Exposome and Social Vulnerability: An Overview of the Literature Review

Abstract

Background—The exposome concept refers to the totality of exposures from internal and external sources, including chemical and biological agents from conception throughout the lifetime. Exposome is also made up of psychosocial components such as socio-economic status (SES), which will focus on in this review. Despite exposures to the same environmental nuisances, individuals and groups are impacted differently. According to the literature, health inequalities exist among different socioeconomic groups, and SES may influence the association between environmental nuisances and health outcomes. However, the variation of this interaction across ages has rarely been studied. There is a need to adopt a life course approach to understand the history of diseases better. Objective—The main objective of this review is to document how SES could modify the association between environmental nuisances and health outcomes, across different ages, as a first crucial step introducing the emerged concept of social exposome. Methods—The PubMed database was searched from January 2010 to August 2021 for systematic reviews published in English addressing the interaction between SES, environmental nuisances, and health outcomes. Socio-economic indicators considered include education, level of income, neighborhood environment. Environmental nuisances considered many environment nuisances, mainly air pollution and noise. Results—Among 242 literature reviews identified, 11 of them address the question of the effect modification. Overall, our work reveals that environmental nuisances were mostly associated with poorer health outcomes and that SES modified this association, increasing the health risk among the poorest. Very interestingly, our work reports the existence of this interaction across different ages, including pregnancy, childhood, and adulthood, and for various environmental nuisances. Conclusion—In conclusion, our work confirms that we are not all equal to face environmental nuisances. The poorest are more vulnerable to the health effect of environmental nuisances. Policy decisions and interventions should target this high-risk population as a priority. Further investigations are needed to formalize the concept of social exposome more precisely and then communicate about it.

Associations of Adolescence Exposure to Industrial Air Pollution with Cancer in Young Adults

“…This is consistent with other examples of effect modification of environmental factors by SES, such as in the cases of ambient temperature and nonaccidental mortality or ozone and childhood respiratory disease . In both of these examples and many others, lower SES populations are found to be more vulnerable to environmental effects . The reasons for this phenomenon may include interactions of the environmental agent with additional exposures (such as diet and physical activity) and reduced use of preventive health services due to limited accessibility or awareness.…”

Interdisciplinary fetal-neonatal neurology training applies neural exposome perspectives to neurology principles and practice

“…TSI continues to threaten MPF triad health during each pregnancy. A social exposome introduces vulnerabilities to individuals and populations who experience health disparities, resulting in reduced health outcomes across all stages of life ( 34 ).…”

The Neighborhood as Social Exposome: Black Mothers’ Narratives of Chronic Stress as a Consequence of Living in Racially Hypersegregated Neighborhoods on the South Side of Chicago

“…However, scholars are expanding this perspective to explore how social experiences can also materialize in the body in the form of adverse mental and physical health outcomes [18]. These exposures can include psychosocial characteristics, with unequal impact across individual and groups [19]. However, some scholars have found it challenging to engage the exposome framework to understand differential imprinting across conditions of socioeconomic and sociopolitical inequalities, and their impacts on health and biological development [20].…”