Assignment 1
1. Write a paragraph describing the extent to which an socioecological framework incorporating issues related to social determinants has been applied to your area of research. Are there opportunities for improving our understanding of or approach to disparities in your area with a greater emphasis on a socioecological framework?
My current research is assessing 181 Latinx youth at first contact with the Juvenile Justice System, a longitudinal study that is assessing behavioral health needs and recidivism. I am also examining how family (e.g., parental monitoring) and cultural variables (e.g., neighborhood factors) predict future patterns of behavioral health needs and recidivism and how these differ by gender. This study is guided by Ecodevelopmental Theory (ET), which is based on Brofenbrenner’s (1994) social-ecological model. The social-ecological model addresses individual development while emphasizing complex systems of relationships influenced by several contextual levels, or ecological layers, in an individual’s environment. In social-ecological theory there are four contextual influences, or interacting systems, present in a youth’s environment that can be visually depicted as four concentric circles or nested layers; interactions between and among these systems can have a bi-directional and/or circular impact. In addittion to the social-ecological theory, ET adds two components: a) an emphasis on psychosocial development, and b) social interactions. After completing a review of Latinx youth in the Juvenile Justice System (Hoskins, Tolou-Shams, and Perez-Gualdron, in review), I found that while researchers were approaching their studies and identifiying the use of a ET framework, they were only testing the social-ecological model and assessing protective and risk factors of behavioral health needs and recidivism. These studies were not assessing the second and third component of ET, which is psychosocial maturity and social interactions.
2. In the WHO reading, A conceptual framework for action on the structural determinants of health, the authors describe structural stratifiers (e.g. income, education, etc) and intermediary determinants such as material and psychosocial circumstances. Pick 3 of these factors (at least one structural and one intermediary). Explain why you chose the factors (might use Braveman article to provide justification) and describe how each could be an important determinant of a health outcome of your choosing. 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.
Social Class: Among studies that have primarily focused on the JJS, when ethnicity is held constant, social class affects juvenile justice decision-making among Latinx samples; that is, Latinxs in poverty are significantly more likely to be monitored by law enforcement and referred to juvenile court than are Latinx youth from middle-class backgrounds (Bond-Maupin & Maupin, 1998). Urbina (2007) noted that the historical processes that push individuals to migrate to the U.S., along with the opportunity to progress economically, vary dramatically. This is important for researchers, practitioners, and public policy officials to understand because applying a treatment intervention uniformly across Latinx population misses out on the reasons why different subgroups immigrate. Some examples include traumatic experiences from political warfare, escape extreme poverty, and search for healthcare.
Race: A number of challenges exist for researchers attempting to understand ethnicity and race as it applies to the Latinx population. Data collection that utilizes racial categorization alone fails to provide a comprehensive picture as Latinxs may identify as White, Black, or Asian. In the Juvenile Justice System, Latinxs are often classified by race as Hispanic vs non Hispanic White (Arya, 2009). Tapia (2015) indicated that the lack of multiple racial and ethnic identifiers has discouraged scholars from pursuing scholarly inquiry into issues related to Latinx youth incarceration, in contrast to scholarship on issues related to the incarceration of other ethnic groups like African Americans and Whites. Further, there is a lack of consensus in federal and state databases on whether to use the term “Hispanic” or “Latino” for this population (Gabiddon & Greene, 2009). An additional challenge related to categorization and group membership identification of Latinx populations includes classification between the experiences of foreign-born and U.S.-born Latinxs groups. Serving as an additional challenge to understand the heterogeneous needs of this population, Urbina (2007) identified that when public-use data sets (including the U.S. Census) only use the term Hispanic, it fails to distinguish among Latinx groups from South America, Central America, Mexico, and Latinxs born in the United States. Because of the dearth of research on Latinx youth in the JJS and lack of rigorous methods, scholarship that addresses the lack of research regarding the specific needs of this population as it relates to the juvenile’s and their contact with the justice system is needed.
Health System as a Social Determinant: Lopex & Nuño (2016) noted that healthcare disparities are present for Latinx youth. In their review, they noted that the Census of Juveniles in Residential Placement, in 2013, a larger percentage of Latinx females (41.1%) were detained compared to White females (34.6%). They also noted that in the 2013 Census, Latinx females were more often placed in detention centers than were White females (46.5% vs. 38.7%) and had higher rates of long-term secure placement facilities compared to White females (23% vs. 14.4%). In addition, a lower percentage of Latinx females (16%) than White females (28%) in out-of-home placement facilities were served in treatment centers where substance use treatment may have been made more available. Given that two years prior, Latinx females were noted by the Center on Addiction and Substance Abuse (2011) to have the highest rates of substance abuse in comparison to any other racial adolescent group in the U.S., this trend of Latinx females not receiving treatment is alarming.