title: The public health exposome: a population-based, exposure science approach to health disparities research.
abstract: The lack of progress in reducing health disparities suggests that new approaches are needed if we are to achieve meaningful, equitable, and lasting reductions. Current scientific paradigms do not adequately capture the complexity of the relationships between environment, personal health and population level disparities. The public health exposome is presented as a universal exposure tracking framework for integrating complex relationships between exogenous and endogenous exposures across the lifespan from conception to death. It uses a social-ecological framework that builds on the exposome paradigm for conceptualizing how exogenous exposures "get under the skin". The public health exposome approach has led our team to develop a taxonomy and bioinformatics infrastructure to integrate health outcomes data with thousands of sources of exogenous exposure, organized in four broad domains: natural, built, social, and policy environments. With the input of a transdisciplinary team, we have borrowed and applied the methods, tools and terms from various disciplines to measure the effects of environmental exposures on personal and population health outcomes and disparities, many of which may not manifest until many years later. As is customary with a paradigm shift, this approach has far reaching implications for research methods and design, analytics, community engagement strategies, and research training.
authors.affiliation: Research Center on Health Disparities, Equity, and the Exposome, University of Tennessee Health Science Center, 66 N. Pauline, Memphis, TN 38105, USA. pjuarez@uthsc.edu.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Juarez
authors.affiliation: Research Center on Health Disparities, Equity, and the Exposome, University of Tennessee Health Science Center, 66 N. Pauline, Memphis, TN 38105, USA. pmatthe3@uthsc.edu.
authors.forename: Patricia
authors.initials: P
authors.lastname: Matthews-Juarez
authors.affiliation: Department of Environmental Health Sciences, College of Public Health, Ohio State University, Columbus, OH 43210, USA. hood.188@osu.edu.
authors.forename: Darryl B
authors.initials: DB
authors.lastname: Hood
authors.affiliation: Vertices, Inc., 317 George Street 411, New Brunswick, NJ 08901, USA. wansooim@gmail.com.
authors.forename: Wansoo
authors.initials: W
authors.lastname: Im
authors.affiliation: Department of Family & Community Medicine, Meharry Medical College, Nashville, TN 37208, USA. rlevine@mmc.edu.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Levine
authors.affiliation: Department of Sociology, Tennessee State University, Nashville, TN 37209, USA. bkilbourne@tnstate.edu.
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Kilbourne
authors.affiliation: Department of Electrical Engineering and Computer Science, University of Tennessee, Knoxville, TN 37996, USA. langston@eecs.utk.edu.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Langston
authors.affiliation: National Space Science and Technology Center, Universities Space Research Association, NASA Marshall Space Flight Center, Huntsville, AL 35805, USA. mohammad.alhamdan@nasa.gov.
authors.forename: Mohammad Z
authors.initials: MZ
authors.lastname: Al-Hamdan
authors.affiliation: National Space Science and Technology Center, Universities Space Research Association, NASA Marshall Space Flight Center, Huntsville, AL 35805, USA. bill.crosson@nasa.gov.
authors.forename: William L
authors.initials: WL
authors.lastname: Crosson
authors.affiliation: National Space Science and Technology Center, University of Alabama, Huntsville, AL 35805, USA. maury.estes@nsstc.uah.edu.
authors.forename: Maurice G
authors.initials: MG
authors.lastname: Estes
authors.affiliation: National Space Science and Technology Center, Universities Space Research Association, NASA Marshall Space Flight Center, Huntsville, AL 35805, USA. sue.m.estes@nasa.gov.
authors.forename: Sue M
authors.initials: SM
authors.lastname: Estes
authors.affiliation: Department of Family & Community Medicine, Meharry Medical College, Nashville, TN 37208, USA. vagboto@mmc.edu.
authors.forename: Vincent K
authors.initials: VK
authors.lastname: Agboto
authors.affiliation: Department of Ophthalmology, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA. paulrobinson@cdrewu.edu.
authors.forename: Paul
authors.initials: P
authors.lastname: Robinson
authors.affiliation: Research Center on Health Disparities, Equity, and the Exposome, University of Tennessee Health Science Center, 66 N. Pauline, Memphis, TN 38105, USA. pmatthe3@uthsc.edu.
authors.forename: Sacoby
authors.initials: S
authors.lastname: Wilson
authors.affiliation: Research Center on Health Disparities, Equity, and the Exposome, University of Tennessee Health Science Center, 66 N. Pauline, Memphis, TN 38105, USA. pmatthe3@uthsc.edu.
authors.forename: Maureen Y
authors.initials: MY
authors.lastname: Lichtveld
mesh_terms: D004781:Environmental Exposure; D004782:Environmental Health / Q000379:methods*; D054624:Health Status Disparities; D006801:Humans; D033183:Interdisciplinary Communication; D008137:Longitudinal Studies; D011634:Public Health; D014481:United States