Hi all - I know this first lecture has the potential to be overwhelming, so I want to reassure you that we are going to continue to revisit the conceptual issues we covered today throughout the course. Over the next four weeks specifically we are going to dissect the RWJ socioecological model, taking social determinants first, then behavior, then biology, and finally health care. There will be lots of chances to ask questions and I look forward to a lively discussion!
From today, I want to make sure you think about the following take-away points:
1. Black box epidemiology is limited in its attention to the context in which behaviors and health outcomes occur, and thus can have limited impact
2. Acknowledging the importance of a socioecological framework is not inconsistent with targeting proximal influences on health, but requires that we do so in a contextualized way that acknowledges multilevel influences on health outcomes and disparities
3. Examples of incorporating a multilevel socioecological perspective even while investigating/intervening on more proximal mechanisms include:
a. Health coaches that help with diet and medication adherence in the context of social situation (including food insecurity)
b. PrEP promotion efforts that acknowledge issues of gender-based power and relationship dynamics (e.g. not just stopping at offering PrEP)
c. Barbershop/church interventions to address risk for chronic diseases
d. Policies with impacts on determinants of health, such as soda taxes
4. In addition, you can consider research on policy with impact on health through distribution of resources, such as the earned income tax credit
5. Overall, you can do quality human research by making sure you appropriately measure sociodemographic characteristics, recruit and retain diverse populations, and incorporate a socioecological perspective into what questions you as, how you ask the questions, and how you interpret the results.
Please let me know if you have any questions!