Week 4 HW
Questions Related to Week 4 Readings:
1. Hertzmann and Boyce argue that “it is not genes or environment, nor is it genes and environment, but rather it is gene-by-environment interactions that influence developmental trajectories.” To what extent do you think that GxE interactions can contribute to major disparities along racial/ethnic, socioeconomic, or geographic dimensions? Please consider this both in general and in respect to your particular area of interest.
Hertzman and Boyce do a good job explaining how it is the interaction between the gene and environment, in addition to the response that contributes to disparities in health outcomes. For example, you can think of someone responding to stress in their early childhood environment in ways that might make them more resilient or less, psychologically or behaviorally. In terms of reproductive health, we can see this play out when we think about maternal mortality being higher in blacks than whites. Leaving aside this being a result of health care associated disparities, likely contributing is also geneXenvironment interactions which make black women more susceptible to diseases that occur during pregnancy.
2. Discuss implications of epigenetic mechanisms of disease for intergenerational effects on health disparities, as well as for interventions designed to address health disparities.
I think the clearest example is the methylation due to perceived stress that Barcelona de Mendoza et al. discuss. In this paper, you can imagine a mechanism whereby stress causes the methylation of certain genes that get turned on and then passed down to progeny overtime, making them more susceptible to diseases. Also, disease burden can lead to further experiences of stress and discrimination, causing a vicious cycle. To intervene, I think we would have to try to change culture to decrease the amount of social discrimination that certain groups experiences, as well as implement broad-based programs, like free early childhood programs (like described in the Hertzmann paper in BC.
3. Discuss how the findings in the Robinette paper relate to socioecological model we are using in this course – e.g. briefly describe how the different levels displayed in this model are related to each other in this paper.
The Robinette paper discusses neighborhoods’ effects on allostatic load, or the factors that contribute to the likelihood to experience chronic disease. Working from the bottom up, Robinette discusses biology and interactions between biology and experiences by discussing the individual allostatic load, and then controlling for that to try to see the effects of neighborhood allostatic load. Robinetee discusses that the behaviors of individuals can be different even in similar neigbhorhoods, so that is not really accounted for except by controlling for it, as discussed above. Medical care is not discussed although one could imagine that if there are a lot of quality medical facilities in a neighborhood, that would lower the allostatic load. The Robinette paper really focuses on the next two semi-circles of the living and working conditions and the economic social opportunities and collapses those when looking at neighborhood.