June 24, 2024

She was a dedicated advocate for social justice and internationally renowned for her groundbreaking work revealing the connection between health and socioeconomic factors.

To those who knew her best, she also was beloved for her humility, dedication to her family and mentoring generations of researchers.

So, the passing of Nancy E. Adler, a part-time resident of Glen Ellen, from pancreatic cancer on Jan. 4 at the age of 77, was deeply felt by her many family members, friends and colleagues.

“A gifted scientist and a generous, warm mentor, Nancy Adler was unwavering in her commitment to her multiple colleagues and trainees throughout the globe,” wrote Claire D. Brindis, distinguished professor emerita of pediatrics and health policy at University of California, San Francisco (UCSF), on the university’s website. “Nancy will remain a beacon, illuminating the path for all who pursue her aspirational and inspirational vision for health equity. As a colleague, mentor, and close friend, I will always treasure her in my heart.”

Adler’s pioneering work found that life expectancy is determined more by inequality, income disparity and other social factors rather than genetics. In a report written in 2000 for the MacArthur Foundation Research Network on Socioeconomic Status and Health — which Adler began directing in 1996 — she wrote that “premature death is more than twice as likely for middle-income Americans as for those at the top of the income ladder, and more than three times as likely for those at the bottom than those at the top.”

This discovery and other pioneering work of Adler’s on the connection between life expectancy and social factors are now accepted as truisms among public health experts.

Dr. Arnold Milstein — Adler’s husband as well as a professor of medicine and director of the Clinical Excellence Research Center at Stanford University — said that the discovery for which she is most widely known in the scientific community is the MacArthur Ladder.

“It shows that how people perceive their status on a scale of 1 to 10 within their community is a critical link in the chain between their actual income and educational attainment, and chronic hormonal changes that govern the health of their cells,” he said.

Adler also was a fierce advocate for women’s health. While completing a doctorate program in social relations at Harvard University in the early 1970s, she wrote her dissertation on abortion. Titled “Reactions of Women to Therapeutic Abortion: A Social Psychological Analysis,” it focuses on her interviews with women before and after having an abortion.

At the time, an abortion was widely regarded as causing lifelong trauma for women, but Adler found that many women see it as an opportunity to reposition their lives through healthy coping strategies.

Throughout her career, she had an unwavering commitment to dismantle health care inequities that women and marginalized communities face.

Adler taught undergraduate courses at Harvard while working on her doctorate. She subsequently served as an assistant professor at the University of California, Santa Cruz and as the Lisa and John Pritzker Professor of Medical Psychology and director of the Center for Health and Community Sciences, both at UCSF.

Milstein feels that Adler’s main accomplishment was serving for 15 years as director of the MacArthur Foundation Research Network on Socioeconomic Status and Health.

“She successfully composed and led a transdisciplinary team of eminent scientists from across the world to map how lower income and educational attainment get into the body to deteriorate cellular function,” he said.

Milstein recalled some of her other top achievements.

“Nancy trained scores of graduate students during her career and catalyzed health care delivery systems across the United States to expand their vision by mitigating social and environmental factors that made it more difficult for less well-off Americans to take good care of their health,” Milstein said.

Adler retired in 2022, culminating a career in which she co-authored a book, “Health Psychology,” wrote 635 research articles and won a host of prestigious awards.

Her awards include the Chancellor’s Award for the Advancement of Women from UCSF in 1995, the Distinguished Scientific Award for the Applications of Psychology from the American Psychological Association in 2009, the Lifetime Achievement in Mentoring Award from UCSF in 2009, the Holly Smith Award for Exceptional Service from UCSF School of Medicine in 2014 and the J. Michael McGinnis Leadership Excellence Award from the Interdisciplinary Association for Population Health Science in 2020.

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