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 all major health disparities are mediated to some extent by genetic and environmental interactions. Other than a cursory introduction to epigenetics in medical school, it was fascinating to learn about the exact mechanisms whereby the environment and social stressors can actually mediate biologic stress based on underlying genetics. In my specific area of opioid research, I can imagine how stress mediates certain susceptibility to substance use disorders. I am less familiar with how DNA methylation (InterGen study) impacts substance use susceptibility, but it is something that I will look into now.
2. Discuss implications of epigenetic mechanisms of disease for intergenerational effects on health disparities, as well as for interventions designed to address health disparities.
The idea of epigenetics is that environmental exposures can impact our genes by activating or silencing certain genes that can mediate physiologic or disease processes. To the extent that process is then inheritable, I am not sure (I would have to read more about that), but the same social stresses that make epigenetics relevant are of course going to be present intergenerationally. Just like housing insecurity or environmental racism are compounded through the generations, epigenetic mechanisms of disease would similarly compound over generations. In terms of interventions, I think addressing underlying social determinants are most important but perhaps identifying certain susceptible genes could open up a whole field of targeted genomic research.
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 socioecological model includes an organizational level where we could examine neighborhood level factors and how they impact health. Robinette et al. found that people in lower income levels have a higher allostatic load. These people are likely to experience an impact on their behaviors and degree of social cohesion. Considering the other readings about biological embedding and epigenetics, the interactions within the model become more clear.