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 do think that there is a potential for geneXenvironment interactions to contribute to major health disparities. In general, I am thinking about how a lot of historical traumatic events (e.g. slavery or Jim Crow and redlining laws) have a lot to do with both the gene piece, but also the geographical environment where the discrimination occurred. In terms of my interests in racism and perinatal epidemiology, I think a good contemporary example of the Hertzmann and Boyce argument is the current lead water crisis in Flint, Michigan. Early reports have shown a spike in fetal deaths and lower fertility among the Black women living in the impoverished racialized communities. I feel like this demonstrates how genes can interact with environmental injustices further racial disparities in birth outcomes.
2. Discuss implications of epigenetic mechanisms of disease for intergenerational effects on health disparities, as well as for interventions designed to address health disparities.
In my specific field of study, I feel like taking an epigenetic perspective can further the overall understanding of how racism influences the risk of adverse perinatal outcomes. In the United States, racism has an intergenerational effect, by definition. As I mentioned in my answer to question one, important historical racist events such as slavery, lynching, Jim Crow segregation laws, redlining, 1994 crime bill etc., continue to have enduring intergenerational effects on the Black population in America. Therefore, the current racial health disparities seen in maternal mortality, and other birth outcomes do not exist in a vacuum, but rather they represent the how epigenetics have passed down the experiences of racism from ancestors to the women experiencing inequality today. Consequently, I think that in my field specifically, we both need to think about measuring racism with a more intergenerational scope (i.e. moving from looking at everyday experiences of discrimination to lifetime and “generational” experiences of racism), and designing interventions to reduce inequities with a generational lens. Evidently this research is still in its infancy, but I could see this as taking a more reproductive justice approach and looking at how to make an impact at the bigger community or smaller family-level when designing interventions, so that the gains of the intervention can be appreciated by the pregnant person, but also their parents/grandparents etc.
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 findings in the Robiniette paper touched on a lot of the pieces of socioecological model from class. Notably, it discussed how the allostatic load (“interaction with genetic/other biological factors), and low SES neighborhoods (“living and working conditions in homes & communities), can influence chronic health problems, and how this can be modified in some cases by health behaviors ( this relates the behaviors lecture from week 3!). This paper did a good job of showing how these different levels of the model interact together to produce health disparities.