Q&A with Susan B. Sorenson

Susan B. Sorenson grew up in the Midwest with the core social justice value that if something isn’t right, you should try to fix it.

“I think this really is a piece of who I am, which then found a wonderful home in public health,” she says, “because you tell people, ‘Well, I’m trying to prevent violence,’ and some people look at you like, ‘What? How foolish can you be?’ But no, I am confident that things can be improved.”

Sorenson, a professor of social policy and practice, has an interdisciplinary research background that spans the fields of epidemiology, sociology and psychology. A professor at UCLA’s School of Public Health for 20 years before she came to Penn’s School of Social Policy and Practice in 2006, Sorenson has turned her attention to the epidemiology and prevention of violence, including homicide, suicide, sexual assault, child abuse, battering and firearms. She’s also explored the connection between women and the task of fetching water in low-income countries, and is working on a paper analyzing the attitudes of wife beating in Iraq.

“That’s where I see a lot of my work being focused, is how people manage to live when the assumptions of basic safety in one’s home and one’s neighborhood are violated,” says Sorenson, who is also the director of the Evelyn Jacobs Ortner Center, a resource for policymakers and others seeking to reduce domestic violence. “How do you function? How do you go on?”

The Current recently sat down with Sorenson to talk about some of her work studying handgun violence, how she helped to design a new form for the Philadelphia Police Department to use when they investigate domestic violence calls and why exactly students in her undergraduate class on public health shadowed restaurant inspectors around the city.

Q. In your research, you’ve explored gun violence, investigated women and water-carrying, and worked on projects with the Philadelphia Police Department. What is the common theme?
A. My work falls under an umbrella with two parts. The overarching one is that of public health because the focus we take is population-based. It’s based on prevention and largely, but not exclusively, policy and structural issues.
The second thing is, I’m an injury prevention researcher and [this] includes a wide range of things. It can be unintentional injuries, which are motor vehicle crashes, drownings, death from fires. Or it can be intentional injuries, which is where my work focuses. Homicide, suicide, sexual assault, battering and child abuse are the topic areas, and a key mechanism in intentional injury is firearms. That’s how my work comes together. A key theme in my work is how gender, ethnicity and nativity are associated with risk of injury.

Q. You’ve studied gun use and injuries. Was that a natural fit for someone who is an injury prevention researcher?
A. If you’re looking at survival in public health and intentional injury you have to look at guns, specifically handguns. For example, more people die of gun suicide than gun homicide in the United States each year.
Most people’s reaction is ‘Wow—I didn’t know,’ because when people think guns, they think street violence, but the predominant problem with guns in terms of fatalities is suicides.

Q. Is a lot of this intentional violence specifically directed towards women?
A. It’s mostly man-on-man. They had the highest rates. It’s mostly acquaintances, involves alcohol in the street and involves a handgun. If you look at the homicide deaths of women, it’s also handguns, but the assailants are male, it’s in the home and alcohol is often involved. Also, they’re usually male intimates. It’s not a stranger, it’s not an acquaintance, it’s not a woman.

Q. In terms of suicide with a handgun, is that mostly men, mostly women? How do those numbers break down?
A. It’s men, and it’s older men, 75-plus has the highest [rate]. The younger suicides tend to be more impulsive, whereas those of older people tend to be more planned-for. So, they choose methods accordingly. That’s a piece of it.

Q. Does a lot of your work involve gleaning trends from numbers?
A. Most of my work is epidemiological in nature. I teach a couple of undergraduate courses through the Health and Societies program that are related to this. One is ‘The Foundations of Public Health.’ It’s a new course at Penn and we’ve had great fun with the class. Last year, we followed up a suggestion of the city’s Health Commissioner, Don Schwarz, that a good way for people to learn about the public health function is to shadow a restaurant inspector. So the students went to restaurants, they went to institutions, and they seemed to really enjoy the process and learn a lot about it. It’s a survey course so we cover everything from epidemiology to environmental health, to interface between animals and humans and disease.
I also teach an undergrad class called ‘Guns and Health.’ Students can use it for their senior Capstone. The students in there have been absolutely fabulous. We get this incredibly diverse group in terms of experience and knowledge and perceptions, and I think it’s really important that the students have a reality base, not just ideologies. We work with the Division of Public Safety and their firearms instructor takes students to a shooting range so they get to see first-hand how simple and how powerful [guns are].

Q. It seems like guns can be an emotionally charged, polarizing issue.
A. Particularly in the context of our current political process. I think there’s a place for data at the policymaking table and I find it useful when data informs people’s opinions and decisions.
I’m hoping that the students walk out of there better-informed and able to think about the issues, because if the primary thing guiding a lot of decisions is ideology, then we researchers and educators really have a role. The students often come in with strongly held opinions, and usually the most strongly held opinions come from students who’ve never held guns.

