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 1st 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 1st and 2nd generation work was necessary as a foundation for your current work (or current interests).
My current research fits into 1st and 2nd generation models. I am looking at how psychosocial effects (low SES and perceived discrimination) on asthma outcomes differ in those with low and high inflammatory status. This is a “does this disparity exist in different populations” question and can also address a “why” or “how” this association exists by suggesting a possible mechanism (inflammation) behind the general association. The hope for 3rd generation studies based on our data is to intervene at psychosocial exposures. In other words, if we can intervene by lowering discrimination experiences in children or improving the SES that children come from (I know, this would be difficult!), we may be able to improve asthma outcomes. Another 3rd generation study could be drug development of targeted asthma medications that control underlying inflammation to improve asthma outcomes, since asthma medications do not have the same effect in everyone.
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. What aspects of this program might be generalizable to other areas of health? How might this apply to your area of research?
The barbershop intervention engages several social determinants of health, including social and community context (the barbershops are where participants engage in social and community relationships), health care (the intervention group was offered repeated BP measurements and follow up with a primary care provider), and education (through continuous interactions with the health care team during repeated BP screenings and primary care follow up, the participants received more health education).
The intervention format (within the community in a social setting and the follow up of health care for education) can be applied to many other aspects of health. Schools and youth groups are great settings to place health and social interventions for children. For my area of research, if we wanted to implement a psychosocial stress intervention, screening and interventions could occur (or at least begin) at the schools of the participants as most children attend school.