Epigenetics: The process of inheriting health disparities

Genetics, and the key molecule of DNA, have long been thought to be solely responsible for the heritable transmission of traits and for the production of these traits in organisms. Epigenetics has emerged as an alternative and complementary pathway for the phenomenon of the inheritance of traits, whether from cell to cell within the same individual or from individuals to their progeny, and is not dependent on modifying the sequence of DNA. The field has identified three non-DNA sequence-based mechanisms that play a major role in the transmission of traits: the methylation of DNA, the acetylation of histone proteins which serve as DNA's structural backbone, and the production of noncoding messenger RNA molecules. These mechanisms are the most proximal epigenetic changes initiated within cells in response to changes in the environment. Applied research studies have yet to definitively document how these changes lead to either normal or diseased traits or what processes allow the multigenerational stability of epigenetic traits. However, the current evidence promises to offer a better mechanism to explain population disparities in disease incidence and prevalence. To improve population health, clinicians, public health professionals, and policymakers must take this evidence into consideration. Epigenetics and its pathways are presented in this chapter as well as its importance in clinical programs and health policies to address population health.