HW9

HW9

by Rebecca Plevin -
Number of replies: 2

After reading the article by Thomas et al., comment on where your research, or your research interests, fit into the generational framework for health disparities research. If your work is 1rst or 2nd generation, comment on how your work could lead in the future to 3rd or 4th generation work. If your work is 3rd or 4th generation, comment on what 1rst and 2nd generation work was necessary as a foundation for your current work (or current interests).

One of my research interests is pedestrian traffic injury and the ways in which race/ethnicity/SES affect injury rates and the risk of poor outcomes after injury. Previous 1stand 2ndgeneration work demonstrates that disparities do exist in pedestrian traffic injury rates and outcomes based on race/ethnicity. Theories have also been developed regarding why these disparities exist, including that certain racial/ethnic groups have greater exposure to pedestrian traffic and that there is less investment in pedestrian safety measures in minority/low SES neighborhoods. My interest is in creating/identifying city-level policies to effectively combat the structural environment and exposure-related risk factors that disproportionately affect minority/low SES groups; this fits within the 3rdgeneration framework.

2. The barbershop hypertension intervention, while essentially a clinical services intervention operating at either the fence or safety-net level as described by Jones, has some engagement with the social determinants of health. Interventions like that described in the Gottleib article are designed to mitigate the impact of social determinants. How could you apply one of these two types of interventions to your area of research? Propose one or two interventions that engage with social determinants on some level.

Several of the interventions described in the Gottlieb article could be similarly applied to my research question. As described above, one theory to explain the elevated risk of traffic injury in racial/ethnic minorities is that these individuals are more often exposed to pedestrian-traffic interfaces than other groups. Housing, job, and overall financial insecurity may translate to more time spent un-housed, more hours traveling between or in search of jobs, and more use of public transportation with an associated increased exposure to traffic. It would be interesting to study whether improving financial and housing security decreased the risk of sustaining traffic injury, and whether this change correlated purely to the amount of 
In reply to Rebecca Plevin

Re: HW9

by Patrick Yuan -

I appreciate this perspective on causes of pedestrian traffic injuries, as it never occurred to me that this may differ by race. However, this seems plausible given tests like the IAT that reveal subconscious biases when making "fight or flight" decisions that characterize a driver's reaction to pedestrians or perhaps a police man/woman's reaction to a hostile situation. As such, your third generation proposal to reduce pedestrian injuries by making more equitable infrastructure improvements would do well in addressing the social determinants of equality as defined by Jones. Would you also advocate for driver's education to reveal individual subconscious racial biases and how to overcome them to also address disparities in pedestrian fatalities? 

In reply to Rebecca Plevin

Re: HW9

by Matthew Bucknor -

Regarding your number 2, this is a really interesting potential area of inquiry. I would be curious to look at to what extent geography/neighborhood socioeconomic status could mediate these types of effects. For example, I’m wondering if there are certain areas where people live which are more resistant to your proposed financial/housing based intervention, simply because the traffic infrastructure and safety profile of the neighborhood from a design perspective have suffered from chronic neglect.