What #environment in disease aetiology?

Scienza in Rete is an Italian online magazine that popularises scientific research and also discusses various issues related to science and society, including science policy and ethics. It recently featured an article on possible causes of autism. Autism is a disease affecting the individual’s abilities to interact, verbally and non verbally, with other people. Its aetiology still has grey areas and much research is needed to understand its mechanisms.

I was intrigued by the aforementioned article because the title includes ‘ambiente’ – the environment. As you go through it, though, it becomes clear that the environment has a quite specific, restricted sense: the chemicals to which an individual is exposed, whether in life or even in utero. To be sure, this is precisely what environmental epidemiology investigates. The study mentioned in the ‘Scienza in Rete’ article evaluates, specifically, exposure to methylmercury. Fair enough. It is of utmost importance to understand the total exposome, and there is excellent research in progress in this respect.

But can chemicals exhaust all there is about the environment? What about the social environment?

Biological (or, biochemical) and social (or, socio-economic, psychological, behavioural) causes of disease shouldn’t be studied separately. We should instead strive to understand how the biological and the social realms interact. We should work towards integration of disease aetiologies and try to understand the mixed mechanisms of diseases. It is about time to move beyond the biologisation of disease and return to a more holistic understanding.