1. 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).
My research project currently is investigating if there is an association between anxiety and academic performance in children with dyslexia. The study population are students from a specialized private school for children with learning disabilities. As such, even though my research does not directly deal with health disparities research, I have to always keep in mind that any results from this study would be applicable to those of a higher socioeconomic status who can afford to attend this school. However, even within these boundaries, it would be interesting to see if there are any structural and/or individual factors, such as race, parents’ education, neighborhood SES, history of early childhood trauma etc., that are related to the greater anxiety symptoms seen in some children compared to the others. Therefore, my research could be categorized as 1st generation research, where I would be trying to identify vulnerable populations among those with dyslexia (even within this higher SES strata) who are more at risk of developing anxiety. If these disparities do exist, future studies could focus on trying to find the underlying causes of these disparities (2nd generation) and to develop and implement strategies and programs to reduce these disparities at a structural level (3rd generation).
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.
Although it would be difficult to apply one of these interventions directly to my specific area of research, one relevant issue that could be addressed is the disparities in anxiety symptoms or disorders among children in disadvantaged populations compared to the advantaged population. Similar to the one described in the Gottleib article, an intervention to counter this issue is to conduct screenings for anxiety disorders in schools, particularly those located in poorer neighborhoods and that have a high proportion of racial minorities and marginalized populations. The screening could be done by the teachers using validated scales like the School Anxiety Scale – Teacher Report, which evaluates the student’s anxiety over the previous 3 months with 16 questions answered on a 4-point scale. Those with a total score above 18 (i.e. borderline) could then be referred to child or adolescent psychiatrist.