将社会环境与公平视角纳入暴露组学研究范式:社会暴露组学的新概念框架。

Integrating the social environment with an equity perspective into the exposome paradigm: A new conceptual framework of the Social Exposome.

机构信息

University of Bremen, Institute of Public Health and Nursing Research, Department of Social Epidemiology, Germany.

University of Bremen, Institute of Public Health and Nursing Research, Department of Social Epidemiology, Germany.

出版信息

Environ Res. 2023 Sep 15;233:116485. doi: 10.1016/j.envres.2023.116485. Epub 2023 Jun 22.

Abstract

The importance of the social environment and social inequalities in disease etiology is well-known due to the profound research and conceptual framework on social determinants of health. For a long period, in exposome research with its classical orientation towards detrimental health effects of biological, chemical, and physical exposures, this knowledge remained underrepresented. But currently it gains great awareness and calls for innovations in rethinking the role of social environmental health determinants. To fill this gap that exists in terms of the social domain within exposome research, we propose a novel conceptual framework of the Social Exposome, to integrate the social environment in conjunction with the physical environment into the exposome concept. The iterative development process of the Social Exposome was based on a systematic compilation of social exposures in order to achieve a holistic portrayal of the human social environment - including social, psychosocial, socioeconomic, sociodemographic, local, regional, and cultural aspects, at individual and contextual levels. In order to move the Social Exposome beyond a mere compilation of exposures, three core principles are emphasized that underly the interplay of the multitude of exposures: Multidimensionality, Reciprocity, and Timing and continuity. The key focus of the conceptual framework of the Social Exposome is on understanding the underlying mechanisms that translate social exposures into health outcomes. In particular, insights from research on health equity and environmental justice have been incorporated to uncover how social inequalities in health emerge, are maintained, and systematically drive health outcomes. Three transmission pathways are presented: Embodiment, Resilience and Susceptibility or Vulnerability, and Empowerment. The Social Exposome conceptual framework may serve as a strategic map for, both, research and intervention planning, aiming to further explore the impact of the complex social environment and to alter transmission pathways to minimize health risks and health inequalities and to foster equity in health.

摘要

社会环境和社会不平等在疾病病因学中的重要性是众所周知的,这得益于对健康社会决定因素的深入研究和概念框架。在以生物、化学和物理暴露对健康的有害影响为经典取向的暴露组学研究中,长期以来,这些知识一直没有得到充分体现。但目前,它引起了人们的广泛关注,并呼吁在重新思考社会环境健康决定因素的作用方面进行创新。为了填补暴露组学研究中社会领域存在的空白,我们提出了一个新的社会暴露组学概念框架,将社会环境与物理环境结合起来纳入暴露组学概念。社会暴露组学的迭代开发过程是基于对社会暴露的系统编纂,以全面描绘人类社会环境——包括社会、心理社会、社会经济、社会人口统计学、地方、区域和文化方面,在个人和环境层面。为了使社会暴露组学不仅仅是对暴露的简单编纂,我们强调了三个核心原则,这些原则是多种暴露相互作用的基础:多维性、互惠性和时间连续性。社会暴露组学概念框架的关键重点是理解将社会暴露转化为健康结果的潜在机制。特别是,从健康公平和环境正义研究中获得的见解被纳入其中,以揭示健康不平等是如何出现、维持和系统地影响健康结果的。提出了三种传播途径:体现、弹性和易感性或脆弱性以及赋权。社会暴露组学概念框架可以作为研究和干预规划的战略图,旨在进一步探索复杂社会环境的影响,并改变传播途径,以最大限度地降低健康风险和健康不平等,促进健康公平。

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