- People who belong to historically marginalized groups — whether based on race, gender, or sexual identity — are at increased risk of several worse health consequences.
- The community of microbes in the gut or intestinal microbiome is sensitive to many environmental factors and contributes to shaping health. It can therefore play a role in these disparities.
- In a leading journal, scientists have called for more research to break up this complex relationship.
- They believe that a better understanding of the effects of the gut microbiome on the health of underage populations can lead to targeted treatments to restore balance.
The communities of bacteria, fungi and viruses that live in our intestines and are known together as the gut microbiome have a wide range of effects on health. For example, they can protect the intestines from colonization by pathogens, reduce inflammation, and even affect brain function.
A group of scientists led by Northwestern University in Evanston, IL, is calling for more research on possible links between the gut microbiome of underage populations and poorer health.
In an opinion piece in Proceedings of the National Academy of Sciences, they argue that the gut microbiome could respond to and help perpetuate structural inequalities caused by racism and other forms of discrimination.
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High levels of stress and poor sleep quality as a result of discrimination, for example, can alter the intestinal microbiome in a way that is harmful to health.
In addition, researchers already know that environmental factors associated with lower socio-economic status affect the composition and diversity of the gut microbiome.
These factors include:
- more caesarean delivery
- Fewer breast-feeding of infants
- a less healthy diet
- excessive use of antibiotics
- poor access to green spaces
“Because the environments that influence the composition of the [gut microbiome] can be modified, the [gut microbiome]] is an important tool for reducing the effects of structural inequalities and their downstream health consequences,” the authors write.
Health in underage populations
The scientists also find that race, sexual identity, and gender status are significant predictors of many health outcomes.
For example, non-Hispanic black adults are 1.6 times more likely to receive a diabetes diagnosis after taking their socio-economic status into account than non-Hispanic white adults.
According to an older report, gay, lesbian, and bisexual people are up to twice as likely as straight people to report substance abuse, poor mental health, and smoking.
The authors argue that differences in their gut microbiome may mediate some health inequalities in minority groups.
“Research has linked the microbiome in most chronic diseases, and we know that there are differences in most chronic diseases where higher morbidity is observed in underage populations,” says lead author Katherine Amato, Ph.D., assistant professor of anthropology at Weinberg College of Arts and Sciences in Northwestern.
She and her co-authors cite evidence that socioeconomic status has associations with different characteristics of the gut microbiome in both adults and children.
For example, a small study of 44 people in Chicago, IL, found that socio-economic status was up to 22% of the differences from person to person in the diversity of gut microbiome composition in adults.
A larger study in the UK that compared identical twins with different socio-economic statuses to account for genetic and familial influences also found that people with lower socio-economic status had a less diverse intestinal microbiota.
The authors of the new opinion article come to the conclusion:
“Existing literature shows that the same social gradients that predict disparities in key disease classes also predict variations in the [gut microbiome]. These relationships underline the likely role of the [gut microbiome] in mediating social health inequalities.”
However, they stress that so far only a few studies have investigated how structural inequalities affect the gut microbiome and health, or how the balance can be restored.
Stable and resilient gut microbiomes
“biomedical” approaches to improve the intestinal microbiota of underage populations could include prebiotics, probiotics, and stool transplants.
However, the authors also recommend “ecological” approaches to create stable and resilient intestinal microbiota communities.
For example, Prof. Amato told Medical News Today that there is some evidence that minority children are being prescribed more antibiotics, even though the picture is complex.
Lack of access to healthcare can result in reduced prevention, more serious illnesses, and an increased need for antibiotics due to worse infections or health-related procedures such as surgery, she said.
other hand, other studies suggest that populations with good access to healthcare may receive more antibiotic prescriptions for minor illnesses.
“A stronger prescription of antibiotics for infants and children of minority families could therefore explain some of the observed differences in microbiomes between populations, but it will depend on the specific patterns of health use observed in communities,” she said.
“We need more data to better understand these dynamics,” she added.
The importance of breastfeeding
Prof. Amato also advocated carefully tailored measures that promote exposure of infants and children to microbes that help them build strong and healthy skin. intestinal microbiome.
“It has been shown that children who are exposed to soil and plants during their time outdoors at school have more diverse microbiomes and better markers of immune function. So it may not just be about building a playground in a neighborhood, but building it with the right materials,” she said.
In the United States, she found that many employers had clarified guidelines to give mothers space to pump breast milk at work. However, it can have unintended consequences for the intestinal microbiome of infants.
“While this allows mothers to meet infants’ nutritional needs, it ignores the fact that breastfeeding promotes skin-to-skin contact, which facilitates microbial transfer from mother to child,” she said.
“Breast milk itself is also an important source of microbes and “microbial food” or oligosaccharides for infants, and we don’t know how storing breast milk affects their microbial properties.”
She and her co-authors believe that future research should aim to carry out environmental interventions and develop therapies to restore and improve the microbiome of minority populations.
Of course, trying to mitigate the effects of discrimination by understanding these connections is crucial. However, it does not undermine efforts to combat the underlying structural discrimination, which affects not only the gut microbiome but also the entire person, their wider community and society as a whole.