Read on Twitter
In our research team we work on understanding how #HealthInequalities are constructed
We've heard about Black and ethnic minority populations having worse health outcomes, as well as socially disadvantaged people
But HOW do these health inequalities come to be?
[thread]
We've heard about Black and ethnic minority populations having worse health outcomes, as well as socially disadvantaged people
But HOW do these health inequalities come to be?
[thread]
Population health inequalities are partly produced through social-to-biological processes.
One set of processes involved: the long term physiological effects of stressful life conditions. The stress response system keeps us alive & well living within a complex environment
One set of processes involved: the long term physiological effects of stressful life conditions. The stress response system keeps us alive & well living within a complex environment
The continuous experience of stressful conditions, including "microaggressions" because of discrimination, financial strain, harassment etc means we are repeatedly soliciting our physiological stress response & engaging the HPA & sympathetic nervous system https://www.ncbi.nlm.nih.gov/books/NBK541120/#:~:text=Physiologic%20responses%20to%20stress%20are,serve%20to%20attenuate%20further%20tissue
Over time, this repeated activation of the stress response system takes its toll on our physiology. Our physiological systems can then become dysregulated. This has been referred to as 'allostatic load', or multi-system physiological wear & tear
https://www.nejm.org/doi/full/10.1056/NEJM199801153380307
https://www.nejm.org/doi/full/10.1056/NEJM199801153380307
Chronic physiological stress is associated with a downregulation of the immune system, immunosuppression. This may lead to our bodies being less capable of fighting infection or dealing with the appearance of tumour cells https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361287/
Many studies have shown that multi-system wear & tear is associated with worse health outcomes & premature mortality. Here's one by my colleague Dr. R. Castagné, pointing towards the inflammatory system having a driving role:
https://link.springer.com/article/10.1007/s10654-018-0364-1
https://link.springer.com/article/10.1007/s10654-018-0364-1
Discriminations such as racism, which are structured into the daily experiences of People of Colour, may lead to differential stress responses among affected populations: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5374002/#!po=45.6522
Some evidence for racial discrimination being associated with cardiometabolic outcomes through biomarkers among Australian children by @naomi_priest @mandy_tru et al https://www.sciencedirect.com/science/article/pii/S0889159119314977?casa_token=IaLl9oqbeyIAAAAA:RyXjY5roCTHVCfw6Rbsw4xnyXvXn-pmTeAp4053GTkTOjlqmppUuz4-w26FzrD0iyrPLjkIz8Ao
Working with stress biomarkers in humans is extremely challenging. We sometimes also look to the literature from biology & animal models. Scientists like @LupienSonia & her team conduct work on the effects of everyday life stressors & biology: https://humanstress.ca/our-impact/stress-in-everyday-life/
This starts to helps us *understand* some of the ways in which structural & social determinants affect health...
But where does this leave us if we want to *redress* #HealthInequalities?
But where does this leave us if we want to *redress* #HealthInequalities?
To start addressing #HealthInequalities we need to look at the society we've built & how to change it. We need to fight racism & all discriminations as a #PublicHealth priority
We need primordial prevention & health promotion across all policies as well as universal health care
We need primordial prevention & health promotion across all policies as well as universal health care
