas MD, Méndez RM, Di Giuseppe EC, Roberts NS, Márquez-Magaña L. Geospatial Distributions of Lead Levels Found in Human Hair and Preterm Birth in San Francisco Neighborhoods. Volume 19 of Issue 1. International journal of environmental research and public health 2021. PMID: 35010345


  20. Guan A, Thomas M, Vittinghoff E, Bowleg L, Mangurian C, Wesson P. An investigation of quantitative methods for assessing intersectionality in health research: A systematic review SSM Popul Health 2021. PMID:


  21. Thomas MD, Sohail S, Mendez RM, Márquez-Magaña L, Allen AM. Racial Discrimination and Telomere Length in Midlife African American Women: Interactions of Educational Attainment and Employment Status. Volume 55 of Issue 7. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine 2021. PMID: 33289498


  22. Thomas MD, Reeves AN, Jewell NP, Michaels EK, Allen AM. US law enforcement policy predictors of race-specific police fatalities during 2015-16. Volume 16 of Issue 6. PloS one 2021. PMID: 34161363


  23. Garcia ME, Goldman EL, Thomas M, Chan S, Mitsuishi F, Schillinger D, Mangurian C. Accuracy of Primary Care Medical Home Designation in a Specialty Mental Health Clinic Psychiatr Q 2021. PMID:


  24. Thomas MD, Michaels EK, Darling-Hammond S, Nguyen TT, Glymour MM, Vittinghoff E. Whites' County-Level Racial Bias, COVID-19 Rates, and Racial Inequities in the United States. Volume 17 of Issue 22. International journal of environmental research and public health 2020. PMID: 33238526


  25. Darling-Hammond S, Michaels EK, Allen AM, Chae DH, Thomas MD, Nguyen TT, Mujahid MM, Johnson RC. After "The China Virus" Went Viral: Racially Charged Coronavirus Coverage and Trends in Bias Against Asian Americans. Volume 47 of Issue 6. Health education & behavior : the official publication of the Society for Public Health Education 2020. PMID: 32911985


  26. Jones N, Niu G, Thomas M, Riano NS, Hinshaw SP, Mangurian C. Peer Specialists in Community Mental Health: Ongoing Challenges of Inclusion Psychiatric Services 2019. PMID:


  27. Michaels EK, Reeves AN, Thomas MD, Price MM, Hasson RE, Chae DH, Allen AM. Everyday Racial Discrimination and Hypertension among Midlife African American Women: Disentangling the Role of Active Coping Dispositions versus Active Coping Behaviors. Volume 16 of Issue 23. International journal of environmental research and public health 2019. PMID: 31783683


  28. Allen AM, Thomas MD, Michaels EK, Reeves AN, Okoye U, Price MM, Hasson RE, Syme SL, Chae DH. Racial discrimination, educational attainment, and biological dysregulation among midlife African American women. Volume 99. Psychoneuroendocrinology 2018. PMID: 30286445


  29. Nuru-Jeter AM, Michaels EK, Thomas MD, Reeves AN, Thorpe RJ, LaVeist TA. Relative Roles of Race Versus Socioeconomic Position in Studies of Health Inequalities: A Matter of Interpretation. Volume 39. Annual review of public health 2018. PMID: 29328880