1. Write a brief paragraph discussing what social determinants are most relevant to your area of research and why. The association could be reported in published research or it could be your hypothesized relationship. Consider whether how these factors might function over the lifecourse and/or intergenerationally.
Some of the most obvious examples of disparities in care re: race and class are observed in Peripheral Arterial Disease (PAD). Vulnerable populations present to care later and are more likely to have functionally debilitating amputations. I have several ideas I want to explore as it relates to PAD such as the association of Adverse Childhood Experiences with PAD development, access to healthy food and surgical outcomes, and qualitative studies of how ableism impacts type of operations that patients undergo.
2. Describe 2-3 health behaviors that are relevant to your area of interest. Write a paragraph exploring how these may be influenced by the social determinants you described in #1, and another paragraph considering how they are influenced by the levels of racism described in the Gardner’s Tale assigned in Week 1.
Smoking, exercise, and diet
are major risk factors for PAD development. As described in lecture, particular
communities have had predatory targeting of tobacco products which could be
related to the increased proportion of smoking in particular communities. Further,
structural racism and poverty increase stress that could lead to an individual
wanting to smoke. These same structural factors play a role in access to
healthy food (food insecurity and/or Food Deserts) and time to prepare them,
and time to exercise. Poverty truly robs individuals of the time and energy to
take the best care of ones health.
3. Describe a qualitative or quantitative study design that could deepen your understanding of the relationship between social determinants of health, racism, health behaviors, and your health outcome of interest..
I have previously studied how Food Deserts impact chronic limb-threatening ischemia outcomes following revascularization and found increased wound complications and 30-day readmissions. This study is limited by its geographical proxy for eating healthy food but is encouraging to explore individual food insecurity. From this we can explore whether food insecurity replicates these findings or does not. If it doesn’t it is likely that the findings we had in the prior study are confounded by other SDOHs such as social support, health literacy, education, etc.