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The Social Domain of Exposome
By the social domain of the exposome, we mean the persons a child interacts with (e.g. family, peers, teachers) and the societal context (economy, social institutions, norms, values) a child operates in as well as on social (in)equities. This pertains to (in)equities in exposure distribution and accumulation across generations, vulnerability to exposures and potential equity impacts of urban (planning) policies on different societal groups.
The Social Exposome concept is based on the key assumption that the entirety of social exposures systematically impacts a child’s development and health. The omnipresence of the social environment is symbolised in the illustration by bedded circles surrounding an individual (see the illustration below).
The social exposome comprises different layers:
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Layer 1 is the interactions with the environment, a child's social network. Key elements are the ‘actors’, ‘places’ and ‘relational dynamics’ that together characterise the structure, function and quality of a child’s social network.
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Layer 2 is the broader social context that affects the child indirectly.
The broader societal context is represented by six interrelated dimensions: Socioeconomic circumstances and sociodemographic characteristics; systems, institutions and priorities of the political economy; social norms and cultural values; social inequalities and structural injustices.
All these dimensions, together with the puzzle pieces, represent the entirety of social exposures that shape mental health and cognitive development.
Understanding the Exposome
The role of the individual
A child is always in interaction with their social environment (visualised by the dashed contour of the inner figure in the illustration). The ‘inside’ of a child, e.g. personality, stress sensitivity, identity, skills and abilities, and knowledge, are shaped in interaction with others. In turn, what a child brings with them also shaped the interaction with the social environment. A child’s development and health can be regarded as visible ‘outside’, which is shaped and developed in interaction with the social environment.
Systems, institutions and priorities of the political economy
The systems, institutions and political economy of a city, region or country a child is born in critically influences their possibilities in life; e.g. the provision of education and health care services, housing policy, conditions for parents to build a family.
Social norms and Cultural value
Social norms can be described as being “the expected and acceptable standards of behaviour in specific social settings and contexts”.
They are prevalent in families, peer groups, and wider societal systems, including other cultural groups, and can play an important role in establishing a sense (or lack thereof) of belonging and acceptance that are important in the development of a child’s identity. These social norms can be understood in terms of the perceived norms (the individual’s belief about typical or standard behaviour in a group), as well as the actual norms (the beliefs and actions of the group).
Cultural values in the Social domain of the Exposome represent the frame within which social norms are established, shared and maintained and include assumptions and beliefs, as well as rules of morality. Cultural values can refer to a national culture, although culture and values can also be unique to collectives such as organizations, institutions, occupations, and communities.
Social inequalities and Structural injustices
Social inequalities refer to population-level differences in social conditions. These inequalities are not only consequences of differing socioeconomic and sociodemographic aspects, but are systematically maintained and aggravated by economic, political, and sociocultural forces. Inequalities lead to different exposure of risks in the population as well as access to resources and opportunities. To participate in a decision-making process to optimise circumstances is also a question of basic financial, time and mental resources. In this way, social inequalities ultimately determine structural inequities and injustices in circumstances in which people grow, live, work, and age.
Socioeconomic circumstances and Sociodemographic characteristics
For children, socioeconomic circumstances are the results of the socioeconomic background of parents and caregivers: the household the child lives in, as well as the surrounding neighborhood context (e.g.for example, area-level socioeconomic deprivation). They are dynamic and can change throughout life in relevance and impact.
The intergenerational impact of parental socioeconomic attainment means that the socioeconomic outcomes of the child are essentially affected by the socioeconomic status of their parents, although these influences may change along with the individual child, e.g. in the course of education and leaving home. Similarly, sociodemographic characteristics, such as age, migration background, religious affiliation, ethnicity, and marital status, evolve during the life course and may partially change. Additionally, these attributes could be reasons for experiencing discrimination and structural injustice.