About

Tim Bruckner is a Professor and Chancellor's Fellow of Public Health at the University of California. The page indicates his role within the university's public health department, but does not provide specific details about his research focus, background, or key contributions.

Research topics

• Medicine
• Demography
• Sociology
• Political Science
• Obstetrics
• Computer Science
• Environmental health
• Pediatrics
• Ecology
• Biology
• Immunology
• Internal medicine
• Gerontology
• Environmental science

Selected publications

• Economic connectedness and fetal and infant death: a population-based cross-sectional study of California

  Journal of Epidemiology & Community Health · 2026-04-11

  articleOpen access1st authorCorresponding

  BACKGROUND: Bridging capital (ie, friendships across socioeconomic strata) increases upward economic mobility, yet its role in shaping health outcomes remains poorly understood. Evidence appears especially limited for low-income communities and populations experiencing disproportionate health risks. We examine the association between economic connectivity, a type of bridging capital, and perinatal health disparities. We used a recently released zip code level measure of bridging capital derived from Facebook data on more than 70 million US adults to examine the associations between social connectedness and fetal and infant death in California (8 million births; 2005 to 2021). METHODS: We used generalised estimating equations to test the association between the z-scored economic connectivity and the odds of fetal death and infant death. We used information on median household income in each zip code to focus on mothers residing in the lowest quartile neighbourhoods of income. We also examined non-Hispanic (NH) black mothers in low-income neighbourhoods given that they experience persistently elevated risks of perinatal mortality. RESULTS: We found strong protective associations (p<0.001) between bridging capital and fetal and infant death among residents of low-income areas (OR: 0.75, 95% CI 0.70 to 0.80 ; OR: 0.82, 95% CI 0.82 to 0.94). We also found strong protective associations when restricting to NH black persons only for fetal death (OR: 0.81, 95% CI 0.71 to 0.93) and infant death (OR: 0.79, 95% CI 0.70 to 0.90). CONCLUSION: Cross-class social connections may play an important but underexamined role in promoting maternal and infant health, particularly within disadvantaged communities.

  PublisherOA PDFDOI

• Changes in state-level definitions of fetal death and the reporting of fetal death and periviable live births in the United States, 1996–2021: A panel study

  Annals of Epidemiology · 2026-02-17

  articleOpen accessSenior author

  BACKGROUND: The World Health Organization's 2030 Sustainable Development Goals include reducing the risk of fetal death. Even in high-income countries such as the United States (US), fetal deaths remain under-counted, with reporting showing variable quality across place and time. In the US, a uniform national definition of fetal death does not exist. Scant work characterizes whether, and to what extent, definitional changes in fetal death in US states over time affect fetal death reporting as well as counting of live births among similarly very frail (i.e., periviable [born <26 weeks]) infants. We aimed to (i.) identify state-level changes in fetal death reporting guidelines or definitions for all 50 US states from 1995 to 2020 and (ii.) examine whether counts of fetal deaths, periviable births, and neonatal deaths among periviable births shifted in the years following such changes. METHODS: We retrieved data for all 50 US states from 1996 to 2021 for this descriptive analysis (n = 642,551 fetal deaths, n = 420,000 periviable births, n = 195,663 neonatal deaths among periviable births). We reviewed the fetal death user guides for state changes in reporting guidelines and conducted an internet search to find other state changes in the definition of fetal death. Next, we modeled fixed-effects linear regressions to examine associations between changes in fetal death reporting guidelines and our three outcomes. RESULTS: Over the test period, 12 states changed their definition of fetal death. Regression results show increases in the counts of fetal deaths, periviable births, and neonatal deaths among periviable births following changes in reporting guidelines. These increases followed any change in reporting guidelines-whether perceived as a more inclusive or more restrictive change. Results hold across a range of alternative specifications. CONCLUSIONS: Our findings cohere with the notion that any state-level change in fetal death definitions corresponds with broader efforts to improve data collection and reporting protocols among not only fetal deaths but also periviable births. The fact that we observe such associations should encourage strategies to control for such "data breaks" for scientists and officials concerned with fetal death and/or periviable birth.

