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Framework for understanding health inequalities over the life course: the embodiment dynamic and biological mechanisms of exogenous and endogenous origin
  1. Michelle Kelly-Irving1,2,
  2. Cyrille Delpierre1
  1. 1 Center for Epidemiology and Research in POPulation health (CERPOP), Université de Toulouse, Inserm, Université Toulouse III Paul Sabatier, Toulouse, France
  2. 2 Iferiss-Fed 4241, Université Toulouse III Paul Sabatier, Toulouse, France
  1. Correspondence to Dr Michelle Kelly-Irving, Center for Epidemiology and Research in POPulation health (CERPOP), Faculté de médecine, 37 allées Jules Guesde, 31062 Toulouse, Occitanie, France; michelle.kelly{at}inserm.fr

Abstract

Understanding how structural, social and psychosocial factors come to affect our health resulting in health inequalities is more relevant now than ever as trends in mortality gaps between rich and poor appear to have widened over the past decades. To move beyond description, we need to hypothesise about how structural and social factors may cause health outcomes. In this paper, we examine the construction of health over the life course through the lens of influential theoretical work. Based on concepts developed by scholars from different disciplines, we propose a novel framework for research on social-to-biological processes which may be important contributors to health inequalities. We define two broad sets of mechanisms that may help understand how socially structured exposures become embodied: mechanisms of exogenous and endogenous origin. We describe the embodiment dynamic framework, its uses and how it may be combined with an intersectional approach to examine how intermeshed oppressions affect social exposures which may be expressed biologically. We explain the usefulness of this framework as a tool for carrying out research and providing scientific evidence to challenge genetic essentialism, often used to dismiss social inequalities in health.

  • health inequalities
  • social and life-course epidemiology
  • social inequalities

Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study. No data are relevant to this paper.

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Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study. No data are relevant to this paper.

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Footnotes

  • Twitter @shell_ki

  • Contributors MK-I conceived designed, drafted and edited the manuscript. CD designed and edited the manuscript.

  • Funding MK-I receives funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (grant agreement No. [856 478]).

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

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