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.
In general, this is a principal that has been discussed prior but not so well articulated or described as in this paper. Thinking about the example proposed by Hertzmann and Boyce regarding antisocial behavior having both genetic and environmental implications, one can see how both contributes. Hertzmann and Boyce note the genetic polymorphism in the MAO promoter region of the genome with biologic plausibility for the aggression pathway but this phenomenon is not completely realized until coupled with childhood maltreatment in terms of the manifestation of antisocial behavior. In another example proposed in the text, environmental factors including urban vs rural residency can interact with the serotonin receptor 2A gene in the expression of depression symptoms. Here, researchers noted the T allele as associated with high depressive symptoms in remote rural areas but with low depressive symptoms in urban or suburban areas. When considering my particular areas of interest, much about the genetic contributions to infertility and subfertility are just being realized through genome wide association studies. As we continue to investigate the genetic basis for different diseases, I anticipate the increased utilization of gestational carriers vs that of oocyte donors and eventual childhood/adulthood outcomes will be of particular importance in elucidating the contributions of both genetic and environment on health and in particular health disparities. Currently, information that has been gathered centers on twin studies in which individuals with the same genetic material who are raised in different environments can exhibit widely different behaviors. Similar propensities for a disease can manifest in different health outcomes based on one’s environment.
2. Discuss implications of epigenetic mechanisms of disease for intergenerational effects on health disparities, as well as for interventions designed to address health disparities.
While the influence of environment on one’s genome transcription (ie epigenetics) is established, it is challenging for me to wrap my head around that being intergenerational. I feel these concepts are quite entangled as similar enviroment’s whether geographic or sociocultural tend to persist within families so its challenging for me to argue that someone inherited a health condition or behavior because the generation prior was exposed to environment that promoted a change in gene transcription. With this being said, if present, interventions designed to address health disparities would need to have a generational approach which is challenging for both the researcher and the population.
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.
In the Robinnette paper, allostatic load as defined as a measure posited to capture the cumulative effects of wear and tear on physiological regulatory systems”. This has been shown to be elevated in those living in low income neighborhoods. In particular, they found that those who exercised regularly, consumed less tobacco, and who reported eating less fast food had significantly lower allostatic load. Additionally, although perceived stress was not associated with higher allostatic load, those with higher levels of anxious arousal (which I perceive as an unconscious measure) was associated with higher allostatic load. When examining the RWJ Foundation framework, ones economic/social opportunities and resources directly contribute to their living conditions. This in turn can affect ones behaviors and in essence medical care.