  PublisherDOI

• Inflated Denominators, Selection In Utero, and the Black Male Neonatal Death Paradox

  Paediatric and Perinatal Epidemiology · 2026-03-08 · 1 citations

  articleSenior author

  BACKGROUND: Epidemiologists speculate that comparatively high rates of fetal death among males conceived by non-Hispanic Black (NHB) women in the United States (USA) could explain the unexpectedly low neonatal death rate among extremely preterm (ePTB) NHB males. Consistent with this 'selection in utero' argument, conception cohorts exhibiting high sex ratios (M:F) of NHB stillbirths reportedly exhibit greater NHB advantages in ePTB male neonatal death rates. Sceptics, however, attribute this association to an artefact that spuriously inflates the denominators of neonatal death rates in highly stressed populations. OBJECTIVE: To determine whether the positive association over conception cohorts between the NHB male neonatal death advantage and the sex ratio of NHB stillbirths survives correction for inflated denominators. METHODS: We retrieved vital statistics for NHB and non-Hispanic white (NHW) singleton ePTB infants born in the USA from 1995 through 2018. We aggregated these data into 282 monthly conception cohorts. We avoided the inflated denominator problem by substituting a 'NHB share of burden' variable for the difference between NHB and NHW neonatal death rates. We specify this variable as the NHB proportion of neonatal deaths among NHB and NHW ePTB males born from each conception cohort. We determined, using Box-Jenkins methods, whether cohorts exhibiting unusually high sex ratios of NHB stillbirths also exhibited unusually low NHB shares of the burden of ePTB male neonatal death. RESULTS: Consistent with the selection in utero argument, the NHB share of neonatal deaths among ePTB males fell 7% below expected among the cohorts exhibiting unusually high sex ratios of NH Black stillbirths. CONCLUSIONS: Stillbirth affects the composition of birth cohorts by selecting against less fit males in conception cohorts. Although clinical manifestations of this bias remain largely unexplored, they likely include the Black male neonatal death paradox.

  PublisherDOI

• Low-risk Cesareans Across the US: A Decomposition of Individual- and County-level Factors by Race/Ethnicity

  Journal of Racial and Ethnic Health Disparities · 2026-01-16 · 1 citations

  articleOpen accessSenior author

  Non-Hispanic (NH) Black birthing persons show the highest prevalence of low-risk cesareans (30.8%), compared to NH White birthing persons (25.3%). Individual, as well as place-based and ecological factors, may contribute to this racial disparity. We examine individual- and county-level characteristics that contribute to the racial disparity, as well as the extent to which the disparity can be attributed to differences in measured characteristics of racial groups. We retrieved data on all live births in the US, between 1998 to 2018, from natality files assembled by the National Center of Health Statistics Division of Vital Statistics. We conduct an Oaxaca-Blinder decomposition of all low-risk births (> 11 million) from all counties in the US. We find that differences in measured characteristics comprise 47.5% of the racial disparity. Older maternal age, higher birthweight percentile, and unmarried status contribute the greatest towards widening the disparity, whereas contextual factors, such as county-level poverty and education, play a more complex and nuanced role. Given that over half of the disparity remains unexplained, it indicates that unmeasured differences - either due to treatment of racial groups, patient preferences, or other healthcare supply-side factors - could play a significant role. Future research should investigate additional antecedents of low-risk cesareans among NH Black birthing persons.

