Advancing Health Disparities Science Through Social Epigenomics Research.

Although scientific and technological discoveries have improved the health of the US population overall, racial and ethnic minority (American Indian and Alaska Native, Asian, Black or African American, Hispanic or Latino, or Native Hawaiian and Pacific Islander persons) and socioeconomically disadvantaged populations continue to experience a disproportionate burden of disease and other adverse health conditions. To better understand and address the drivers of health disparities and inform the development of effective interventions, integrative mechanistic studies examining the dynamic interplay of multiple factors across the life course and even between generations are needed. The emerging field of social epigenomics, which seeks to link social stressors and protective factors to health status through the examination of epigenomic modifications of various biological pathways, is one promising area of research contributing to this need. This thematic issue of JAMA Network Open highlights new findings from the grantees of the National Institutes of Health (NIH) Social Epigenomics Program. These findings, taken together, examine the associations of a variety of social, behavioral, and structural factors throughout the life course with epigenomic and other biological changes among populations experiencing health disparities. The studies link early-life exposures, structural inequities, and behavioral factors and interventions to epigenetic changes, and in some studies, later health outcomes. While there is still more work to be done to fully characterize the mechanistic pathways linking social exposures to epigenetic changes and health outcomes, the body of work presented in this special issue represents solid progress toward this goal. The studies highlighted in this special issue demonstrate important scientific progress in the complex integration of social determinants of health and health disparities with biological pathways and health outcomes to improve understanding of the mechanisms underlying health disparities among various underserved populations. Continued progress remains important in integrating different disciplines to transform the field of health disparities research.