1. State your health outcome of interest. (It could be the one you used for week #2 or another one.) Pick two key behaviors that are important factors leading to your health outcome. Explain the importance of these behaviors either for etiology, prevention, or intervention. (If none of the behaviors in the readings are important for your health outcome, suggest another behavior that is.)
I am looking into salivary gland cancers, which are associated most closely with radiation and viral infections (EBV, HPV, HIV). One subset of salivary gland cancers (Warthin tumor) is associated with smoking. Thus, two key behaviors that can lead to salivary gland cancer are sexual behavior and smoking.
2. Describe how you would study the role of one of the behaviors described for question #1 and your health outcome of interest. Incorporate a social factor (e.g. race/ethnicity, social exclusion, stress) in the study approach.
It would be interesting to study patients’ past sexual behavior in more detail, such as age of first sexual contact, number of sexual partners, and use of protection during intercourse. It is unclear what the critical window is for HPV in the development of salivary gland cancers, so querying into age of first sexual contact would be particularly interesting to look into. The reading does not include sexual behavior as a key social factor, likely because it is so variable across socioeconomic classes. However, it would be interesting to see if it is associated with education, social exclusion, and stress. Smoking would also be important to investigate, along with its associations with race/ethnicity, stress, education.
3. If key health behaviors (e.g. smoking, exercise, nutritious diet) are strongly influenced by neighborhood, income, and/or education, do we need to continue to study how these behaviors influence health outcomes? Why or why not?
Yes, it is critical to study health behaviors even if they are influenced by more concrete, immutable factors like neighborhood and education. By identifying these health behaviors, strategies to uncouple their link to immutable factors can be developed and hopefully modify patients’ health behaviors. For instance, if smoking is part of the culture of certain districts/neighborhood, grassroots education campaigns can target these areas to influence health outcomes.