Health Disparities Forum

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 2^nd generation, comment on how your work could lead in the future to 3^rd or 4^th generation work.  If your work is 3^rd or 4^th generation, comment on what 1st and 2^nd generation work was necessary as a foundation for your current work (or current interests).

I would consider my current research to hover between the 1^st and 2^nd generations of health disparities research framework, with clear implications for informing the 3^rd and 4^th generations. Socioeconomic disparities in smoking are well documented across various measures and indices SES (1^st generation). Despite this knowledge, it has been difficult to tackle this disparity not only because SES is multifaceted but also because smoking and quitting are shaped by a variety of influences. The Thomas et al. article articulates this problem quite well actually. In my research, I am examining the association between food insecurity and cigarette smoking. My rationale was to identify aspects of poverty and socioeconomic disadvantage that have been found to be independently associated with smoking but is also viable targets of change through policy. Thus far, the research has focused on providing further evidence of the disparity in smoking by food insecurity (1^st generation- documenting) to identifying mechanisms associated with the association (2^nd generation- understanding). This work could eventually lead to 3^rd and 4^th generation research when the research starts to move into the intervention framework. For example, perhaps reducing food insecurity also results in reduced smoking rates, or vice versa.

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?

Several aspects of this program might be generalized to other areas of health. The two that are immediately salient to me are people and places. Engaging trusted individuals in the community as lay health workers may be an effective way to connect people to needed services. This builds trust and rapport and perhaps even a sense of empowerment about their own health because individuals are exposed to health messages from their peers rather than from a more paternalistic approach. Another generalizable aspect of this program is leveraging non-traditional venues as intervention sites. Oftentimes we think of health interventions taking place in clinics and the like, but it’s important to meet people where they are. This might apply to my area of work by working with food assistance venues to provide smoking cessation resources or connect individuals to smoking quitlines.