Introducing the Microbes and Social Equity Working Group: Considering the Microbial Components of Social, Environmental, and Health Justice

The Microbes and Social Equity (MSE) Working Group posits that microbial exposures across ecosystems, urban and rural settings, and individuals are sociopolitical. Our purpose is to connect microbiology with social equity research, education, policy, and practice to understand the interplay of microorganisms, individuals, societies, and ecosystems. Collectively, we seek to generate and communicate knowledge that will spark evidence-based public policy and practice, supporting equity and sustainability for all.

Connecting diverse demographics, cultures, and geographic regions is an underappreciated opportunity in the microbiologist’s domain. This work requires us to develop teams of biological and social scientists and policy experts who engage with affected communities to create solutions for substantial change. This creativity requires research journals to accommodate biological and anthropological data in the same piece, imaginative study endpoints that create meaningful change, and the intellectual freedom to weave detailed narratives when presenting research findings. For data-driven sciences, this collaboration requires interrogating one’s own research within social contexts and existing biases (44). For example, previous work investigating microbial mechanisms of health disparities has focused on how environmental, structural, and racial politico-economic discrimination and other inequities influence microbiomes, instead of falsely assuming inherent biological differences between people of different races (38). Interventions that ignore social interactions or neglect the social determinants of health may fail to meet their goals (44, 45).

Links between social equity and microbial communities cannot be studied solely within the confines of the laboratory; community engagement and clear communication about research impact improve inclusivity (47, 48). At its worst, barriers to inclusivity exclude populations from health care and research, treating them as study objects (49) or as sources of extractable resources (50, 51), rather than equal partners. The disregard of cultural and personal dignity, as well as “othered” forms of knowledge (52, 53), creates a lasting atmosphere of institutional betrayal (54) in health care and research. We embark on this work with acknowledgment of colonial histories from which our universities and disciplines emerged (52, 55–57).

Microbiome science must consider applications that will benefit study populations in the foreseeable future, since direct, immediate intervention is unlikely at this stage of our understanding. Thus, we support an “ethics of care” (58) that requires microbiome researchers not only to attend to current predicaments of research participants, to support meaningful infrastructural changes, and to remain alert to possible commercial exploitation (38, 59–61) but also to consider that a participant’s health extends well beyond the boundaries of “skin and skull,” and to consider the microbiome as integral to the individual’s inherent functioning (38, 46, 59–61). Certainly, this complicates the ways in which we understand our own physiology (44) and calls into question our self-conception (62, 63), our individuality (64), and, thus, some of the most central categories that we integrate into our ethical and political reasonings. Accordingly, collaboration within the MSE Working Group necessitates an explicit feminist, antiracist, anti-imperial, and anticolonial framework for knowledge production. Our goals are aspirational, and as with all abolitionist future-making projects which seek liberation from oppressive systems and institutions, our imperfect endeavor necessitates revision and reflexivity over time (65, 66).

While grade school to graduate-level training requires an educational balance of biological science, social sciences, and humanities coursework, these disciplines are treated as epistemologically incompatible. Courses that meld these curricula (80; S. L. Ishaq’s “Microbes and Social Equity” course materials) attract students from multiple disciplines and promote their agency in tackling seemingly intractable social problems through collaborative problem-solving assignments (1). Further, decades of attempts to diversify the science, technology, engineering, and mathematics (STEM) workforce have resulted in only modest increases (67). This necessitates a paradigm shift that centers and values marginalized voices in science curriculum development. Marginalized minorities (e.g., Indigenous peoples and nonwhite, sexual, and gender minorities) are usually left out of the system due to logistical (e.g., lack of infrastructure), technical (e.g., lack of formal education), and/or structural (e.g., lack of resources, institutional racism) circumstances. Centering intersections between microbiomes, human health, planetary health, social justice, and environmental justice signals to students the importance of an integrated worldview and is a means of promoting congruent scientific and cultural identities for those from marginalized groups (81, 82). Trainees have expressed a desire for integrated educational approaches (83) which ultimately promote the success of a diverse student population in the sciences (82, 84, 85).

Universities can actively support these efforts by (i) promoting and funding socially integrated science courses and programs; (ii) including and funding out-of-discipline students, educators, and researchers (86); (iii) collaborating with other institutions to implement multisite global classrooms; and (iv) changing the underlying model of education and research, which establishes a clear divide between basic and applied science (or as D. E. Stokes put it, rigor versus relevance [87]). Further, this assumes that the social benefits of research and education will eventually be derived, but this relationship is not linear. It is circular and complex; research and education embedded in people’s social, cultural, and political realities mean inherently applying and creating knowledge. The modern conception of the educational system as a supermarket of knowledge deters itself from seamlessly applying that very same knowledge into broad understandings and meaningful interventions, programs, products, and devices. This is relevant because scientists are expert dichotomy creators; the paradigmatic example is the ages-long nature-versus-nurture debate, whose solution is almost never nature or nurture but both. Future scientific efforts—as an embedded dialogue between the world and the laboratory—should deal with the diverse realities afforded by rethinking the basic/applied dichotomy. Likewise, microbiology, a discipline that emerged from the study of microorganisms in contexts of hosts or ecosystems, has long spanned this divide given that Pasteur’s seminal work makes both basic and applied contributions to science and society (87). The MSE Working Group naturally affords a setting for the simultaneous pursuit of both research and educational programs with direct impacts on developing and testing novel hypotheses, as well as promoting and creating more effective practices.