Q. Do you do much policy work advising lawmakers?
A. Since coming to Penn, I have testified at a Congressional hearing, briefed Pennsylvania legislators and provided testimony at a state-level legislative hearing. It’s hard to do research on firearms from a public health perspective here, though, because Pennsylvania restricts access, in fact, prohibits access to data. [In California] the law is written so it is available to bona fide researchers. There have been a couple of us—not many—with good access to the data [in California], but it can, in theory, be obtained [by any researcher]. And I was granted access to those data. It’s a different political and scientific climate here.

Q. Talk about your work with the Philadelphia Police Department, and your work with other city groups.
A. Since arriving here, I’ve collaborated with local community-based and government agencies. There are some wonderful domestic violence and rape crisis services here and we’ve helped them with different projects that they’ve wanted to do. For example, one of my students did a study on strangulation with the sole battered women’s shelter here.
I also helped with a form that would improve the on-scene evidence collection in domestic violence calls. On a parking ticket here, there is a box at the bottom—that’s the size [police officers] have to write the report on. If they come out on any call, that’s what they’ve got. What they would do in the little tiny space, they’d write, as all humans would, ‘He beat her up.’ Well, by the time there’s a more thorough investigation, you may have forgotten [details] so we helped develop a checklist that  looks at the location of any observed injuries, whether the residence is in disarray, if things are broken.

Q. How did you design the form?
A. I worked with a battered women’s shelter. I got input from the police, from brass, from [domestic violence] organizations, then from the officers themselves. I did ride-alongs with them—and those bulletproof vests are uncomfortable. I got input from battered women, residents at the shelter. They piloted it. About a year after that, the department took it on and developed their own thing and it’s much more detailed.

Q. So, it sparked this bigger change in how police document domestic violence calls?
A. It showed them it can be done. Mine was a feasibility study. Could it be changed? Would officers use it? Would it be useful? You’ve got to make sure the information is useful to the DA’s office because they’re the ones who are going to be moving forward. But now the police and victim services agencies are working together to get victim services out there. It’s been a really productive collaboration that the police have taken the lead on.

Q. You also direct the Ortner Center. What’s the focus of the Center?
A. Dean [Richard] Gelles was the founding director. The Ortner Center is a small, endowed center that conducts research. Our benefactor, Evelyn Ortner, died just a couple of months ago, and we miss her because she was a huge life force. She developed a domestic violence shelter in Short Hills, New Jersey in a place where everybody said, ‘We don’t have that problem here’ and she provided free services there and really got a lot of community involvement for a couple of decades. We’re trying to continue with that sort of energy. We largely fund graduate student research and travel. We got a small grant from the Trustees’ Council of Penn Women just a couple of months ago to expand it to include undergraduate research. It includes SP2 and Nursing and other schools.
I have an article that’s coming out in the American Journal of Public Health about gender discrepancy in injury. When people talk about health disparities they almost automatically think ethnic disparities. I think a lot of people have been and will be surprised that the gender disparity exceeds the ethnic group disparities for every kind of injury—homicide to drowning to when they make errors in hospitals. Even injuries from unknown reasons, it’s higher among men.

Q. What is your current research?
A. I have an article that’s coming out in the American Journal of Public Health about gender discrepancy in injury. When people talk about health disparities they almost automatically think ethnic disparities. I think a lot of people have been and will be surprised that the gender disparity exceeds the ethnic group disparities for every kind of injury—homicide to drowning to when they make errors in hospitals. Even injuries from unknown reasons, it’s higher among men.

Q. Why is that the case?
A. There’s no reason to think that men are more physiologically vulnerable. At least, we have no evidence of that at this point. Men might be involved in occupations that put them at higher risk, but even when you control for those things, gender ... is the largest factor. One of the things is probably risk-taking and alcohol consumption, because men tend to drink more than women do. As early as age 8, maybe 10, girls and boys both see boys as being more risk-taking and they think boys are less likely to be injured. It’s this sense of invincibility that at a very young age, boys and girls attribute to boys. We talk about changing behaviors so we have healthy habits. We have embraced healthier eating, exercising. In theory, some of this risk-taking could be amenable to similar intervention efforts.
We’re also writing up a couple of articles based on a survey we did of Penn undergrads about their personal knowledge of sexual assault. … We asked about blame and fault and responsibility, and had a randomized experimental design within it. It has both the substance and the scientific components that will probably be of some interest. We’re analyzing [blame and fault] right now.

Susan B. Sorenson