Understanding Health Inequalities Through the Lens of Social Epigenetics

Annu Rev Public Health. 2022 Apr 5:43:235-254. doi: 10.1146/annurev-publhealth-052020-105613.

Abstract

Longstanding racial/ethnic inequalities in morbidity and mortality persist in the United States. Although the determinants of health inequalities are complex, social and structural factors produced by inequitable and racialized systems are recognized as contributing sources. Social epigenetics is an emerging area of research that aims to uncover biological pathways through which social experiences affect health outcomes. A growing body of literature links adverse social exposures to epigenetic mechanisms, namely DNA methylation, offering a plausible pathway through which health inequalities may arise. This review provides an overview of social epigenetics and highlights existing literature linking social exposures-i.e., psychosocial stressors, racism, discrimination, socioeconomic position, and neighborhood social environment-to DNA methylation in humans. We conclude with a discussion of social epigenetics as a mechanistic link to health inequalities and provide suggestions for future social epigenetics research on health inequalities.

Keywords: DNA methylation; epigenetic mechanisms; health inequalities; psychosocial stressors; racism; socioeconomic disadvantage.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • DNA Methylation
  • Epigenesis, Genetic
  • Epigenomics*
  • Health Status Disparities*
  • Humans
  • Racial Groups
  • United States