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 am currently focusing on reproductive health research and will be looking at Latinas’ perspectives on sterilization (tubal ligation). I am focusing on this particular group because while female sterilization is the most commonly used method of contraception for women in the United States, women of color are disproportionately more likely to use female sterilization when compared to White women. Yet, women of color (Latina and Black women) are more likely to regret having had their tubes tied. It is not clear what is behind this paradox of high utilization and high regret. Research has shown that there are variations in sterilization rates due to factors such as level of education, race/ethnicity, and method of payment or insurance coverage. However, we still do not know exactly what factor(s) are responsible for these differences. Thus, it is important to look at income, education, and race/ethnicity as structural stratifiers. In addition, taking into account the sociopolitical context of the past, such as the history of coercion/forced sterilization, can help us understand why Latinas are disproportionally likely to use sterilization, but also to regret it. In addition, intermediary determinants like psychosocial stressors (e.g. stressful living circumstances) may also be playing a role in Latinas’ decision to have a tubal ligation when perhaps they were not ready to commit to this permanent method of contraception and ends up regretting it.
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 far as I know there has not been a socioecological framework, incorporating issues related to social determinants to my area of research. In fact, there is little research on Latinas’ perspectives on sterilization and almost none looking at how the history of nonconsensual sterilization of Latinas in the United States may affect perceptions of sterilization in Latinx communities. Gathering information on Latinas’ beliefs, knowledge, and attitudes on sterilization can help address and meet their reproductive health needs. It can also help generate evidence-based strategies for improving sterilization care and policy.