Interrogating Patterns of Cancer Disparities by Expanding the Social Determinants of Health Framework to Include Biological Pathways of Social Experiences

Valencia, Celina I.; Gachupin, Francine C.; Molina, Yamilé; Batai, Ken

doi:10.3390/ijerph19042455

Cited by 10 publications

(7 citation statements)

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“…This is a critical gap as there is substantial overlap in factors that result in DNAm age acceleration ( 5 ) and breast cancer risk ( 29 ). As a predictor for breast cancer, DNAm has substantial translational applications to address current issues of poor diagnostics and identifying clinical biomarkers of disease ( 22 ) the addition of social factors in the assessments of DNAm and breast cancer risk can provide meaningful insights for curbing patterns of disease disparities ( 30 ).…”

Section: Discussionmentioning

confidence: 99%

DNA methylation accelerated age as captured by epigenetic clocks influences breast cancer risk

et al. 2023

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IntroductionBreast cancer continues to be the leading form of cancer among women in the United States. Additionally, disparities across the breast cancer continuum continue to increase for women of historically marginalized populations. The mechanism driving these trends are unclear, however, accelerated biological age may provide key insights into better understanding these disease patterns. Accelerated age measured by DNA methylation using epigenetic clocks is to date the most robust method for estimating accelerated age. Here we synthesize the existing evidence on epigenetic clocks measurement of DNA methylation based accelerated age and breast cancer outcomes.MethodsOur database searches were conducted from January 2022 to April 2022 and yielded a total of 2,908 articles for consideration. We implemented methods derived from guidance of the PROSPERO Scoping Review Protocol to assess articles in the PubMed database on epigenetic clocks and breast cancer risk.ResultsFive articles were deemed appropriate for inclusion in this review. Ten epigenetic clocks were used across the five articles demonstrating statistically significant results for breast cancer risk. DNA methylation accelerated age varied by sample type. The studies did not consider social factors or epidemiological risk factors. The studies lacked representation of ancestrally diverse populations.DiscussionDNA methylation based accelerated age as captured by epigenetic clocks has a statistically significant associative relationship with breast cancer risk, however, important social factors that contribute to patterns of methylation were not comprehensively considered in the available literature. More research is needed on DNA methylation based accelerated age across the lifespan including during menopausal transition and in diverse populations. This review demonstrates that DNA methylation accelerated age may provide key insights for tackling increasing rates of U.S. breast cancer incidence and overall disease disparities experienced by women from minoritized backgrounds.

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Section: Discussionmentioning

confidence: 99%

DNA methylation accelerated age as captured by epigenetic clocks influences breast cancer risk

et al. 2023

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“…Here, we will not explore genetic ancestry, deoxyribonucleic acid (DNA) variants, but focus our disparities discussion on the social construct of race or social and self-assigned categories [12]. However, there is a growing area of science seeking to understand the mechanisms by which one's lived environment and socioeconomic circumstances act on biologic systems [13,14]. Future conceptual models of the SSODH will likely be expanded in scope and include an integration of biological pathways.…”

Section: Definitions and Conceptual Frameworkmentioning

confidence: 99%

The Impact of Racial Disparities on Liver Disease Access and Outcomes

Nephew

Aitcheson

Iyengar

2022

Curr Treat Options Gastro

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Purpose of Review We aim to review 1) the changing epidemiology of liver disease and the impact that systematic differences in the opportunities for ethnic and racial minorities to gain access to care have had on mortality and 2) community interventions aimed at reducing disparities. Recent Findings There continues to be disparities in acute/chronic viral hepatitis. The success of the campaign to eliminate viral hepatitis depends on innovative initiatives like home-based screening in highest risk communities and improved access to treatment. We describe increasing rates of high-risk drinking and a need for culturally tailored treatment. We discuss rising rates of non-alcohol associated fatty liver disease and the need for improved education of patients and providers. Data on disparities in mortality in cholestatic liver diseases are emerging; qualitative data on barriers to care are needed. Summary Understanding racial disparities in liver disease is only the first step. Achieving health equity will take innovative initiatives. Publisher's NoteSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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“…While economic, social, and environmental factors influence cardiometabolic health, extensive evidence demonstrates the impact of racism on hypertension and diabetes outcomes (Bell, Thorpe, Bowie, & LaVeist, 2018; Crear‐Perry et al., 2021; Gaskin et al., 2014; Jilani et al., 2021; Lindley et al., 2021). Physiologic pathologies associated with SDOH factors, chronic stress, and subsequent adaptive inflammatory processes contribute to these well‐documented racial disparities in age‐associated cardiometabolic and cancer outcomes, which are discussed below (Noren Hooten, Pacheco, Smith, & Evans, 2022; Valencia, Gachupin, Molina, & Batai, 2022; Wright, Eddy, & Kent, 2020). Structural and social risk factors increase risk for chronic health conditions and, simultaneously, the financial burden of medical care to manage these conditions.…”

Section: Health Outcomes Associated With Sdoh Exposuresmentioning

confidence: 99%

Inclusion of Social and Structural Determinants of Health to Advance Understanding of their Influence on the Biology of Chronic Disease

et al. 2022

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Social Determinants of Health (SDOH) consider social, political, and economic factors that contribute to health disparities in patients and populations. The most common health-related SDOH exposures are food and housing insecurity, financial instability, transportation needs, low levels of education, and psychosocial stress. These domains describe risks that can impact health outcomes more than health care. Epidemiologic and translational research demonstrates that SDOH factors represent exposures that predict harm and impact the health of individuals. International and national guidelines urge health professionals to address SDOH in clinical practice and public health. The further implementation of these recommendations into basic and translational research, however, is lagging. Herein, we consider a precision health framework to describe how SDOH contributes to the exposome and exacerbates physiologic pathways that lead to chronic disease. SDOH factors are associated with various forms of stressors that impact physiological processes through epigenetic, inflammatory, and redox regulation. Many SDOH exposures may add to or potentiate the pathologic effects of additional environmental exposures. This overview aims to inform basic life science and translational researchers about SDOH exposures that can confound associations between classic biomedical determinants of disease and health outcomes. To advance the study of toxicology through either qualitative or quantitative assessment of exposures to chemical and biological substances, a more complete environmental evaluation should include SDOH exposures. We discuss common approaches to measure SDOH factors at individual and population levels and review the associations between SDOH risk factors and physiologic mechanisms that influence chronic disease. We provide clinical and policy-based motivation to encourage researchers to consider the impact of SDOH exposures on study results and data interpretation. With valid measures of SDOH factors incorporated into study design and analyses, future toxicological research may contribute to an evidence base that can better inform prevention and treatment options, to improve equitable clinical care and population health.

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Interrogating Patterns of Cancer Disparities by Expanding the Social Determinants of Health Framework to Include Biological Pathways of Social Experiences

Cited by 10 publications

References 108 publications

DNA methylation accelerated age as captured by epigenetic clocks influences breast cancer risk

DNA methylation accelerated age as captured by epigenetic clocks influences breast cancer risk

The Impact of Racial Disparities on Liver Disease Access and Outcomes

Inclusion of Social and Structural Determinants of Health to Advance Understanding of their Influence on the Biology of Chronic Disease

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