Dr. Marybel R. Gonzalez, a professor in the Department of Psychiatry and Behavioral Health, School of Medicine at Ohio State University, is dedicated to exploring the social determinants of health among youth in relation to neurocognitive development, mental health, and substance use prevention. In this interview, she discusses her research journey, the importance of community involvement, and how research can drive meaningful social and policy change.
1. Can you tell us about your background and how you got started in youth well-being research?
Yeah, so that is actually a really hard question to answer. But I will try to, you know, give my story.
When I was in high school, I knew that I wanted to study the brain. I'm not sure where that came from, but I think I was just always really curious about why people acted a certain way. I was always very observant, watching what other people were doing.
At the same time, I did a pre-med program at USC because I was growing up in Los Angeles at that time. USC had a program where every Saturday, you’d go to their campus, and they would talk to you about the pre-med track and what that would look like, as well as do science experiments. I did that for, I think, maybe a year or two.
After that, I decided to volunteer at General Hospital in Los Angeles, which was back then still the OG County Hospital—one of the oldest hospitals ever built. It was really old and really creepy. I was a candy striper, so I had to wear that bib with the traditional candy stripes.
But in that role, I actually had the opportunity to see a lot of things, which was surprising because I was probably only 16. At that time, I thought, “Well, what can I possibly help with?” Most of the time, I was just assigned to get something from a patient’s room or bring them water. But just by being there, I was able to see a lot—illnesses, diseases, and the things people were coming in to get treated for.
One time, I was assigned to the Brain Injury Ward. That experience was very transformative because I got to see what happens at the most severe end of the spectrum when someone has a brain injury. That really reinforced my curiosity about understanding the brain.
So I went off to college and completed my undergraduate degree at UC Berkeley. I wanted to leave Los Angeles, so I didn’t apply to any schools there—and I didn’t tell my parents. When they asked where I got in, I said, “Oh, I don’t have any schools to go to in Los Angeles.” My choices were UC Berkeley or Columbia.
My mom said Columbia was too far and completely freaked out. She was like, “You can’t go that far! What if something happens?” So I said, “Okay, fine.” I ended up getting a full ride to UC Berkeley, which made my choice a lot easier.
When I got there, I thought I wanted to do psychology, maybe pre-med. But then I found this major called Cognitive Science. It required courses in six different disciplines—everything from linguistics to neuroscience, psychology, and computer science—so it was really well-rounded and comprehensive.
Around that time, I started exploring different internship and research opportunities, and I kept gravitating toward child development. I was really interested in understanding the origins of the developing brain, so I spent a long time working with child populations.
Eventually, I was ready to go to grad school, and by then, I had already been working in an infant lab doing EEG studies with babies. Those studies were really hard. If you’ve ever tried to do science with a two-year-old, it doesn’t go well. They rip off the EEG cap, they need a nap, and if they’re hungry, they won’t do the study.
After that, I thought, “Oh man, I don’t think I want to study babies and I’m not even sure I want to study kids because it’s so hard to do an experiment with them.”
As my training continued, I kept moving up the age range. I started in an infant lab, then worked with children, and during my postdoc experience, I ended up studying adolescents. So far, I have found adolescence to be the most fascinating stage.
There are almost as many changes happening in the brain during adolescence as there are during infancy. But the difference is that you can actually talk to adolescents, and you can get answers—if they’re in a good mood and willing to engage, unlike babies.
So, that’s the long-winded answer to how I ended up studying adolescence.
2. What inspired you to focus on the social determinants of health, particularly in Latinx and Black youth?
What I will say is that research is one of those careers—one of the very few, I think—that actually allows you to follow the things you’re passionate about.
And you almost have to be passionate about something to stay with it for so long because it takes a long time to get not just your B.A., but also your doctorate and training. And then it’s a lot of long hours with very low pay, so you don’t make a lot of money for a long time.
So you really have to be passionate about what you’re doing because otherwise, you’re not really gonna be motivated to do it. I tell people, “You can't be in it for the money because the money doesn't come in the beginning.” It takes a long time to make a good salary.
So, like I said, I started off being trained in neuroscience and neurodevelopment—understanding how brain structure changes from infancy into adolescence and how behavior maps onto the brain.
So what does it mean when behavior changes? Do we see those changes in the brain first? Or is it the changes in the brain first and then the changes in behavior?
And as I went through my program, it was very traditional and very non-diverse. There are some statistics on the number of people who have PhDs in the world.
So does anybody know what percentage of people in the world have PhDs? 2% of Americans have a PhD. When you go into a PhD program, you're literally one of the few. And what I didn't know was that I was choosing a career where I was not gonna see people who looked like me or who had had the same lived experiences as me. If you look at just adults, then 13% of adults have PhDs, and this has gone up from 8% in 2000. And I think part of that has to do with people not finding jobs, so they just keep going back to school. It’s not just PhDs—it’s master's degrees and any professional degree. That can include, like, if you got an MD and you're a physician or a JD and you’re in law. That’s professional degrees following college, specifically. Wow, so that's shockingly low, right? Considering everything. And so we can see here that from 2000 to 2018, the percentage of doctorate degrees is 4.5%. Still pretty small. A lot of people do have master's degrees—21%. And then professional degrees—3.2%. So still, you know, pretty low in terms of the number of careers represented in other areas. But nonetheless, I didn't know that.
