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).
My current research interest is in obese populations and their access and interaction with reproductive health, contraceptive and abortion care. Although obese populations spread the gamut of race, ethnicity and social classes, it disproportionately affects minority and low SES groups and may have a compounded effect with systemic and institutionalized racism - as such this can be a window into health disparities research. My interests at this point would fit into the 1st and 2nd generation categories within the generational framework in detecting, identifying and documenting disparities in care among this group of women and starting to determine causal relationships that underlie these disparities (provider relationships and bias, differences in access to care, etc). Documenting these disparities and linking them with potential causal relationships would lead to 3rd and 4th generational work in developing interventions targeted at this vulnerable population to help provide solutions to reduce these disparities. An example would be if provider bias and feelings of stigmatization about obesity were linked to the compromise of a woman’s contraceptive and abortion care and her access to that care, then developing and testing interventions to reduce stigmatization and provider bias to decrease these disparities would be the next step.
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 community engagement aspect of this program I think is particularly generalizable to other areas of health, especially in the setting of the social determinants of health relying upon people’s interactions with their homes, schools, neighborhoods and communities. In particular, finding a venue in which their population of interest accesses and interacts with regularly to involve the social and communal aspects of their health in order to evaluate for potential interventions to decrease disparities. This could apply to my area of research in obtaining community input in identifying locally relevant issues with reproductive health, contraception and abortion care access and utilization – whether these issues surround stigmatization, fears of reproductive coercion or lack of providers who can provide care particularly for morbidly obese patients. Identifying a community partner, such as local women’s groups/associations or churches, and involving them in reproductive health promotion programs would be a possibility.