Dr. Natali Valdez on Disparities in Epigenetics and Maternal Health

BIOGRAPHY Natali Valdez, PhD, is an Assistant Professor of Women’s and Gender Studies at Wellesley College and specializes in issues of race and gender across biomedical fields. Dr. Valdez is an anthropologist who utilizes feminist and ethnographic methodologies. Her teaching and research lies at the intersection of gender, race, and science to examine how histories of violence and racism are enveloped into scientific knowledge production.

*Responses are paraphrased by interviewer to highlight key points.

What are the key issues that your research work focuses on? Valdez’s research focuses on general topics of reproduction, post-genomics, epigenetics, and evidence-based research or medicine. She is currently writing a book called Weighing the Future that examines epigenetics in late capitalism. More specifically, her book explores current clinical research that examines how dietary and behavioral interventions with overweight and obese pregnant women affect their children’s physical health. Researchers hypothesized that maternal weight-loss interventions could epigenetically improve fetal metabolism and reduce the likelihood of transgenerational child obesity. Such research was unprecedented because chronic illness was not previously understood to be inheritable. Additionally, pregnant bodies were restricted from participating in clinical trials due to safety concerns, but recent changes have allowed pregnant women to be involved in safer, behavioral clinical trials.

Surprisingly, the results from the clinical trials were inconclusive – researchers did not find that maternal weight-loss inventions significantly affect children’s health and obesity. However, this finding does not indicate that maternal interventions are futile. Instead, Valdez argues that this finding demonstrates a key confound in the clinical trials, that pregnant bodies do not exist in a vacuum. Pregnant bodies survive in an environment influenced by violence, institutional racism, unemployment, poor housing, and other structural factors that can negate individualized interventions from the clinical trials. Current research is shaped by future-oriented thinking that assumes that research of today will benefit people years from now. But what about the problems that people face right now? Valdez’s main argument is that future-oriented research is conducted at the expense of marginalized communities that suffer from urgent, structural inequalities.

How did you conduct your research? Valdez was trained as an interventionist to observe patients in research clinical trials. Through ethnographic analysis, Valdez observed how researchers conduct clinical trials and recruit patients in clinical settings.

What do you envision your field of research/area of study to look like in the future? Moving forward, the scientific community needs to reconsider what types of research to invest in, and how to address significant health disparities. Because institutions that control research clinical trials are composed of a privileged community, future-oriented research disregards low-income, Latinx and Black communities who are disproportionately affected by structural inequalities such as difficult access to healthcare. Speculative medicine is directly tied to racism by prioritizing the health of dominant groups over marginalized communities with people of color.

Future-oriented medicine perpetuates a vicious cycle in which science and epigenetics are usurped to affirm susceptibility of illness to marginalized populations. As structural inequalities cause health disparities, marginalized populations suffer from greater disease incidence (e.g. greater COVID-19 infections in Black & Hispanic populations). Thus, epigenetics can be misinterpreted as a way to justify premature death, reaffirming an inheritance of trauma throughout marginalized communities. Therefore, epigenetics has real, life-or-death, political consequences by reinforcing the lack of interventions on racist disparities.

How do you think UNICEF or other NGOs can improve the work they are doing in regard to the issues your research work focuses on? UNICEF and other NGOs can use positive reinforcement to support structural changes that directly address the root of health disparities. More specifically, local and federal governments should support greater access to healthcare to all communities. By addressing structural issues in the healthcare system, governments can mitigate health disparities that are exacerbated by socioeconomic and racial inequalities. However, neoliberal economic and political motives challenge the implementation of structural changes. Therefore, UNICEF and other NGOs can support the structural changes that are needed to dramatically diminish health disparities.

Additionally, feminist and critical race perspectives are fundamental to addressing issues that target marginalized communities. UNICEF and other NGOs can draw on feminist and critical race scholarship, which prioritize people at the margins.

What do you see as being important for the next generation and their potential to improve the state of the world’s children? The next generation should focus on acknowledging how material conditions shape one’s access to healthcare. For example, access to masks is a material good that only some people have access to. Inequalities shape our access to healthcare, but more privileged individuals can share resources to mitigate those inequalities. By sharing our resources and engaging in our local community, we not only protect ourselves, but we also protect our community.

Do you have any upcoming research projects and/or publications you would like to share with us? We would like to publish it on our website and have the global community engage with it. Valdez has recently published a journal article in Medical Anthropology Quarterly titled “The Redistribution of Reproductive Responsibility: On the Epigenetics of ‘Environment’ in Prenatal Interventions” that provides an in-depth discussion of her research in epigenetics and maternal health in a capitalist healthcare system.