Biological Embedding of Social Factors: Epigenetic Processes and Health Inequalities

Biological, psychological and social processes interact over a lifetime to influence health and vulnerability to disease. A wealth of epidemiological data has documented the relationship between socioeconomic status (SES) and health, with low SES groups fairing poorest across multiple outcome measures. Using new methodologies, recent work exploring molecular epigenetic mechanisms of gene expression (in humans as well as other comparative mammalian systems) has provided us with evidence demonstrating that the genome is subject to regulation by surrounding contexts (e.g., cytoplasmic, cellular, organismic, social). I will present data demonstrating that organisms with identical genomes are capable of manifesting dramatically different phenotypic profiles in response to different environmental conditions and experiences. Old assumptions about an inert genome are simply incorrect. It appears that these epigenetic processes may be the missing link which will allow us to understand how social and political conditions, along with individual subjective experiences, can directly alter gene expression, and thereby contribute to observed social inequalities in health. The very recent and powerful new results demonstrating that the epigenome is subject to environmental regulation may provide the direct link between the biological and social/psychological worlds. I suggest that new methods in molecular biology and gene regulation will play a profound role in how we currently conceptualize health inequalities, by informing our concepts regarding the somatization or embodiment of social inequalities.