  PublisherOA PDFDOI

• Psychiatric Emergency Department visits among Asian Americans in California

  International Journal of Mental Health · 2025-02-28 · 1 citations

  articleSenior author
  PublisherDOI

• The Mexican drug war: Homicides and deaths of despair, 2000–2020

  Public Health · 2025-02-12

  articleOpen accessSenior author

  OBJECTIVES: In 2006, the Mexican government deployed their army on Drug Trafficking Organizations (DTOs). The attempt to remove cartel leaders spurred further conflict between DTOs and led to substantial increases in Mexico's homicide rate. The public display of homicide victims and the media coverage of violence may have elicited feelings of fear and depression, increasing the risk of deaths of despair. We examined whether, in Mexico, homicides correspond positively with region-specific rates of deaths of despair. STUDY DESIGN: We applied a fixed effects Poisson count model controlling for population-at-risk, unemployment rates, marriage rates, year indicators, and general seasonality and trend in deaths of despair. METHODS: We utilize data from the National Institute of Statistics, Geography and Informatics to obtain homicides (per 100,000 population) as our exposure and the count of deaths of despair (e.g., alcoholic liver disease, suicide, and drug-related deaths) as our outcome. Our sample size comprised 8064 state-months from 32 Mexican states between 2000 and 2020. We applied a fixed effects Poisson count model controlling for population-at-risk, unemployment rates, marriage rates, year indicators, and general seasonality and trend in deaths of despair. RESULTS: Homicides (per 100,000 population) correspond with a 1.8 % increase in deaths of despair ([IRR] = 1.018; 95 % CI, 1.007-1.029). When examining type of death, alcoholic liver disease deaths drive this relation with a 1.6 % increase ([IRR] = 1.016; 95 % CI, 1.003-1.030) as a function of homicides (per 100,000 population). CONCLUSIONS: Large and public acts of violence may induce adverse mental health, and in turn, greater deaths of despair (specifically alcoholic liver disease deaths) among Mexican populations not directly connected to homicide-related violence. Prevention efforts should target alcohol misuse and liver disease patients in Mexico.

  PublisherDOI

• Impacts of the 2021 child tax credit advance monthly payments on birth outcomes in the United States: a natural experiment

  American Journal of Epidemiology · 2025-09-26

  articleOpen accessSenior author

  We estimated impacts of monthly cash transfers during pregnancy on birth outcomes in the United States through the natural experiment of the 2021 expanded Child Tax Credit. We used US vital statistics birth certificate data 2016 to 2023. We estimated the association between total amount of CTC a pregnant person was eligible to receive during pregnancy (based on number of previous live births, time since last previous live birth, and timing of pregnancy relative to CTC payments) and small for gestational age (SGA, <10th percentile weight for gestational age) and low birth weight (LBW, < 2500 grams). We controlled for time-dependent autocorrelation, individual-level characteristics, COVID-19 hospitalizations, and presence of other pandemic-era safety net programs. We found that a $1000 increase in total pregnancy CTC was associated with an 0.72 percentage point decrease in SGA (95% CI, -0.74 to -0.70) and an 0.49 percentage point decrease in LBW (95% CI, -0.50 to -0.47), correlating to 6.7% and 8.2% decreases in SGA and LBW, respectively. The association between the CTC and birth outcomes was largest among non-Hispanic White and smallest among foreign-born Hispanic people. Our results align with prior studies' findings that cash transfers during pregnancy are associated with moderate declines in adverse birth outcomes.

  PublisherOA PDFDOI

• Stillbirths and the race-specific gap in neonatal death among extremely preterm births

  Scientific Reports · 2025-11-06 · 2 citations

  articleOpen access1st authorCorresponding

  In the extremely preterm period (ePTB; less than 28 weeks), non-Hispanic (NH) Black infants in the US show relatively lower risk of neonatal death than do NH white infants. Explanations for this survival advantage include higher levels of stillbirth among NH Black persons, which could leave behind hardier members of the conception cohort that survive to birth. We test this "high stillbirth" explanation in the US and focus on NH Black singleton ePTB males given their large survival advantage. We applied time-series methods to 288 monthly conception cohorts (1995-2018 US fetal, birth, and neonatal death records) for NH Black and NH white singletons in the ePTB range (N = 473,472). We specified positive monthly outliers in male relative to female NH Black stillbirths in the ePTB range to gauge high NH Black male stillbirths. NH Black male ePTB singleton infants show a stronger neonatal survival advantage (relative to NH whites) for cohorts with high NH Black male stillbirth (4.4 fewer deaths per 100 live births, standard error = 1.3, p < .001). Cohort variation in fetal loss, as measured by high NH Black male stillbirth, may explain a portion of the counterintuitive racial/ethnic patterns in live birth mortality among extremely preterm births.

