Mari Armstrong-Hough
Mari Armstrong-Hough
Associate Professor of Social & Behavioral Sciences and Epidemiology
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Professional overview
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Dr. Mari Armstrong-Hough is Associate Professor in the Department of Social & Behavioral Sciences and in the Department of Epidemiology. She is a medical sociologist and epidemiologist of respiratory disease.
Dr. Armstrong-Hough’s global health research examines the epidemiologic interfaces among tuberculosis (TB), HIV, and non-communicable diseases. Combining training in epidemiology and sociology, her work develops and evaluates interventions to increase early case-finding, status awareness, and linkage to care in high-burden settings like Uganda and South Africa. She has published on predictors of evaluation for TB among high-risk groups, novel approaches to active case-finding for TB and HIV, the ways that providers and patients imagine and communicate risk for respiratory infection, and the availability of essential medicines in settings with double burdens of infectious and non-communicable disease. Her first book, Biomedicalization and the Practice of Culture: Globalization and Type 2 Diabetes in the United States and Japan (University of North Carolina Press, 2018), examined how the practice and experience of global evidence-based medicine is shaped by local cultural repertoires. Her recent work has appeared in the Journal of AIDS, International Journal of Tuberculosis and Lung Disease, and the The Lancet Respiratory Medicine. She also co-directs the NIH-funded Mixed-Methods Fellowship of the Pulmonary Complications of AIDS Research Training Program at Makerere University in Kampala, Uganda. She is PI of a prospective cohort study of patients initiating treatment for pulmonary TB in Uganda and a co-investigator on NIH-funded studies of contact tracing for TB.
Dr. Armstrong-Hough’s US-based research examines racial and ethnic disparities in survival of respiratory failure and seeks to develop interventions to ensure that all patients with respiratory failure receive evidence-based care. Approximately 750,000 Americans die each year from respiratory failure, and its 2.5 million survivors experience poor physical function and quality of life persisting five years after discharge. Minority patients are significantly less likely to survive respiratory failure, with up to twice the odds of death as non-Hispanic White patients. Dr. Armstrong-Hough co-PIs the Promoting Equity via Changes In Practice for Respiratory Failure (PRECIPICE) studies, which use large-scale, multicenter data from US ICUs to identify care processes associated with inequities in survival and long-term outcomes. Early work related to these studies has been accepted to Annals of the American Thoracic Society.
Before coming to NYU, Dr. Armstrong-Hough was an Associate Research Scientist in Epidemiology in the Department of Epidemiology of Microbial Diseases at Yale School of Public Health. She previously taught at Davidson College, Meiji University in Tokyo, and Duke University. She has conducted fieldwork in the United States, Japan, Uganda, Ethiopia, and Nepal and is a recipient of the Robert E. Leet and Clara Guthrie Patterson Trust Mentored Research Award in Clinical, Health Services and Policy Research.
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Education
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BA, Sociology, History, and Political Science, University of Wisconsin–MadisonMA, East Asian Studies, Duke UniversityPhD, Sociology, Duke UniversityPostdoctoral MPH, Applied Biostatistics and Epidemiology, Yale
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Publications
Publications
Drop-out from the tuberculosis contact investigation cascade in a routine public health setting in urban Uganda: A prospective, multi-center study
AbstractArmstrong-Hough, M., Turimumahoro, P., Meyer, A. J., Ochom, E., Babirye, D., Ayakaka, I., Mark, D., Ggita, J., Cattamanchi, A., Dowdy, D., Mugabe, F., Fair, E., Haberer, J. E., Katamba, A., & Davis, J. L. (n.d.).Publication year
2017Journal title
PloS oneVolume
12Issue
11AbstractSetting: Seven public tuberculosis (TB) units in Kampala, Uganda, where Uganda’s national TB program recently introduced household contact investigation, as recommended by 2012 guidelines from WHO. Objective: To apply a cascade analysis to implementation of household contact investigation in a programmatic setting. Design: Prospective, multi-center observational study. Methods: We constructed a cascade for household contact investigation to describe the proportions of: 1) index patient households recruited; 2) index patient households visited; 3) contacts screened for TB; and 4) contacts completing evaluation for, and diagnosed with, active TB. Results: 338 (33%) of 1022 consecutive index TB patients were eligible for contact investigation. Lay health workers scheduled home visits for 207 (61%) index patients and completed 104 (50%). Among 287 eligible contacts, they screened 256 (89%) for symptoms or risk factors for TB. 131 (51%) had an indication for further TB evaluation. These included 59 (45%) with symptoms alone, 58 (44%) children <5, and 14 (11%) with HIV. Among 131 contacts found to be symptomatic or at risk, 26 (20%) contacts completed evaluation, including five (19%) diagnosed with and treated for active TB, for an overall yield of 1.7%. The cumulative conditional probability of completing the entire cascade was 5%. Conclusion: Major opportunities exist for improving the effectiveness and yield of TB contact investigation by increasing the proportion of index households completing screening visits by lay health workers and the proportion of at-risk contacts completing TB evaluation.Origins of Difference: Professionalization, Power, and Mental Hygiene in Canada and the United States
AbstractArmstrong-Hough, M. (n.d.).Publication year
2015Journal title
American Review of Canadian StudiesVolume
45Issue
2Page(s)
208-225AbstractThis study examines the emergence and development of mental hygiene professional organizations in Canada and the US by analyzing discursive differences in the publications of two sister committees: the National Committee for Mental Hygiene and the Canadian National Committee for Mental Hygiene. The analysis finds that while mental hygiene in North America initially emerged as a single, shared continental professional discourse, the two movements diverged in critical ways for reasons directly related to their institutional contexts and donor bases. Even as US popular and political discourse veered towards eugenic policies, the US mental hygiene discourse shifted sharply away from eugenics. In contrast, in Canada, mental hygiene publications focused increasingly on the moral dangers of Canadas immigrant population and played a role in producing scientific legitimacy for eugenic policies. This analysis suggests that the different trajectories of the two professional communities have their origins in organizations membership and donor bases, not broader differences in national character.Performing prevention: risk, responsibility, and reorganising the future in Japan during the H1N1 pandemic
AbstractArmstrong-Hough, M. J. (n.d.).Publication year
2015Journal title
Health, Risk and SocietyVolume
17Issue
3Page(s)
285-301AbstractOne distinguishing feature of modernity is a shift from fate to risk as a central explanatory principle for uncertainty and danger. Framing the future in terms of risk creates the possibility – and, increasingly, responsibility – for prevention. This study analyses qualitative data from semi-structured interviews with 20 physicians and 43 members of the general public in Japan during the H1N1 influenza pandemic of 2009 to examine how risk and responsibility were imagined, managed, and reorganised through preventative behaviours. I examined respondents’ discussions of a specific preventative recommendation issued in Japan during the 2009 pandemic: prophylactic gargling. I found that Japanese doctors had mixed, often conflicting, opinions about the efficacy of gargling to prevent infection; most felt its usefulness as a recommendation lay in its capacity to give patients the belief that they could mitigate the risk of infection. Doctors who were openly dubious about the effectiveness of gargling in reducing risk of infection continued to recommend it because they felt that gargling provided patients with peace of mind, reducing their sense of ontological insecurity. In contrast, lay respondents saw gargling as a practical, common-sense measure they could take to mitigate risk, but also citing responsibility to others as motivation for performing preventative practices that they would otherwise eschew.