Social determinants impact both viral infections and brain development

Abstract

Brain development is a complex process that proceeds from the embryonic stage into young adulthood. During the first three years, the brain rapidly develops and lays the groundwork for downstream structures. Social determinants of health (SDOH), including the wider set of forces and systems that shape everyday life, can have detrimental effects on the structure and function of the developing brain. Differences in the distribution of resources and governance at the global, national, and local levels, can create health disparities in infectious disease proliferation within and between communities and countries. Social determinants of infectious disease and brain development have been thoroughly researched independently, yet research on the interactions between these outcomes is limited. Here, we review the potential that social, economic, and environmental factors can coalesce to mitigate or exacerbate the effects of virally induced brain injury by either buffering against or adding to neurological disability. We synthesize research concerning SDOH, brain development, and viral infection and the interconnectedness between these important global health issues. We find that the same SDOH that impact brain development can also increase the risk of viral infection during pregnancy and adverse sequelae in the fetus, including damage to the developing brain, which can contribute to lifelong effects that reinforce health inequities. IMPACT: Synthesizes the relationship between prenatal social determinants of health and prenatal viral infections, social determinants and brain outcomes, and their interrelationships. This review highlights the need to conduct further research to understand the pathway of these factors and quantify the contributions of each factor to the neurodevelopmental trajectory of a child exposed to prenatal viral infections. Details the social and environmental conditions that increase vulnerability to prenatal brain injury and decrease resilience to neurological developmental interruptions.