Rethinking health priorities for displaced populations through the integration of epigenetics and iterative reasoning

Over 120 million people are forcibly displaced worldwide, nearly half of them children. Current health responses remain largely emergency-driven, addressing immediate survival needs but overlooking the longer-term biological and psychosocial consequences of chronic trauma.

Emerging evidence suggests that severe adversities, for example those happening during pregnancy and early childhood, can become biologically embedded through changes in gene regulation. While data on humans are largely observational, and inherited transgenerational effects remain under investigation, the initial evidence reinforces the importance of prioritizing continuity of care, trauma-informed services, and early-life interventions alongside social determinants.

We propose three complementary actions: (1) scale community-based, culturally responsive, trauma-informed mental health services integrated with primary care; (2) incorporate trauma science, epigenetics, and complex systems-related thinking into medical and social curricula; and (3) adopt iterative, adaptive policy cycles that revisit priorities through shared indicators and stakeholder feedbacks.

Shifting from one-off crisis management to iterative, evidence-informed planning enables health systems to address both immediate needs and longer-term, potentially intergenerational risks, making responses more anticipatory, accountable, and sustainable.