Dr. Elissa Epel: "How Our Environment Gets Under Our Skin"
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This document discusses how social stress from factors like neighborhood conditions, discrimination, and adverse childhood experiences can impact health and aging through biological pathways. Chronic stress gets under the skin by affecting telomere length, inflammation levels, epigenetic aging, and other regulatory systems. Studies show that social stress is associated with shorter telomeres in both human and animal research. Addressing social stress requires efforts at the individual, community, and policy levels to reduce health disparities and promote healthy aging.
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Dr. Elissa Epel: "How Our Environment Gets Under Our Skin"
- 1. How does neighborhood get under the skin? USC Annenberg’s Center for Health Journalism Elissa Epel, PhD Professor, Department of Psychiatry, UCSF
- 2. Longevity gap: Sex & Race 83 vs. 78 years
- 3. Daily discrimination &Allostatic Load
- 7. Psychological Stress The Social Stress Exposome Exercise & Substance use Home & Neighborhood Many biomarkers are associated with these exposures (causal or not) Stressful events trauma Poor nutrition & chemical exposures
- 8. Multi-level Measurement of “stress” Tier 1: Exposures: SES, Life events, chronic stressors Chronic contexts – home, neighborhoods, institutions retrospective or current Tier 2: Perceived stress/distress (Self report) Response to stressors, impact and chronicity Must be tied closely to the event Tier 3: Biological Regulatory systems Steady state set points (allostatic states) Reactivity (homeostatic capacity)
- 10. Lifespan model of stress & aging
- 11. Childhood social stress impacts aging trajectories • Adverse Childhood Experiences (ACES) are a strong predictor of poor mental and adult physical health CDC ACES reports: https://www.cdc.gov/violenceprevention/acestudy/index.html NAS report: From Neurons to Neighborhoods, 2000; NAS report: Preventing mental and behavioral disorders among young people, 2009;
- 12. Social stress impacts aging biology (“Hidden Wounds” “Biological Embedding”: Telomeres, inflammation, epigenetic clock) Meta-analyses TL: Hanssen et al, 2017, Lie et al, 2017 Review inflam: Danese et al, 2014; Coelho et al, 2014 Meta-analysis clock in adults: Wolf et al, 2018
- 13. Telomerase is an enzyme that rebuilds telomeres Telomeres: ‘non-coding’ base pair sequences capping chromosome ends, that serve as a “senescence clock”
- 14. How do our cells age? Some key pathways • Telomere shortening • Systemic Inflammation • Mitochondria impairment • Accelerated Epigenetic clock
- 15. Images from this week at the border in the US:
- 16. • Social status in hyenas (Lewin et al, 2015) " • Social isolation in parrots (Aydinonat, 2014) " • Repeated stress in birds (Hau, 2015; Nettle, 2015) Stressed Animals, shorter telomeres
- 17. Stress and Telomere Length Stress Exposures: • Neighborhood disorder • Caregiving (yrs) • Violence, IPV (yrs) • Maternal pregnancy stress • Early Childhood Adversity Stress Responses • Work exhaustion • Discrimination, implicit bias • Perceived Stress • (Hostility, Pessimism) " Psychiatric Disorders Reviews on exposures: Starkweather et al, 2014 Oliviera et al, 2016 Price et al, 2013 Hanssen et al, 2017 Coimbra et al, 2017 Li et al, 2017 Reviews on PSS:" Schutte et al, 2014 Mathur et al, 2016 Reviews on PD: Schutte et al, 2015 Lindqvist et al, 2015 Darrow et al, 2016 Li et al, 2017 Malouff et al, 2017
- 18. Telomeres are affected by our physical and social environment
- 20. Social stress is complex and must be tackled at every level—individual, community, and policy.
- 21. Sugar is a pathway for health disparities • Added sugars predict met. syndrome and diabetes (eg, Rodriques et al, 2016). • SSB’s account for 184 000 deaths/year, world wide (Singh et al, 2015, Circulation) • High sugar diet in young adulthood reprograms gene expression and reduces longevity... in flies (Dobson et al, Cell Reports, 2017).
- 22. Proof of concept: Reducing sugar at work? • SSB sales ban at UCSF 95 95.5 96 96.5 97 97.5 98 98.5 99 Baseline Post-sales ban waists circumference (cm)