I have selected the following array of portfolio entries in an attempt to represent the trajectory of this course, as one might select time points in a study to measure variation over time. These selections from my portfolio best capture the process of development of my work and thinking about the course content and goals.
Personal & Professional Development Plan (1)
I selected this first sketch (refer to ‘Compiled Sketches’ Sketch Week 1, pages 1-3) as it forms the foundation for this portfolio and serves as the ‘benchmark’ for all portfolio components. In this piece I outlined my background and research interests. I expressed my hopes that I would be able to readjust my sights to include the ‘agent’ in the ‘host, environment, agent’ model of public health, as well as broaden my thinking about disparities in socio-economic determinants and health status and outcomes.
In this first sketch, I set forth my proposed dissertation research questions pertaining to employment based benefits and health status and outcomes. The indicators of health used in the Panel Survey of Income Dynamics (PSID, the dataset I intend to use) were outlined, including overweight and obesity, as well as chronic conditions such as diabetes, cardiovascular disease, and cancer. These three diseases have served as the primary reference points for my glossary entries over the course of the semester. This course has been particularly salient to my research interests, given the emphasis on social inequalities and cumulative life-course effects. I’ve also had the chance to explore concepts and methods pertaining to social influences on disease.
Glossary Entries (3)
I selected the following entries based on my research interests and how they relate to the annotations and sketches I have also included in this Portfolio overview.
Entry #3 Multi-step process in epidemiological reasoning
I developed this entry with the relationship of overweight and obesity and associated chronic diseases in mind. This definition provides a nice framework for looking at the risk factors, clinical indicators and associations involved in disease prevention and treatment. This was a useful exercise in gaining a better understanding of how to utilize health indicators in public health policy and practice.
Entry #12 Cohort, Case-control, and Cross-Section
This was an important entry in my glossary as I have had a tendency to confuse these terms in the past. I feel like the exercise of having to define the terms, as well as provide examples from my area of interest, helped to clarify my understanding of these study designs. I think these entries also reflect my willingness to look at different methodological approaches that may be more or less helpful to my dissertation research interests.
Entry #14 Bias, Strata, Confounding
These terms have also formerly posed a challenge to me, in terms of being clear on the concepts and application. Moreover, they are important terms with respect to measuring associations and the affects of social inequality. I had conceptualized the ordering of my independent variables in my dissertation regression model in terms of categories, but strata is actually a more appropriate term and construct for organizing the worker and job characteristics in order to avoid bias and confounding effects. As I noted in the definition and example, an association may be observed that is in no way causal, that may serve to divert attention from the actual source of causation. This is an important consideration that is now much clearer to me.
I think the annotations in my Portfolio best represent the evolution in my thinking and writing about the course content and goals.
In an early annotation on Categories (refer to ‘Compiled Annotations’ 4th Week pg. 3-4),
I seem to have been very focused on the content of the articles, as opposed to focusing on the concepts and methods that were the primary point of interest. I do seem to have picked up on the point that categories are constructed, and that researchers may reflect their biases in their construction of an issue or population.
As noted in an earlier section, Confounders are a key consideration for my dissertation research questions and model. This week’s readings (refer to 6th Week pg.5) and annotations tie in with those of the 4th week in referencing social constructs and researcher bias. Issues pertaining to bias in research design are also raised, in the instances of birth weight recall versus actual documentation. I appear to be making progress in synthesizing the key points of the various articles without becoming distracted or fixated on the article content.
The ninth week’s topic and readings pertaining to Multi-level Analysis were the most interesting and useful to me (refer to 9th week pg. 6-7). At this point I begin to include my own experiences and reflections, perhaps blurring the lines between the annotations and sketches. In this week, there was also a helpful overlap of the assigned readings and researchers I have been reading on my own or at the suggestion of prospective committee members and additional faculty. Perhaps it’s no coincidence that these articles spoke to me, focusing on environmental factors and SES determinants as they did. I also seem to focus more closely on methodology and data sources than was previously the case.
For my final sketch selected for inclusion in this overview of my Portfolio, I selected the twelfth week topic and readings pertaining to Heritability (refer to 12th week pg. 9-11). In this week, I was responsible for both writing an annotation and also leading the class discussion on this topic. Given the complexity of the topic, I found myself drawing on the Gordis chapters pertaining to heritability as well as the assigned readings. I also consulted with the professor. I found the explanation of disease development, particularly chronic diseases, as an expression of heritable and non-heritable factors to provide the balance I’d like to see in terms of individual versus environmental focus in public health and epidemiology.
The articles in the twelfth week were very technical and complex in their approach to gene-environment interaction and quantitative genetics. Despite struggling with the terminology and concepts, these articles were more accessible at this point in the semester than would have been the case early on. The nature versus nurture debate makes more sense when approached in a complementary fashion. I also appreciated the critical approach that expanded thinking about heritable conditions within and across populations.
I have selected sketches that seem most pertinent to my development and thinking about epidemiology. The readings on structural models (refer to ‘Compiled Sketches’ Sketch Week 11, page 5) and associated sketch and annotation, opened a wider view onto the interconnections of complex variables pertaining to employment base benefits and disparities in health status and outcomes. Particularly, multivariable structural models for change hold promise as a methodological approach to use. This sketch also marks the point at which I began to conceptualize the value of including health indicators as both a dependent and independent variable in my dissertation regression model.
The readings on genetic diagnosis (refer to ‘Compiled Sketches’ Sketch Week 13, page 6), which followed several weeks focused on heritability, and environmental expression of genes, required further reflection on the relationship of the host, agent and environment. At the conclusion of the course, I am still struck by the extent to which U.S. culture tends to overemphasize the host and agent to the exclusion of the environment. Perhaps it’s attributable to the notion of personal responsibility, which is embraced for the illusion of control that it offers. The pendulum shift between individual and environment in public health and epidemiology has been a consistent theme throughout the course. It seems like it would be useful to establish a balance of the two, which is rarely achieved.