1. Write a brief paragraph discussing what social determinants are most relevant to your area of research and why. Consider both structural stratifiers (e.g. income, education, etc) and intermediary determinants such as material and psychosocial circumstances, as described in the WHO reading. Explain why you chose the factors (might use Braveman article from last week to provide justification. The association could be reported in published research or it could be your hypothesized relationship. Consider whether how these factors might function over the lifecourse and/or intergenerationally.
Hi all,
As I briefly mentioned during introductions from last class, my research focuses on the effects of racism on adverse birth outcomes (notably preterm birth) among Black women. Previous studies have found that the racial disparities in rates of preterm birth are seen irrespective of levels of education, social class and income (i.e. even after adjustment for these factors disparities persist). Therefore, I believe that gender and race/ethnicity are the most relevant structural stratifiers to consider in my area of research. I am suggesting that the historical processes which have created and reinforced racialization in America (e.g. slavery, Jim Crow laws), combined with the systemic gender discrimination, have laid the foundation for the current health disparities seen between Black women and women of other racial groups with respect to birth outcomes.
While gender and race are usually defined at birth, I think it can be argued that both of these factors act will have intergenerational and life course impacts. Phenotypic race is inherently intergenerational as the race of one’s parents will in turn determine the race of their children (i.e. an infant’s race at birth is usually assigned based on the mother’s race). Thus, the cumulative impact of racism among one’s ancestors will influence one’s current racialization and experiences of discrimination. Although a bit more abstract, there is also a life course piece to consider; as the social definitions of race and gender change across life course, so will the impacts of race and gender-based discrimination.
2. Write a brief paragraph describing the extent to which a socioecological framework incorporating issues related to social determinants has been applied to your area of research. Are there opportunities for improving our understanding of or approach to disparities in your area with a greater emphasis on a socioecological framework?
Historically, research in perinatal epidemiology had once suggested that disparities in birth outcomes among Black women were likely due to biological/anatomical differences, which reinforced the concept of race as a biological construct. However, there has been a recent movement towards applying a social determinants of health framework to health disparities research, whereby current studies usually evaluate the impact of social stratifiers such as neighborhood disadvantage, education and household income on adverse birth outcomes. I believe there is a great opportunity for application of Dr. Jones’ Gardener framework when studying racial disparities in birth outcomes. If studies of adverse birth outcomes (e.g. preterm birth) in Black women took into account the interactions between institutional, personally mediated and internalized racism, in addition to the other more “traditional” socioecological factors, I think researchers could better understand these disparities at the intersection of race and gender.