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This study examined how social determinants of health affect gut microbiome composition in 131 residents of two low-resource, flood-prone U.S. communities. Using structural equation modeling, researchers found that education level positively influenced microbiome diversity, with effects partially mediated through income and diet. Unexpectedly, higher consumption of processed and fried foods correlated with increased microbial diversity, which the authors suggest may reflect environmental factors like pathogen exposure from flooding rather than diet quality alone.
Why it matters
The findings demonstrate that structural inequalities in education, income, and food access may become biologically embedded through changes to the gut microbiome, which affects disease risk. This suggests public health interventions should address infrastructure and environmental racism rather than focusing solely on individual behavior change, especially in communities facing environmental hazards.
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⚠️ Preprint – Noch nicht peer-reviewed
Dieser Artikel wurde noch nicht von unabhängigen Experten begutachtet. Die Ergebnisse sind vorläufig und sollten mit Vorsicht interpretiert werden.
The gut microbiome influences cardiovascular and gastrointestinal disease risk, yet the indirect pathways through which structural social determinants of health (SDoH) shape microbial composition remain understudied. We investigated causal pathways linking SDoH – systemic conditions that shape health opportunities – to the gut microbiome in two low-resource, flood-prone U.S. communities. We collected questionnaires, dried blood spots, and fecal samples (n=131; ages 3-79) in Mississippi and Illinois (2022-2023) as part of a longitudinal project on infrastructure and health, identifying bacterial composition via 16S rRNA sequencing. Controlling for covariates, structural equation modeling showed education positively predicted microbiome richness and evenness, partially mediated through income and diet. This suggests that structural inequities in education, food access, and income significantly influence the microbiome. Notably, contrary to established literature, greater consumption of processed and fried foods was associated with increased alpha diversity. Therefore, in this context, diet may covary with environmental vulnerability, such as opportunistic pathogen exposure from frequent flooding. Analysis of beta diversity showed direct effects from education, diet, and CRP; income and homeownership had indirect effects mediated through diet. The taxa driving these relationships likely include Tannerellaceae for diet and a subgroup of Firmicutes for income, based on our differential abundance analysis. These findings indicate that pathways linking SDoH to the microbiome may vary by local infrastructure and environmental context. This research highlights how structural inequality may be biologically embedded, suggesting that public health interventions should target infrastructural inequities linked with environmental racism, rather than individual behavioral change.