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.
I have broad research interests in women’s health, but am actively focusing on the use of different treatment methods for symptomatic uterine fibroids, and their long term health impacts. I would consider education, income, race/ethnicity to be structural stratifiers. Education, for instance, enhances receptiveness to relevant health education and enables women to effectively communicate with providers about the benefits/consequences of specific treatment methods. Income specifically affects the attainment of healthcare through resource accessibility, directly impacting management options, number of visits to the gynecologist, and other health-seeking behaviors. When accounting for pertinent demographic factors, the odds of undergoing minimally invasive hysterectomy are diminished in women of Hispanic ethnicity. Significantly more African-American women wait 4 or more years before seeking treatment due to a mistrust of providers, or with the healthcare system in general. Stress as a psychosocial factor, specifically when women are head of households can stunt their opportunity to deal with symptoms and feeling open to invasive surgical treatment because of long recovery time. These factors form part of a dangerous cycle which pushes women to put their wellbeing at risk, and of those they care for.
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?
There is very little research/knowledge on what causes uterine fibroids. The literature argues that their incidence is genetic, or hormonally linked. Therefore, I would argue, that the socioecological framework is applied towards how women experience this condition, through management. There are significant disparities in fibroid burden, especially among African American and Latino women. The odds of undergoing minimally invasive hysterectomy are diminished in both African American and Hispanic women, as well as those enrolled in Medicaid. On an interpersonal level, survey data explains that women of color tend to minimize the severity of their symptoms, despite experiencing heavy menstrual bleeding and severe pelvic pain because of how pain tolerance is perceived. Additional research should continue to be undertaken with the socioecological framework at the forefront, especially when focusing on institutions and community members.