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Research Agenda

I study how legal and institutional systems decide who receives care, how that care is delivered, and how clinicians come to understand their obligations to marginalized patients. My work sits where sociology, bioethics, and medical education meet, and it focuses on people whose encounters with the healthcare system are shaped by legal precarity: immigrants, incarcerated patients, and people navigating language barriers in the clinic. I work through ethnography, policy analysis, and community-engaged research, and I aim both to understand and to change the systems that produce exclusion.Across projects, I focus on populations whose interactions with healthcare systems are shaped by legal or institutional precarity, including immigrant communities, incarcerated individuals, and patients navigating linguistic barriers in clinical care. Using ethnographic methods, policy analysis, and community-engaged research, my work seeks both to understand and to challenge the structures that produce exclusion in healthcare and bioethics.

Immigration, legal status and health

This is the center of my work. Drawing on more than five years of ethnographic fieldwork with mixed-status Mexican American communities in Chicago, I show how undocumented status operates as a master status that governs not only healthcare but employment, education, and everyday belonging. In Health Without Papers (Social Forces), I argue that citizenship functions as a determinant of health in its own right.

More recent work examines how healthcare systems generate new forms of stratification from the inside. Insurance eligibility, enrollment under the Affordable Care Act, and routine encounters with clinical institutions all become moments of status signaling that reshape family dynamics and decisions about whether to seek care at all.

This research also presses on research ethics. I argue that IRB frameworks tend to treat undocumented communities as vulnerable populations to be shielded rather than as partners whose participation is essential to understanding and reducing health inequities.

Bioethics and health justice

A second line of work pushes bioethics past the individual clinical dilemma toward the conditions that produce inequity in the first place: immigration enforcement, mass incarceration, racism, and the way healthcare institutions are organized. In my writing and teaching I argue for building structural competency, intersectionality, and community-based participatory research into bioethics rather than treating them as add-ons. I have also written on trauma-informed, community-rooted ethics consultation in urban safety-net hospitals, where histories of disinvestment and medical mistrust shape what patients expect from care.

Carceral health and medical education

A third line examines incarceration as a determinant of health and the ethical binds clinicians face when they deliver care inside carceral systems. Through partnerships such as the Prison Health News service-learning initiative, I study how community-engaged programs reshape what medical students understand about inequity and professional responsibility. My recent article in Social Science & Medicine shows how service learning can disrupt the hidden curriculum of medical education, and it identifies four outcomes for trainees: empathy, engagement with injustice, pluralism, and advocacy.

Method as ethical inquiry

I treat qualitative research as a moral practice, not just a technique. When you work with communities facing real vulnerability, the work of interviewing, interpreting, and representing carries weight, so I build approaches to collaborative coding, consensus, and interdisciplinary analysis that keep teams honest about power and positionality. Recent work develops the idea of productive complicity: the recognition that a researcher is at once observer, collaborator, and participant in the world being studied, and that responsible scholarship has to hold those roles together rather than pretend one of them away.