Background and Rationale

The importance of social, economic, cultural, and environmental factors for driving and sustaining health disparities is increasingly recognized. The World Health Organization identifies the social determinants of health (SDH) as the circumstances in which people are born, grow up, live, work, and age. These circumstances are shaped by social and economic policies, the distribution of power and resources, schooling and education, and other overarching fundamental factors.

In addressing the social determinants that drive and sustain disparities in obesity and chronic illness, we take a life-course approach, which pinpoints critical periods in a person’s life course, such as pre-natal period and infancy, childhood, and advanced age, when social context may be more salient in the way it affects physiology or shapes health behavior. When studying these critical periods, we use cross-sectional analyses informed by the social-environmental model and focusing on the relationship between social factors and health at a single point in time. At the same time, to test if certain social determinants have contemporaneous, lagged, or cumulative effects on health, we utilize longitudinal analyses, which allows us to examine the impact of social determinants on disease etiology and management over the entire life span.

Why the Mid-South?
Gaps in health outcomes exist between the general population and groups of people who experience systematic obstacles to health. Nowhere are such health gaps more evident than in the Mid-South, home to some of America's poorest communities.
The Interplay Between Social Determinants, Biology, and Behavio

Biomedical research has traditionally focused on how physiological processes affect health, while public health research has emphasized how the behavioral characteristics of individuals affect health. However, the social contexts in which people are born and live are also important – if not most important – for shaping health. In fact, they impact both the physiological processes and the health behavior of individuals.

In exploring the social factors responsible for the differential health outcomes of minority populations as far as obesity and chronic diseases are concerned, the Mid-South TCC promotes an integrative approach that accounts for multiple simultaneous forms of disease causation, including fundamental social factors as well as behavioral and biological factors. The complex interplay of socio-environmental, behavioral, and bio-physiological influences involved in the etiology, management, and amelioration of obesity and chronic diseases cannot be underestimated. This transdisciplinary collaboration among multi-sector experts and stakeholders studies the pathways to racial/ethnic disparities in obesity and chronic diseases. Such integrative approach is the only feasible strategy for understanding how risk of disease is differentially acquired and manifested over the life course.

The Mid-South TCC aims to bridge biomedical and sociological research in a translational effort to bring the biological mechanisms discussion to a social-contextual level, with the ultimate goal of informing policy decisions on an ecological level. By understanding how social factors affect multiple physiological systems, we can identify key intervention points to bolster protection and can also determine which specific interventions and treatments are most effective for vulnerable populations such as racial/ethnic minorities.

circleSuch integrative approach, promoted by the World Health Organization’s Commission on the Social Determinants of Health, recognizes that health disparities arise from the conditions in which people are born, grow, live, work, and age, referred to as SDH, a term encompassing the social, economic, political, cultural, and environmental factors that impact a person’s health.

The Mid-South TCC proposes to address the social, economic, cultural, and environmental factors that interplay to impact a person’s health and produce disparate health outcomes in minority populations.

The specific focus is on pathways to obesity and chronic illness and the mechanisms connecting these pathways to health disparities throughout the life-course.