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The intersection of social determinants of health,the microbiome,and health outcomes in immigrants: A scoping review
Authors:Dany Fanfan  Connie J Mulligan  Maureen Groer  Volker Mai  Michael Weaver  Fatma Huffman  Debra E Lyon
Institution:1. College of Nursing, University of Florida, Gainesville, Florida, USA;2. Department of Anthropology, University of Florida, Gainesville, Florida, USA;3. College of Nursing, University of Tennessee, Knoxville, Tennessee, USA

Contribution: Conceptualization (supporting), Writing - review & editing (equal);4. College of Public Health and Health Professions and College of Medicine, Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA

Contribution: Writing - review & editing (supporting);5. College of Nursing, University of Florida, Gainesville, Florida, USA

Contribution: Writing - review & editing (supporting);6. College of Public Health and Social Work, Florida International University, Miami, Florida, USA

Contribution: Writing - review & editing (supporting);7. College of Nursing, University of Florida, Gainesville, Florida, USA

Contribution: Conceptualization (supporting), Supervision (equal), Writing - review & editing (supporting)

Abstract:In the present scoping review, we explore whether existing evidence supports the premise that social determinants of health (SDoH) affect immigrant health outcomes through their effects on the microbiome. We adapt the National Institute on Minority Health and Health Disparities' research framework to propose a conceptual model that considers the intersection of SDoH, the microbiome, and health outcomes in immigrants. We use this conceptual model as a lens through which to explore recent research about SDoH, biological factors associated with changes to immigrants' microbiomes, and long-term health outcomes. In the 17 articles reviewed, dietary acculturation, physical activity, ethnicity, birthplace, age at migration and length of time in the host country, socioeconomic status, and social/linguistic acculturation were important determinants of postmigration microbiome-related transformations. These factors are associated with progressive shifts in microbiome profile with time in host country, increasing the risks for cardiometabolic, mental, immune, and inflammatory disorders and antibiotic resistance. The evidence thus supports the premise that SDoH influence immigrants' health postmigration, at least in part, through their effects on the microbiome. Omission of important postmigration social-ecological variables (e.g., stress, racism, social/family relationships, and environment), limited research among minoritized subgroups of immigrants, complexity and inter- and intra-individual differences in the microbiome, and limited interdisciplinary and biosocial collaboration restrict our understanding of this area of study. To identify potential microbiome-based interventions and promote immigrants' well-being, more research is necessary to understand the intersections of immigrant health with factors from the biological, behavioral/psychosocial, physical/built environment, and sociocultural environment domains at all social-ecological levels.
Keywords:health disparities  immigrants  microbiome  social determinants of health
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