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.)
Health outcome: Anxiety
Two key behaviors that may contribute to anxiety are substance abuse and overeating. Substance abuse may worsen anxiety in the long-run while temporarily mitigating symptoms, which makes drugs and alcohol particularly alluring for those suffering from anxiety. Similarly, overeating may temporarily quell feelings of anxiety due to activation of the parasympathetic nervous system but may exacerbate anxiety as negative long-term consequences such as obesity and diabetes develop. Furthermore, these behaviors may result in the downregulation of the immune system, triggering opportunistic diseases that can further exacerbate anxiety. As such, any intervention or preventative strategies must emphasize healthy eating behaviors and the perils of substance use in a biopsychosocial approach to overcoming anxiety.
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.
Evaluating if substance use causes anxiety, I would create a DAG that incorporates all of the behavioral, biological, environmental, sociocultural, and healthcare system elements that may contribute to anxiety. Social exclusion would be an important social factor to consider, since substance use may cause social exclusion, leading to heightened anxiety. Then, controlling for confounding variables and mediators, I would estimate the effects of substance use on anxiety by regression. This would give an estimate of how much substance use affects anxiety and how much each of the controlled variables contribute, controlling for all other variables.
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?
Yes, it is important to continue building evidence that demonstrates these relationships because they are changing as the result of sociopolitical factors, policy, culture, etc., because there are nuances that may not have been studied, and because further evidence is needed to better approximate the truth, which can be used to instruct social change.