1. State your health outcome of interest. (It could be the one you used for week #2 or another one.) Pick two key behaviors that are important factors leading to your health outcome. Explain the importance of these behaviors either for etiology, prevention, or intervention. (If none of the behaviors in the readings are important for your health outcome, suggest another behavior that is.)
I am interested in understanding racial/ethnic disparities in abortion-related morbidity and mortality. A number of factors could lead to this disparity. Poorer baseline health is one obvious one. An abortion is associated with more complications for someone who has more medical problems, who is obese, who smokes, who has had more c-sections previously, who presents at a later gestational age. Key behaviors thus that might lead to abortion mortality and morbidity include diet, exercise, smoking status, health behaviors in prior pregnancies, seeking pregnancy termination earlier. I think the problem with focusing on behaviors, is that behaviors are the downstream effects of systemic, structural problems. Behaviors naturally seem to place blame on individuals for their health outcomes, but really there are structural factors that create differences in opportunities, exposures, and behaviors. I think as related to the outcome of abortion morbidity and mortality, focus on behavior may help some individuals, but still misses the upstream problems of systemic racism, inequality, and oppression.
2. Describe how you would study the role of one of the behaviors described for question #1 and your health outcome of interest. Incorporate a social factor (e.g. race/ethnicity, social exclusion, stress) in the study approach.
I think it would be interesting to understand the role of the behavior in a study participants life. I can’t clearly imagine how to do this outside of a qualitative study. For smoking, for instance, it would be interesting to understand how smoking fits in that person’s life. How did they start smoking? When did they start smoking? What exposure to smoking did they have growing up? Understanding these questions would help to get a lens on what neighborhood did they grow up in? What is their education? How has stress played a role in their lives. I really would want to understand behavior in the context of the structural factors of their lives.
3. If key health behaviors (e.g. smoking, exercise, nutritious diet) are strongly influenced by neighborhood, income, and/or education, do we need to continue to study how these behaviors influence health outcomes? Why or why not?
I think we know how behaviors influence health outcomes (at least in many aspects of health). I think the focus be on how these upstream factors of neighborhood, income, education are linked to health outcomes mediated through differences in behaviors and opportunities.