Social Genomics as a Framework for Understanding Health Disparities Among Adolescent and Young Adult Cancer Survivors: A Commentary

Abstract

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Disparities in cancer care among sexual and gender minority adolescent and young adult patients: A scoping review

“…Further research is needed to develop necessary interventions to alleviate the lifelong impacts of stress processes (e.g., experience of prejudice, expectations of rejection, internalized homophobia) on SGM AYA psychosocial outcomes during and after treatment. A social genomics approach to minority stress among SGM AYAs is needed to further understand the relationship between social determinants of health and cancer's biologic mechanisms 46 . The social determinants of health are defined as the economic, education, healthcare access, built environment, and social conditions in which people live and have been identified as widely contributing to health disparities and inequities 47…”

“…A social genomics approach to minority stress among SGM AYAs is needed to further understand the relationship between social determinants of health and cancer's biologic mechanisms. 46 The social determinants of health are defined as the economic, education, healthcare access, built environment, and social conditions in which people live and have been identified as widely contributing to health disparities and inequities. 47 The finding that SGM survivors reported a lack of social support, experiences of isolation or disconnection, and poorer QOL is consistent with literature that demonstrates a lack of appropriate formalized support for SGM AYAs.…”

Fostering resilience in adolescence and young adulthood: Considerations for evidence‐based, patient‐centered oncology care

“…Indeed, social determinants of health, such as financial and insurance status, household material hardship, poverty, access to care, and histories of discrimination and marginalization, can all exacerbate stress and push corresponding appraisals toward a negative valence. 48,49 Failing to recognize the 50 In this framework, shifting describes accepting and adjusting oneself to stressors that occur in daily life, and persisting emphasizes enduring adversity by developing purpose in life and holding onto hope. Studies in mixed cultures emphasize the importance of meaning-making (or the ability to hold onto a sense of hope that life makes sense in the midst of stress, worry, and despair) as one of the single-most universal resilience resources.…”

“…This becomes important when access to resilience resources itself is a challenge. Indeed, social determinants of health, such as financial and insurance status, household material hardship, poverty, access to care, and histories of discrimination and marginalization, can all exacerbate stress and push corresponding appraisals toward a negative valence 48,49 . Failing to recognize the impact of these social determinants of health on person‐centered outcomes thus can undermine resilience.…”

How cy pres promotes transdisciplinary convergence science: an academic health center for women’s cardiovascular and brain health

“…Thus, the physiologic dysregulation accompanying socially determined lifestyles that contribute to the metabolic syndrome, a known risk factor with consequences for both CVD and dementia [ 39 , 40 ], can be linked directly to changes at the molecular level. Furthermore, research in human social genomics has begun to identify molecular pathways through which SDoH, like psychological factors and characteristics of one’s social environment, can regulate expression of genes in immune cells and consequently affect chronic disease progression, symptom development, treatment resistance, morbidity, and mortality [ 41 , 42 ]. These findings present a background for reducing social disparities in health by mitigating molecular risk changes before they develop into diseases, such as by interventions that seek to alter social contexts, behavioral, or family environments in early life.…”