Аңдатпа
A BSTRACT Social determinants of health (SDH) play a fundamental role in shaping population health and driving health inequalities, yet the biological mechanisms underlying these associations remain incompletely understood. In recent years, epigenetics has emerged as a promising framework for explaining how social and environmental exposures can influence gene expression without altering the DNA sequence. This review aims to synthesize current evidence on the role of epigenetic mechanisms in mediating the effects of SDH and to explore their implications for population health. A comprehensive narrative review of the literature was conducted, drawing on peer-reviewed studies examining the relationships between social exposures – such as early-life adversity, socioeconomic status, environmental conditions, and psychosocial stress – and epigenetic modifications, including DNA methylation, histone modifications, and noncoding RNA regulation. The evidence indicates that adverse social conditions are associated with differential epigenetic patterns in genes involved in stress response, immune function, and metabolic regulation. These epigenetic changes may contribute to the development of a range of health outcomes, including cardiovascular diseases, mental health disorders, cancer, and metabolic conditions. The findings support the concept of biological embedding, whereby social experiences become incorporated into biological systems, influencing health trajectories across the life course and potentially across generations. However, the current evidence is limited by methodological challenges, including the predominance of observational studies, heterogeneity in exposure and outcome measurement, and difficulties in establishing causality. In addition, issues related to tissue specificity and population diversity constrain the generalizability of findings. From a public health perspective, integrating epigenetic insights into research and policy may enhance the understanding and prevention of health inequalities. These findings highlight the importance of early-life interventions and upstream strategies targeting social and environmental determinants of health. Nevertheless, the application of epigenetic knowledge must be approached cautiously, with careful consideration of ethical implications and equity. In conclusion, epigenetic mechanisms provide a biologically plausible pathway linking social environments to health outcomes, offering new opportunities to bridge biological and social sciences in public health. Further longitudinal and interdisciplinary research is needed to strengthen causal inference and inform effective, equity-oriented interventions.