Systemic racism can get under our skin and into our genes

Mulligan, Connie J.

doi:10.1002/ajpa.24290

Cited by 26 publications

(18 citation statements)

References 71 publications

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“…While some commentaries and discussions about the exposome have grown to acknowledge many of the factors that the Roadshow communities experience, the methods used to measure these factors rarely capture the specific exposures detailed in the communities' concept maps. Although biomarkers of stress and discrimination, including epigenetic changes, have been documented and are available for incorporation into exposome science ( 63 – 65 ), the operationalization of these factors and the methods to study their cumulative impact have not been routinely incorporated into exposome science. Relevant to Rappaport's ( 2 ) critique of traditional environmental and epidemiological methods that fragment environmental risks, these communities experience multiple types of environmental exposures collectively, and we need to study them as such.…”

Section: Discussionmentioning

confidence: 99%

Defining the Exposome Using Popular Education and Concept Mapping With Communities in Atlanta, Georgia

Lebow-Skelley

Young

Noibi

et al. 2022

Front. Public Health

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IntroductionThe exposome concept provides a framework to better incorporate the environment into the study of health and disease and has been defined by academics to encompass all lifetime exposures including toxicants, diet, and lifestyle choices. However, initial applications of the exposome concept have been less apt at measuring social determinants of health, focusing primarily on conventional environmental exposures and lifestyle choices that do not reflect the complex lived experience of many communities. To bring community voice into the exposome concept, the HERCULES Exposome Research Center and its Stakeholder Advisory Board co-developed the Exposome Roadshow. We present and discuss the resulting community-exposome definition to inform and improve exposome research.Materials and MethodsFour communities from distinct areas across metro-Atlanta participated in separate 2-day Exposome Roadshow workshops with concept mapping. Aligned with a popular education approach in which community knowledge is used to work collectively for change, concept mapping provided a systematic method to collect and visualize community members' knowledge and create a shared understanding to take action. Community members brainstormed, sorted, and rated their responses to the prompt: “What in your environment is affecting your and your community's health?” Responses were analyzed and visually depicted by concept maps consisting of separate but interrelated clusters of ideas. Community members discussed and validated the maps, selecting a final map illustrating their community's exposome.ResultsA total of 118 community members completed concept mapping. On average communities identified 7 clusters to define their exposome. The resulting concept maps offer a community definition of the exposome. Five major themes arose across all four communities: conventional environmental concerns, built environment, social relationships, crime and safety, and individual health and behaviors.DiscussionThe resulting community-exposome definition demonstrates the importance of expanding the scope of exposures beyond traditional environmental influences to include the lived experience of individuals and communities. While newer exposome definitions align more closely with this community definition, traditional exposome methods do not routinely include these factors. To truly capture the totality of lifetime exposures and improve human health, researchers should incorporate community perspectives into exposome research.

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Section: Discussionmentioning

confidence: 99%

Defining the Exposome Using Popular Education and Concept Mapping With Communities in Atlanta, Georgia

Lebow-Skelley

Young

Noibi

et al. 2022

Front. Public Health

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“…In addition to disadvantages within the physical environment, racially minoritized individuals also experience more psychosocial stressors, such as racism, discrimination, and acculturation stress, which shape social settings and experience in their developmental niche [ 104 , 105 ]. The weathering hypothesis posits that health disparities among racially minoritized groups are consequences of these cumulative daily stressors, which cause “wear and tear” on health throughout the life course [ 100 , 106 ].…”

Section: Current State Of Dnam Research In the Context Of Race Ethnic...mentioning

confidence: 99%

An integrative framework and recommendations for the study of DNA methylation in the context of race and ethnicity

Chan

Merrill

Konwar

et al. 2023

Discov Soc Sci Health

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Human social epigenomics research is critical to elucidate the intersection of social and genetic influences underlying racial and ethnic differences in health and development. However, this field faces major challenges in both methodology and interpretation with regard to disentangling confounded social and biological aspects of race and ethnicity. To address these challenges, we discuss how these constructs have been approached in the past and how to move forward in studying DNA methylation (DNAm), one of the best-characterized epigenetic marks in humans, in a responsible and appropriately nuanced manner. We highlight self-reported racial and ethnic identity as the primary measure in this field, and discuss its implications in DNAm research. Racial and ethnic identity reflects the biological embedding of an individual’s sociocultural experience and environmental exposures in combination with the underlying genetic architecture of the human population (i.e., genetic ancestry). Our integrative framework demonstrates how to examine DNAm in the context of race and ethnicity, while considering both intrinsic factors—including genetic ancestry—and extrinsic factors—including structural and sociocultural environment and developmental niches—when focusing on early-life experience. We reviewed DNAm research in relation to health disparities given its relevance to race and ethnicity as social constructs. Here, we provide recommendations for the study of DNAm addressing racial and ethnic differences, such as explicitly acknowledging the self-reported nature of racial and ethnic identity, empirically examining the effects of genetic variants and accounting for genetic ancestry, and investigating race-related and culturally regulated environmental exposures and experiences.

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“…In like manner, one should not presume that clinical medicine can do without race. For again, only other-or self-identified race grants clinicians epistemic access to the aetiology of the disease inasmuch as it depends on experienced racism or the epigenetic effects of racism as experienced by one's ancestors [66][67][68][69]. Certainly, one must eliminate race from clinical settings in all those circumstances in which its use is only functional to reinforce health inequities and is grounded on false ideas about genetic and even hierarchical differences among human groups -as it is the case in most, if not all, race-adjusting clinical care guidelines used and recommended so far.…”

Section: Why Race Should Not Be Eliminated From All Medical Discoursementioning

confidence: 99%

The indispensability of race in medicine

Lorusso

Bacchini

2023

Theor Med Bioeth

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A movement asking to take race out of medicine is growing in the US. While we agree with the necessity to get rid of flawed assumptions about biological race that pervade automatic race correction in medical algorithms, we urge caution about insisting on a blanket eliminativism about race in medicine. If we look at racism as a fundamental cause, in the sense that this notion has been introduced in epidemiological studies by Bruce Link and Jo Phelan, we must conclude that race is indispensable to consider, investigate, and denounce the health effects of multilevel racism, and cannot be eliminated by addressing more specific risk factors in socially responsible epidemiology and clinical medicine. This does not mean that realism about human races is vindicated. While maintaining that there are no human races, we show how it is that a non-referring concept can nonetheless turn out indispensable for explaining real phenomena.

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Systemic racism can get under our skin and into our genes

Cited by 26 publications

References 71 publications

Defining the Exposome Using Popular Education and Concept Mapping With Communities in Atlanta, Georgia

Defining the Exposome Using Popular Education and Concept Mapping With Communities in Atlanta, Georgia

An integrative framework and recommendations for the study of DNA methylation in the context of race and ethnicity

The indispensability of race in medicine

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