Again, I was out of the country during week so I am posting this late, better late than never :)
1. After reading the article by Thomas et al., comment on where your research, or your research interests, fit into the generational framework for health disparities research. If your work is 1rst or 2nd generation, comment on how your work could lead in the future to 3rd or 4th generation work. If your work is 3rd or 4th generation, comment on what 1rst and 2nd generation work was necessary as a foundation for your current work (or current interests).
As a reminder, my work centers on understanding how structural racism influences adverse perinatal outcomes among Black and Brown women in the Bay Area. I believe my work is 4th generation as we employ a critical race praxis in our research, in contrast to previous studies that have adopted a ‘Mother blame” position in regards to adverse perinatal outcomes, we focus on how the cumulative exposure to racist events across the life course impacts the health of the pregnant person and their birth experience. Further, women of color lead our study, and we constantly aim to interrogate how our social position influences our ability to conduct research in our own communities.
My research would not be possible without the foundational work of Drs. David R. Williams, Arlene Geronimus and Nancy Krieger. The aforementioned were among the first to observe stark health disparities in communities of color, and create a framework to explain how racism and weathering influences health outcomes. Moreover, their research led to several studies that aimed to reduce these inequities (e.g. Jackson Health Study).
2. The barbershop hypertension intervention, while essentially a clinical services intervention operating at either the fence or safety-net level as described by Jones, has some engagement with the social determinants of health. Interventions like that described in the Gottleib article are designed to mitigate the impact of social determinants. How could you apply one of these two types of interventions to your area of research? Propose one or two interventions that engage with social determinants on some level.
Perinatal interventions often focus on the pregnant person, but offer very little support to their family and in turn do not address the larger social determinants of health. I've given a brief example below that shows how we can go beyond providing care to the parent and widen our scope to ensure their family benefits from the intervention.
Black women are consistently reported to have lower breastfeeding rates than women of other races. In an attempt to increase breastfeeding rates, I would conceptualize an breastfeeding intervention for Black women who live in resource-limited areas in the Bay Area, which goes further than providing assistance with breastfeeding initiation, but also provides meals for the mother and her family who may have trouble accessing affordable food. Expectantly, this intervention would help to additionally intervene on the geographical determinants of health, as we know access to affordable food options will greatly impact the mother and her family.