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 4thgeneration, comment on what 1rst and 2nd generation work was necessary as a foundation for your current work (or current interests).
One of my current research interests is to gain understanding of how chronic stress/social disadvantage “get under the skin.” Towards this end we have developed tools for measuring cortisol from hair and telomere length in DNA extracted from saliva samples. These tools are being used in collaborative work with social science and public health researchers to paint a comprehensive picture of how SDH (including reported racism/discrimination) affect human biology. This information can then be used to provide mechanistic links between SDH (including reported racism/discrimination) and the biological basis of health disparities.
The use of tools for measuring cortisol from hair and telomere length from saliva in health disparity populations is 1rst or 2nd generation. We designed our studies to use hair and saliva as biospecimens because their use met many of the criteria we developed for successfully engaging community members as participants in our studies. Having recently achieved this goal we are nurturing strategic collaborations with social science and public health researchers who are investigating societal and individual level factors that contribute to health disparities. To elevate the work to 3rd generation research we plan to investigate how interventions designed to address health disparities affect cortisol levels and telomere length. To advance to 4th generation work we (the transdisciplinary research team) will engage in self-reflection, and thoughtful efforts to align our research results with practice.
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 hypertension intervention is most generalizable to primary and secondary health interventions in marginalized communities. These communities often experience dis/mistrust of health care providers. Consequently they fail to benefit from primary prevention and secondary screening practices that could keep them from experiencing preventable diseases. This leads to health disparities that can be overcome by engaging trusted individuals in the community (e.g., barbers) to deliver primary and secondary health interventions.
The principles of the barbershop intervention could be applied to my area of research by engaging trusted individuals in the community to gather biospecimens. For example, our preliminary studies have shown that African American women are more reluctant to donate hair than women of other ethnicities. Perhaps we can work with hair salons that cater to an African American clientele to collect hair from this population as part of a get a free cut and donate hair incentive approach to research. Additionally, beauticians in the salon could be trained to deliver tools for reducing chronic stress due to social disadvantage, racism, and discrimination.