School of Life Sciences, Arizona State University, Tempe, Arizona, USA.
Center for Evolution and Medicine, Arizona State University, Tempe, Arizona, USA.
Phys Ther. 2022 Jan 1;102(1). doi: 10.1093/ptj/pzab245.
Human health is affected by lived experiences, both past and present. The environments we encounter throughout our lives, therefore, shape how we respond to new challenges, how we maintain a healthy immune system, and even how we respond to treatment and rehabilitation. Early in life and throughout adulthood, social experiences-such as exposure to various forms of adversity-can alter how cells in our body function, with far-reaching consequences for human health, disease, and treatment. This Perspective highlights studies from an ever-growing body of literature on the social determinants of health, with a focus on exposure to social adversities, such as social isolation, discrimination, or low social status, experienced both early in life and adulthood and how they variably impact health. By focusing on recent observational studies in humans and experimental studies on social nonhuman animals, this article details how social adversity can become biologically embedded in our cells at the molecular level. Given that humans are social animals, it is no surprise that social adversity can negatively impact our health, and experimental animal studies have helped us to uncover some of the causal mechanistic pathways underlying the link between social adversity and health outcomes. These molecular consequences can have far-reaching implications and, when combined with our growing knowledge on the social determinants of health, should inform how we approach treatment and rehabilitation.
人类健康受到过去和现在生活经历的影响。因此,我们一生中所遇到的环境塑造了我们如何应对新挑战、如何维持健康的免疫系统,甚至影响我们对治疗和康复的反应。在生命早期和成年期,社会经历——如接触各种形式的逆境——可以改变我们体内细胞的功能,对人类健康、疾病和治疗产生深远影响。本观点重点介绍了越来越多的关于健康的社会决定因素的文献研究,关注的是在生命早期和成年期经历的社会逆境,如社会隔离、歧视或社会地位低下,以及它们如何不同程度地影响健康。本文通过关注最近在人类中进行的观察性研究和对社会性非人类动物的实验研究,详细说明了社会逆境如何在分子水平上在我们的细胞中被生物嵌入。鉴于人类是社会性动物,社会逆境会对我们的健康产生负面影响并不奇怪,而实验动物研究帮助我们揭示了社会逆境与健康结果之间联系的一些因果机制途径。这些分子后果可能具有深远的影响,并且结合我们对健康的社会决定因素的不断增长的认识,应该为我们如何处理治疗和康复提供信息。