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 life course and/or intergenerationally.
My research focuses on the association between atopic dermatitis and depression/internalizing symptoms in children and young adolescents. Social determinants play a crucial role in mental health risk and outcomes in both children and adults. Moreover the association between atopic dermatitis has been well described and is thought to be bidirectional and multifactorial, due to genetic predispositions, environmental risk factors, stress, diet, sleep and other unknown factors.
Income, one of the indicators of socioeconomic position, will directly affect access to health services, and more particularly mental health services, which are often not only stigmatized but also much less accepted and understood for pediatric populations. Occupation is linked to workplace stress while social class is linked to living conditions and be a source of emotional stress.
The structural stratifiers above will determine material circumstances. High poverty neighborhoods are more likely to be plagued by violence outside of the home, substance abuse and food insecurity, among a multitude of other conditions that will negatively impact mental health. These social aspects of living conditions will have a huge impact on Adverse Childhood Experiences, which are known to play a huge role not only in a child’s mental health, but also on their mental well-being throughout their adult life. Moreover, the behavioral factors such as diet and sleep will also depend on the structural stratifiers discussed.
It thus becomes clear that social determinants health ingrained in the structural stratifiers and intermediary determinants will directly affect stress, access to both mental health and primary care services, diet, and lifestyle, which are on the causal pathway of both atopic dermatitis and mental health.
2. Write a brief paragraph describing the extent to which an 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?
As mentioned above, it is widely accepted that the association between atopic dermatitis and depression/internalizing behavior is multifactorial. However atopic dermatitis has also been studied in the context of other mental health problems, including childhood stress caused by a number of psychosocial or socioeconomic experiences. These are very often directly related to a child’s housing situation, education, family’s income, environmental risk factors, all of which are structural stratifiers. Sleep, another well known trigger for atopic dermatitis, has also been studied in the context of social class, education and housing conditions. Atopic dermatitis research has also focused on patient and caregiver education regarding the condition and behavioral interventions to prevent or alleviate this chronic, waxing and waning skin condition. Finally, studies have examined community availability of integrative health care services for children to address both the biological and psychological factors at play.