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Biological Pathways Linking Social Determinants to Health

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Understanding Health Determinants

Abstract

This book reviews theoretical explanations for how social circumstances ultimately affect health and longevity. The final step in the causal chain, addressed in this chapter, involves understanding how biological systems respond to the influence of social determinants, triggering disease processes. The chapter opens with a discussion of the central role of the brain and the limbic system in interpreting and responding to challenges. It describes how brain circuits that fire repeatedly tend to become the default setting, with lasting effects on health over the life course. The physiological responses involve the endocrine, nervous, and immune systems, and the key mechanisms are summarized. In particular, the stress response and chronic inflammation form key pathways that link social determinants to adverse health outcomes, and this chapter describes the ways in which these vary by socioeconomic status. Genetic and epigenetic mechanisms that explain individual susceptibility are described. This chapter closes with a discussion of the concept of embodiment as a summary of how external influences ‘get under the skin.’

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Notes

  1. 1.

    The prefix ‘sym-’ is a Latinized form of the Greek συμ. Like ‘syn’ or συν, it means with, together, or alike. The ‘sym’ form is used before labials (letters formed with the lips such as p, b, m, f, v). The suffix ‘-pathetic’ comes from Greek pathos (παθος) and refers to feeling, suffering, or disease. ‘Para-’ (παρα) means beside or beyond. ‘Sympathetic’ alludes to the idea that this branch reacts to feelings of threat, whereas the ‘para’ counteracts such feelings.

  2. 2.

    Genetic variance is an estimate of how much of the variation in a phenotype is attributable to genetic variation.

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    Ian McDowell

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McDowell, I. (2023). Biological Pathways Linking Social Determinants to Health. In: Understanding Health Determinants. Springer, Cham. https://doi.org/10.1007/978-3-031-28986-6_4

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