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.)
My research focuses on organ allocation in liver transplantation, so my outcome of interest is waitlist outcome (time on waitlist, dropout for being too sick, dropout for improving, death, transplant). Once patients are listed for liver transplant, they receive a significant amount of counseling and support and are required to meet certain metrics in order to remain on the waitlist. As such, diet, exercise, and abstinence from substance use and alcohol consumption are significant behavioral factors that impact etiology of liver disease, but could also contribute to waitlist outcome.
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.
The current dataset that I am using does not include particularly granular data regarding the reason for certain outcomes (like waitlist removal), so I think the study of behaviors would be limited in a practical sense because of this constraint. However, in an ideal world (or perhaps at a single center level), it would be feasible to look at patients who had a positive tox screen or failed to meet AA attendance requirements after they were listed for transplant, and to study the impact of race/ethnicity in this population.
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?
I think it is essential to continue studying health behaviors even with the knowledge that they are strongly influenced by elements of the larger societal infrastructure. While the overall goal of research in health disparities is to effect sweeping change at the level of the institution, in the interim we can make meaningful strides by addressing behaviors at the level of the individual.