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 work, which the detection of risk factors related to cognitive aging in the setting of diabetes, most likely fits into a first-generation level of health disparities research. However, the disparities detected in large cohort studies such as these could be used to address disparities in 3rd or 4th generation work, for example, by using this understanding of causality (by race, insurance status, etc.) to design targeted interventions in communities where these risk factors are most prevalent.
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.
One of the risk factors for diabetes includes residence in low-income “food desert” communities where access to affordable fresh produce is severely limited. A possible “fence” intervention would include the subsidized introduction of fresh produce and/or a home delivery service of produce to decrease the barriers to healthy eating and reduce the risk of weight gain and subsequent metabolic disease.