Writing in the PLOS Biology journal, the research team say that lack of access to healthcare, healthy foods and a suitable environment found in social inequality impedes access to microbiodiversity and its health benefits.
The team go further in their essay, arguing that this “microbial inequality,” threatens health to such an extent that access to them should be a human right.
As a result, governments have a duty to eliminate social barriers that stop people from developing and maintaining a healthy microbial community as an issue of social equity.
“It seems like a stretch to think that microbes are involved in social equity," says Dr Suzanne Ishaq, team leader and an assistant professor at the University of Maine in the US.
"That is until you realize that so many social equity issues affect your exposure to microorganisms in some way, and your ability to recruit and maintain a beneficial microbial community."
Low microbial diversity’s link to poor health is well documented with obesity, metabolic problems, mental health and psychiatric disorders implicated.
Dr Ishtaq and colleagues say these problems may disproportionally affect poorer individuals and compound existing health disparities.
The infant microbiome
More concerning is the microbiome development in the critical first years of a child’s life. The effects are devastating for the long-term microbial community structure of the gut with alterations to these foundational processes affecting multiple generations.
The essay goes on to highlight the period immediately before and after birth as critical for maternal microbial transfer.
However, women who are socioeconomically disadvantaged experience social barriers and stressors preventing access to prenatal care, adequate nutrition, or education.
This increases the risk for complications during and after birth and increases psychological stressors, which further worsen health outcomes.
Further points in the essay include access to nutrition, where it is highlights the link between lower-income communities and a higher prevalence of cheaper high-fat, high-sugar, or highly processed foods.
“By providing universal access to healthy foods that promote microbial diversity, diet interventions may provide an effective way to prevent the health problems associated with inadequate microbial diversity, as well as make nutritional access more equitable,” says the essay.
The right to microbe diversity
One of the questions posed by the team is whether an individual owns its microbiota and whether we have the right to a healthy microbiome profile.
The argument is the microbiota represents a means of social equity due to its role in health and development.
The essay refers to a landmark paper written in 2011, which discusses the collection of biological tissues samples (biobanking) and the ethical, legal, social issues of genome research that arise.
While the paper gives a series of recommendations, it has had no real bearing in a real life, where to date there has not been a legal instance, where ownership of a microbiome is established or if a healthy microbiome is a legal entitlement.
In conclusion Dr Ishaq and her team put forward the suggestion that the fluid nature of the microbiome sets up a legal angle that underlines healthy microbe access rather than microbiome ownership.
“You’re picking up and putting off hundreds of thousands of microbial cells every day so to think that what’s in your gut is completely yours is probably the wrong way to think about it,” says Dr Ishaq. “They are more like passengers than things that you own.”
Source: PLOS Biology
Published online: doi.org/10.1371/journal.pbio.3000536
“Framing the discussion of microorganisms as a facet of social equity in human health.”
Authors: Suzanne Ishaq et al