{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T06:41:15Z","timestamp":1791614475766,"version":"4.3.4"},"reference-count":75,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:p>The social determinants of health (SDOH)\u2014including socioeconomic position, education, housing, and social networks\u2014are fundamental drivers of health inequalities worldwide. These inequalities persist because social determinants interact dynamically across time and context, with health emerging from the interplay of social, political, environmental, and biological processes in which determinants act simultaneously as causes and consequences. Early-life exposures and historical conditions produce enduring physiological vulnerability through biological embedding, encompassing stress dysregulation, inflammation, and epigenetic modifications. Feedback loops, non-linearity, and path dependence stabilise disadvantage across the life course and across generations\u2014mechanisms that explain why interventions targeting isolated risks or single factors often yield modest or context-dependent effects. A complex adaptive systems perspective reconceptualises health inequalities as emergent outcomes of these interacting social\u2013biological processes and identifies leverage points where systemic, multi-level interventions can shift trajectories. Promising approaches include coordinated, place-based strategies, relational continuity in primary care, and strengthened social infrastructure.<\/jats:p>","DOI":"10.3389\/fpubh.2026.1923212","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T05:35:24Z","timestamp":1788845724000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["From exposure to embedding: how interconnected social determinants drive health inequalities\u2014a complex adaptive system dynamics approach"],"prefix":"10.3389","volume":"14","author":[{"given":"Joachim P.","family":"Sturmberg","sequence":"first","affiliation":[{"name":"Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle","place":["Callaghan, VIC, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmel M.","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Nursing and Allied Health, Monash Health, Monash University","place":["Clayton, VIC, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stewart W.","family":"Mercer","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Multimorbidity, Usher Institute, College of Medicine and Veterinary Medicine University of Edinburgh","place":["Edinburgh, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark J.","family":"DeHaven","sequence":"additional","affiliation":[{"name":"Academy for Research on Community Health, Engagement, and Services (ARCHES), University of North Carolina","place":["Charlotte, NC, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holger","family":"Pfaff","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital Cologne, Institute for Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), 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