Meet Laura Henkhaus, a 4th-year Health Economics PhD student. In this interview, she shares her career aspirations and describes her experience presenting at the International Summit on Violence, Abuse, and Trauma in La Jolla where she was recognized with the B.B. Robbie Rossman Annual Memorial Child Maltreatment Research Award.
What was your academic and career background, prior to coming to USC? What prompted your interest in health economics?
My BS is in Environmental Economics and Policy from UC Berkeley. While that was my intended major since orientation, my career goal changed wildly across fields each semester until junior year when I took my first econometrics class. Then I knew I wanted to be a researcher. I was fascinated by the breadth of questions we can attempt to answer using tools from econometrics. I was interested in health, labor, and development economics and decided to work before graduate school to confirm and narrow these interests. I worked at a health economics consulting firm for two years. Because this firm was led by academics and my project managers also had PhDs in economics, I received great mentorship there. Also because of the economics expertise level at the firm, we were able to win interesting projects leveraging various methods beyond product-specific work applying the same framework to evaluate different health technologies. For example, in my favorite project we examined determinants of disparities in diabetes diagnosis. My work at Precision Health Economics solidified my interest in the health economics field and helped me determine specific areas I wanted to explore in my own research.
How did you come to the decision to pursue a PhD in Health Economics at USC?
I chose the Health Economics PhD program at USC for three reasons: the strong concentration of health economics faculty here as compared to traditional economics departments, the rigor of economics training compared to other applied programs—such as in policy or public health departments with concentrations in health economics, and quality of life (i.e., location in sunny Southern California and funding from a USC School of Pharmacy fellowship).
Historically, this degree program was Pharmaceutical Economics and Policy. My research interests broadly include childhood circumstances and later life health and economic well-being, mental health, and insurance design and health outcomes. The addition of the Microeconomics track made the program a good fit for me, and I am in the second cohort of this track.
Tell us about your experience at the International Summit on Violence, Abuse and Trauma in La Jolla and the poster you presented.
I wanted to present at this conference to collect feedback from health care practitioners and to gather insight on evidence barriers to changes in policy or care practices to support trauma survivors. In the conference session, I found most interesting and relevant to my research, a psychologist discussed the brain science, epigenetics, and physical toll of trauma.
I presented my research on the adult earnings of people who have suffered adverse childhood experiences (ACEs) such as abuse. Using nationally representative US data, I measured an earnings decrement for those who were sexually abused as kids, on average. This is separate from the relationships between childhood socioeconomic status and adult earnings and observed and unobserved neighborhood-level factors and adult earnings, among other factors included in models. Scientists posit neurobiological mechanisms explaining effects of chronic childhood stress on physiological systems as well as cognitive development. Yet while there has been substantial research on ACEs and health outcomes—there has been little research on human capital outcomes. I was excited to receive a lot of interest in my work from people who actually practice in the area of trauma and to be recognized with the B.B. Robbie Rossman Annual Memorial Child Maltreatment Research Award.
What are your long-term goals and plans after your PhD?
I will go on the job market for academic positions in public policy, social welfare, and public health departments. I am also interested in working as a researcher within the NIH at the National Institute of Child Health and Human Development or the National Institute of Mental Health.
What do you envision the health economics landscape looking like in 5 years, or 10 years? What is your hope for the future?
Well, I have many hopes but no clear vision of what is to come.
I’ll comment on health care in an area discussed here: trauma. I hope we expand access to support for people who have suffered trauma and make knowledge of these support services readily available before people need them. I hope that all children will have access to mental health support at school through an on-site counselor / social worker. Every child needs an advocate, but some do not have this at home. In my research using national US data, 18% of respondents reported child physical abuse by a caregiver, and 7% reported child sexual abuse by a caregiver. How do we expect kids will get help when the people responsible for caring for them and accompanying them to doctor visits abuse them? While teachers are obligated to report suspicions of abuse, the abuse may not have physical manifestations that are noticed, and the trauma may not stem from abuse but other household distress such as divorce.
More broadly, I hope we address violence as a mental health issue—both for survivors and for perpetrators. A problem with a primarily punitive approach to violence is that this requires evidence that a legal definition of harassment or assault has been met, however so often there is no evidence. Yet, people who allege harassment or assault are suffering—whether there is evidence of violation of the law or not, whether the alleged act violates the law or not. Let’s help them.