  PublisherOA PDFDOI

• Impacts of the Pacific Northwest Heat Dome on preterm birth rates in Oregon and Washington State

  American Journal of Epidemiology · 2025-12-19

  preprintOpen access

  Acute heat exposure, which is increasing with climate change, likely increases preterm birth risk. However, few studies consider susceptible exposure windows for extreme heat events, particularly among historically unexposed populations. The 2021 Pacific Northwest Heat Dome produced the highest temperatures ever recorded in usually temperate Oregon and Washington State, offering an ideal study setting. We used 2016-2022 vital statistics records to estimate the gestation month-specific impact of the Heat Dome on preterm birth. Using an interrupted time series design with a synthetic control, we compared the observed odds of preterm birth in the exposed (in utero November 2020-July 2021) Oregon and Washington conception cohorts to counterfactual odds had the Heat Dome not happened. Analysis included 716 096 exposed births across 67 monthly conception cohorts. We identified increased odds of preterm birth in cohorts exposed during months 2-3 (11% increase, 95% CI: [1%, 22%]) and 6-7 (14% increase, 95% CI: [5%, 24%]) of pregnancy. These findings partially agree with literature reporting elevated preterm birth risk after heat exposure in all trimesters. As extreme heat events are now expected once to twice per decade rather than once every thousand years, they pose risks to perinatal health.

  PublisherOA PDFDOI

• State-level Payday Loan Bans and Preterm Births in the US, 2000–2019

  Epidemiology · 2025-04-08

  article

  BACKGROUND: Payday loans refer to high-interest, short-term loans. These loans can provide immediate financial relief for individuals with limited access to traditional credit. However, the predatory nature of payday loans may portend increased financial strain and adverse public health consequences. METHODS: We examine whether state-level temporal variation in payday loan restrictions over a 20-year period (2000-2019) corresponds with a reduction in preterm births: a leading cause of infant mortality in the United States (US). Between 2000 and 2019, 10 US states and the District of Columbia imposed restrictions on payday lending at varied time points. We use data on preterm births provided by the Centers of Disease Control's WONDER database (2000-2019) and apply staggered difference-in-difference approaches to examine whether preterm births (per 100 live births) declined among states that imposed payday lending restrictions, relative to states that never imposed restrictions. We also control for state-specific time propensity of preterm births, derived through time-series analysis. RESULTS: Results indicate a decline in the preterm births by approximately 0.22 per 100 live births (95% confidence interval: -0.31, -0.13) within the first 3 years of payday loan restrictions, which corresponds to 4512 fewer than expected preterm births. CONCLUSION: Our findings are consistent with the hypothesis that state-level payday lending restrictionsare associated with a reduction in preterm births.

  PublisherDOI

Recent grants

• Racial disparities in pediatric psychiatric emergencies: A Health systems approach

  NIH · $454k · 2017–2020

Frequent coauthors

• Ralph Catalano

  University of California, Berkeley

  105 shared

• Parvati Singh

  The Ohio State University

  61 shared

• Bharath Chakravarthy

  Thai Red Cross Society

  41 shared

• Alison Gemmill

  Johns Hopkins University

  39 shared

• Joan A. Casey

  Columbia University

  33 shared

• Nhung T. H. Trinh

  University of Oslo

  27 shared

• Abhery Das

  University of Illinois Urbana-Champaign

  25 shared

• Shahram Lotfipour

  University of California, Irvine

  23 shared

Education

• Ph.D., Environmental Health Sciences

  University of California, Los Angeles

  1992

• M.S., Environmental Health Sciences

  University of California, Los Angeles

  1988

• B.S., Environmental Health Sciences

  University of California, Los Angeles

  1986

Awards & honors

• 2005-2006, National Institute on Child Health and Developmen…
• 2004-2005, National Institute on Aging Pre-Doctoral Fellowsh…