Built and Social Environments, Environmental Justice, and Maternal Pregnancy Complications

Abstract

Purpose of Review The Environmental Justice Movement centers on addressing inequitable distribution of environmental harms in marginalized communities. It has been commonly understood as the disproportionate concentration of environmental pollutants or hazards. As such, much of the work on environmental harms and maternal pregnancy complications have focused on environmental toxins. This scoping review surveyed the literature exploring the built and social environment factors and maternal pregnancy complications among racially marginalized women and highlights how an environmental justice framework can inform policy interventions for maternal health inequities caused by structural racism in built and social environments. Recent Findings The literature examining the association between neighborhood level built and social environment factors and maternal pregnancy complications in the last five years is sparse. When excluding environmental toxins, we identified 16 studies that fit our criteria of neighborhood-level environmental exposure, with the majority focused on built environment factors, specifically proximity to greenspace and food environment. Summary We identified a few important gaps and opportunities for future research in this area. First is a need to explore additional built environment elements. Secondly, extensive research is needed on the social environment. Third is a critical understanding to incorporate structural racism and cultural perspectives to better understand these relationships in minoritized populations and highlight the intersection between environmental hazards concentration and their structural causes. Finally, an environmental justice framework is critically needed in the interpretation and translation of this literature to inform policy solutions that can counteract the harms in racially marginalized communities and improve health.

Climate and environmental changes exacerbate health disparities in pregnant people and their offspring. How can we protect women and their babies?

“…People of color are more vulnerable to heatwaves, extreme weather events, and environmental contaminants (https://www.nytimes.com/2021/04/28/climate/air-pollution-minorities.html; Berberian et al, 2022; Butler et al, 2022; Deivanayagam et al, 2023; Tessum et al, 2019). Discriminatory policies and social, political, and economic inequalities also contribute to health disparities in women of color (Butler et al, 2022). Environmental racism, the unequal access to a clean environment and basic environmental resources based on race, has also been associated with adverse health in pregnant people and their offspring (Tessum et al, 2019).…”

“…In the United States, climate change is clearly exacerbating existing inequalities in women's health, particularly in communities with socioeconomic inequalities. People of color are more vulnerable to heatwaves, extreme weather events, and environmental contaminants (https://www.nytimes.com/2021/04/28/climate/air-pollution-minorities.html; Berberian et al, 2022; Butler et al, 2022; Deivanayagam et al, 2023; Tessum et al, 2019). Discriminatory policies and social, political, and economic inequalities also contribute to health disparities in women of color (Butler et al, 2022).…”

Evidence Gap Map of the Relationship between Blue and Green Spaces and Pregnancy Outcomes

“…While most of the reviews (n=12) did not restrict their inclusion criteria to a specific green space measurement, one review focused exclusively on the NDVI and excluded primary studies utilizing other green space metrics. Moreover, three reviews focused on the broader concept of the built environment, with green spaces being a subset [30][31][32]. In contrast, the majority of the reviews (n=12) included studies conducted in various geographic locations, while one study [32] exclusively included studies conducted in the United States.…”

“…Moreover, three reviews focused on the broader concept of the built environment, with green spaces being a subset [30][31][32]. In contrast, the majority of the reviews (n=12) included studies conducted in various geographic locations, while one study [32] exclusively included studies conducted in the United States.…”

“…Twelve reviews examined infant-related pregnancy outcomes such as birth weight, low birth weight, and head circumferences, with five of these reviews also incorporated maternal pregnancy outcomes such as gestational diabetes, postpartum depression, and pre-eclampsia. Only one review solely focused on maternal health outcomes [32] . Most of the reviews (n=9) encompassed a wide range of pregnancy outcomes that fell under either infant or maternal health outcomes.…”