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.
· I think this paper brings up interesting points. Its example of the antisocial behavior and the low MAOA Activity bring up a convincing argument for gene-by-environment interaction. While I find myself agreeing with the authors’ logic, I almost think this gene-by-environment interaction has a much smaller effect than the paper leads me to believe. For instance, say, for argument’s sake, that certain populations of X Race have a gene that is more likely to cause them to have lower IQ’s if certain environmental factors are met, I would argue that the environment has too much of an effect to reliably state that it is gene’s fault. The family may have to work multiple jobs, older generations of the family may also be working because of poor retirement options now, causing a dearth of dedicated childcare behaviors seen in higher SES classes such as daily reading etc. Furthermore, there may be poorer school districts without the resources to provide high teacher to student ratios. Then, the institutional, structural racism this hypothetical child will endure can have a multitude of effects on the development and IQ. In my mind there are countless environmental factors, and to say the gene was triggered by the environment to cause a perfect storm causing disparities is farfetched. I believe there is likely some genetic component that could be impacted by the environment, but I think it is over stated because there are too many external factors, too much institutional and structural racism/prejudice that exist for me to believe that this causes major disparities. I do not think this would be in the case in cervical cancer screening either, while certain races may have a predisposition to getting cervical cancer, I think there are too many structural disparities that cause the patient to not be able to get cervical cancer screening rather than the gene causing the patient to not be able to get cervical cancer screening.
2. Discuss implications of epigenetic mechanisms of disease for intergenerational effects on health disparities, as well as for interventions designed to address health disparities.
Drawing further from the Hertzmann and Boyce article, I still think this is over playing the effects of the genes on health disparities. For instance, say a person of X race is growing up in a world with institutional and structural racism, causing them to live in a poor neighborhood with limited routes for social and economic advancement, and this causes the epigenetic changes to the person’s DNA that could be passed on to the person’s children. This ignores the fact that those environmental factors that caused the epigenetic factors in the first place will likely still exist. So, I am kind of at a loss, did the health disparity come first or did the gene factor come first. It almost seems like a chicken or the egg sort of factor. Right now, I do not think interventions targeted towards these gene factors are worthwhile, rather we should be focusing on social determinants of health that are causing health disparities.
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.
I enjoyed the Robineete article and thought it did a good job at integrating the “Living and working Conditions” with interactions of personal behaviors and genes/biological factors, ie poor neighborhoods and allosteric loads it impacts on people. I think it tied together these three aspects well, though I think it also provided some interesting nuance as poorer SES neighborhoods are more likely to have convenience stores, fast food, etc, which influence individual behaviors, and possibly contribute to the poor SES of the neighborhood, while all of these factors also increase the allosteric loads of the individuals, possibly causing worse health over all. I found it very convincing and highlighted how important it is to develop interventions that potentially address all of the levels otherwise I do not think the health disparities will be able to be fully addressed.