So when I decided to do a PhD program, I didn't know I was going into something that very few people did—much less, very few people who had had the lived experiences I did. I grew up in East Los Angeles, which is not the rich part of Los Angeles. It’s not the glamorous part of LA that you see on Hollywood Boulevard or Sunset Boulevard—or the glamour you see in TV shows. My experience was like, you know, gangsters, shootings, and drive-bys. That’s what I grew up with.
And so, having had that lived experience—knowing that there was this complex reality that many people faced, full of hardships, adversities, and challenges—when I went into my PhD program, my peers didn't really have experience with that. They came from very privileged backgrounds. Sometimes, their own parents were PhDs, lawyers, or MDs—medical doctors. And so, a lot of the science that was designed was created with that perspective. From the perspective of, “Oh, in a world where you have resources, this is how we should test this.”
And I always found myself feeling confused by that because I knew there were different experiences. I knew my experience wasn’t like that. And that’s when I first started to think, “Okay, but what about when you go to a neighborhood where the school environment isn’t great because of a lack of resources? What happens to brain development then?” And that was when I first knew that I wanted to ask these kinds of questions. How do the places where we grow up and live influence our development, who we are, and the opportunities we have for where we end up?
And it’s a bit of a journey to get to where I’m at because, oftentimes, my ideas were challenged since the people around me didn’t have that lived experience. So they would say, "Oh yeah, it’s because if you grow up poor, you’re just more violent.” And they would say these very segregating things, and I was like, “Well, I think that’s not true because I came from a house where, at least, my mom took advantage of every opportunity she could and figured it out for us with what she had."
So I knew, like, okay, that deficit story isn’t true for everybody. So it took a journey, I think, to get to this point—finding the right mentors who then started to say, "Oh yeah, the ideas that you have are true, but your peers around you won’t understand because they don’t have that lived experience.”
And so, I think it’s about the right time and the right place. The COVID-19 pandemic, as well as the racial reckoning following the murder of George Floyd, finally gave us the platform and the space to talk more openly about the social determinants of health, health equity, and how racism affects health—acknowledging that these are real experiences people have and that they happen as a product of systemic inequity, not necessarily individual choice, right?
And I think for a long time, especially in how science is taught in development, there has been this idea that you're choosing these environments—that you're choosing to be poor or choosing to not have resources. So I think, finally, it's just a combination of the right time and the right place where we can talk about these things and acknowledge that inequality leads to different outcomes.
So, long story short, I spent a long time training to gain credibility as a cognitive neuroscientist and build up that reputation. And then, finally, when I got to that point, I said, "Okay, now I want to ask the questions that I think are important." And those questions have to do with my lived experience and the reality I faced growing up. I’m more interested in understanding how environments with less access to resources influence development—and then, how we can intervene so that not everybody has to have a "deficit" story.
3. How do neighborhood conditions specifically impact youth mental health?
So, I think I was already starting to answer a little bit of that question. And honestly, we really don’t know. I don’t think we have a complete answer yet.
Some of the research we are conducting with this funded project aims to understand how neighborhood conditions influence factors like substance use and mental health. One theory suggests that growing up in an environment with fewer resources puts individuals in situations where they experience scarcity or a lack of access to essentials that promote good health—such as healthy food or quality education. Education quality is inherently tied to the influence of the neighborhood. If a neighborhood has more resources, schools in that area are more likely to have better funding and support. This happens for a number of reasons, including policy-level decisions on how money is distributed and parental advocacy. Parents in more affluent neighborhoods either have the means to fundraise for schools and create additional resources or are more experienced in advocating for improvements, such as by attending city council meetings and demanding better conditions.
All of these factors contribute to the supportive elements within a child’s neighborhood that promote their overall health. If we consider the school context, I think very few—if any—schools have traditionally focused on providing mental health services. In the past, if you went to see a counselor, it was typically to discuss grades or course selection, not to talk about personal challenges. Additionally, many schools only have one counselor responsible for hundreds, if not thousands, of students. However, we are now shifting toward a model where every school should offer counseling—not just for students who are struggling, but as a proactive measure to support their mental well-being. This approach would help students develop the skills needed to navigate challenges in a healthy way.
Since we spend so much time growing up in our environment, the resources available to us inevitably shape our health in significant ways. As I mentioned earlier, one theory is that living in a resource-limited neighborhood creates stress. This stress arises from competing for those limited resources. How can someone focus on getting a better job if their mind is consumed with worries about simply putting food on the table for their family? The conditions people live in take up mental and emotional space, making it difficult to think about long-term goals like taking a vacation or even just relaxing.
There is still a great deal of work to be done in this area, and I don’t think we have a clear understanding yet. However, one proposed mechanism is that stress—along with exposure to adversity in certain neighborhoods—places extra demands on health. Chronic stress impacts people differently depending on individual coping skills and overall health. At the same time, a child who has never faced adversity may also require support in their development.
So, while there are many unanswered questions, it is an incredibly important area of research. I believe we are moving toward studies that will provide more clarity and hopefully lead to answers.
In the next section, Prof. Gonzalez discusses research methods in studying youth mental health and how quantitative and qualitative methods complement each other to uncover insights of health disparities.
