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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).
I really appreciate the framework that the Thomas et al article offers in thinking about generations of disparities research and thinking forward about how the work can be put to action. I think my work right now is in the 4th generation. I am studying the lived experience of abortion for Black women and using Public Health Critical Race Praxis as one of my guiding frameworks. My interests fall in this realm as I think it is important to use new research paradigms that center community voices. I also think we need to recognize and unpack the role of racism in health disparities. I think it is important to recognize the communities we study as experts regarding their own experience. My work builds from first generation research that documents racial differences in abortion. I think a lot of the work in 2nd generation research around differences in abortion by race discuss the differences in unintended pregnancy and contraception use that are linked to differences in abortion. The conversation has evolved further within 2nd generation research to reframe unintended pregnancy and contraception use as differences in patient preferences rather than racial disparities.
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.
I think a similar intervention to the one described in the Gottleib article could be applied to accessing abortion. When people access abortion they may face issues with affording the abortion, transportation to abortion care, need for childcare, and housing instability. These issues are some of the reasons why people might access abortion later in their pregnancies. An intervention of an abortion navigator could help refer patient’s to necessary resources to help navigate the process and services available to help support other social needs. This intervention similarly would intend to mitigate the social determinants of health.
Addressing the social determinants of health equity and tackling the larger structural barriers that lead to reproductive injustice is a much more challenging piece of addressing social determinants of health. I think these interventions happen through the work of activists and advocates—by fighting for the right to abortion, fighting for maternal autonomy in pregnancy, fighting for decriminalizing pregnancy, and engaging in anti-racism work.