There are major logistical challenges to effectively recruiting and engaging diverse human study participants in microbiome projects (48, 108–110). Even when participants are compensated, there is a cost to participating in a research study that precludes true representation because it not only skews our understanding of microbiomes but also deepens the divide of research exclusionism. These costs include personal time (precluding those with multiple jobs, shift-based employment, or family care responsibilities), transportation to research facilities, and the time and mental energy needed to fit research activities into daily life (48, 111–113).

To overcome logistical challenges, creative techniques based on empathy and anthropological understanding are required to reduce these impacts (48, 110, 114, 115). These can include sample collection training (116); accounting for local resources, such as providing freezers or using alternate sample preservation methods, ensuring reliable power for laboratory equipment, and providing for transportation of samples from field sites; and/or using biological or environmental samples previously collected for another purpose (117). Establishing sustained and equitable partnerships with communities also requires an awareness of the barriers posed by the use of English as the primary language of science. While an expansion of scientific literacy will be critical to forming connections with many underserved communities, the process of literature review and knowledge generation would also benefit from expanding linguistic boundaries (118).

Even without an understanding of the effect of microorganisms on our lives, most people recognize that individual health and well-being are common global goods (119). The benefits of considering social inequities in microbial ecology are both qualitative and quantitative, but for some audiences, “money talks.” Fortunately, the benefits of social policies that promote equitable access to resources are strongly supported by demonstrable, repeatable returns on investment (120–127). Future research must examine the effects of neoliberal racial capitalism and its corollaries that promote market-based solutions, such as mass-produced commodities or lifestyles. For instance, what are the effects of industrial diets on human microbiomes or the impacts of political, economic, and social variables in shaping microbial communities (128, 129)?

We need comparative research that examines the structural constraints faced by people with microbe-associated disease (1), while staying vigilant about “magic bullet” biotechnological solutions that, while often endorsed by policymakers, rarely address the sociocultural, political, or economic factors that engender and reproduce health inequities on a global scale. Singling out nutritional deficiencies (e.g., golden rice to resolve vitamin A deficiency) without considering broader dietary contexts of food insecurity or placing an isolated focus on particular public health concerns (e.g., obesity interventions instead of food quality and access interventions) may lead to lopsided social outcomes which resolve health issues in those populations which had available resources for short-term treatment but do not supply sustainable, prevention-based solutions to underresourced populations (130, 131). Moreover, the neocolonial attitude of international aid and global/public health programs frequently equates “development” with Western hygiene and behaviors, with little regard for microbial community dynamics in situ. While microbiome sciences continue to identify certain biological patterns that are more reliably correlated with health and disease, it is still worth mentioning that “healthy microbiomes” are broadly situational and continue to defy standard definitions. We reiterate that “one microbiome does not fit all.”

For a greater impact on public health and to achieve equitable health outcomes, policy efforts can focus on improving the local nutrition environment. While programs like the Supplemental Nutrition Assistance Program (SNAP) in the United States increase the food-purchasing power of lower-income households, increased food security may not translate into improved food quality (132), as neighborhoods of lower socioeconomic status have fewer supermarkets and more convenience, liquor, and fast-food outlets (133–135). Predatory marketing practices in these neighborhoods create higher proportions of advertisements promoting unhealthy foods (136, 137). It is crucial that policy efforts not only focus on providing enough calories but also use a combination of incentive (138, 139, 152) and disincentive (140, 141) programs to improve the affordability, availability, and accessibility of healthy options. Further, much remains unknown about the impact of food processing and food additives on microbial ecology, and we need microbiome research in partnership with the food industry and policy makers to mitigate potential harmful effects.

Healthy soils are intimately linked to human health through ecosystem processes like global nutrient cycling and food production, and more research should focus on how human-mediated land use change (i.e., deforestation, intensive agriculture, urbanization) impacts patterns of soil biodiversity (32, 142). For example, plant biodiversity, a primary driver of soil microbiome diversity and community structure, is lower in communities disenfranchised through “redlining” (inequitable development districting), demonstrating how systemic racism affects ecosystem biodiversity (143). Soil microbiomes offer promising metrics for assessing soil health across environmental change and through time (144). It is critical to understand how anthropogenic climate change impacts environmental microbes, as well as how microbes drive global change processes (8), and to consider this during environmental impact studies for infrastructure development or industry permitting to avoid ecosystem disruption.

By placing social justice as the central articulator between health and disease over a lifetime, the MSE Working Group provides a multidimensional perspective on social justice, situating the health consequences of exposure to depauperate or pathogenic microbial communities among systemic issues, like disempowerment, threats of violence, abiotic environmental hazards, and others. Likewise, the MSE Working Group has a core focus on the effective translation of its principles into successful research outcomes and impactful public policy. Thus, the vision of the MSE Working Group necessitates engaging with public policy and pushing back on private interests that are both responsible for and seek to profit from microbial (and human) inequities. Finally, the MSE Working Group is poised to advance the concept of “microbial stewardship” (119) in fostering the resilience and sustainability of environmental microbial communities and promoting equity in the ways in which people are exposed to and interact with these communities. However, this cannot be accomplished through research alone. If we recognize microbiomes as a common good, then it requires all of us to progress our knowledge to action and advocate to protect that good.