Mari Armstrong-Hough, MPH, PhD

Associate Research Scientist in Epidemiology (Microbial Diseases)

Departments & Organizations

School of Public Health: Epidemiology of Microbial Diseases

Obesity Research Working Group

Yale Institute for Global Health

Yale Institute for Global Health

Biography

Mari Armstrong-Hough is a medical sociologist and epidemiologist with interests in the intersections of infectious and non-infectious diseases, conceptualizations of risk, the mechanisms by which stigma shapes health-related decision-making, and the development of mixed-methods designs. She directs the Mixed-Methods Fellowship of the Pulmonary Complications of AIDS Research Training Program.  

Dr. Armstrong-Hough’s research has examined how cultural repertoires shape differences in the practice and experience of evidence-based medicine in diverse national settings. In her first book, Biomedicalization and the Practice of Culture: Globalization and Type 2 Diabetes in the United States and Japan (University of North Carolina Press, 2018), she explored the origins and consequences of national differences in clinical management of type 2 diabetes in the United States and Japan through hundreds of in-depth interviews and a year of ethnographic participation and shadowing. She has published on the ways that health care providers and patients conceptualize and communicate risk for respiratory infection, on how minor institutional differences conditioned scientific discourse in two national mental hygiene movements in the early 20th century, and on the comparative medicalization of attention deficit hyperactivity disorder (ADHD).  

At Yale, her work seeks to understand how social-structural inequalities reproduce health disparities, focusing on the intersection of communicable and non-communicable diseases. She develops mixed-methods designs that integrate qualitative interviews and individual- and household-level demographic, clinical, and behavioral data in multilevel models to answer questions related to testing and seeking care for tuberculosis (TB), HIV, and diabetes.  

One line of Dr. Armstrong-Hough’s ongoing work examines care for TB, a curable disease for which treatment is available at low or no cost that is nonetheless the leading infectious cause of death in the world. In settings where evaluation and treatment for TB are offered free of charge, why do 80% of symptomatic individuals eschew evaluation?  

Another line of work examines how norms for testing for HIV are established (or eroded) in settings where living with HIV is common. She has found, for example, that perceptions of whether others in a household have chosen to test for HIV are a major contributor to individual testing decisions, controlling for household- and individual-level characteristics. Her current work aims to elucidate how group processes produce and reproduce HIV stigma within households, and to develop interventions to reduce stigma and increase uptake of HIV testing by altering the interaction architecture of home HIV test offers.  

Her work with Jeremy Schwartz and Sandeep Kishore on disparities in availability of essential medicines in Uganda has been covered in the Yale Daily News and The Conversation.

In 2018, Dr. Armstrong-Hough’s work on these topics has appeared in the Journal of AIDS, Public Health Action, and International Journal of Tuberculosis and Lung Disease. She has conducted fieldwork in the United States, Japan, Uganda, Ethiopia, and Nepal and speaks Japanese. Before coming to Yale, she taught at Davidson College, Meiji University in Tokyo, and Duke University. She holds a PhD in sociology from Duke, an MA in East Asian studies from Duke, an MPH in applied biostatistics and epidemiology from Yale, and a BA in sociology, history, and political science from the University of Wisconsin–Madison.

Education & Training

MPH Yale University (2016)
PhD Duke University (2011)

Activities

  • Community interventions for prevention of schistosomiasis and soil-transmitted helminths Jimma, Ethiopia (2018)

  • mHealth Contact Investigation Study Kampala, Uganda (2016)

  • Biomedicalization and the Practice of Culture Tokyo, Japan (2011)

    Book research.

  • Working Group on Bhutanese Refugees Damak, Nepal (2009 - 2011)

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