Development of a Conceptual Framework Depicting a Childs Total (Built, Natural, Social) Environment in Order to Optimize Health and Well-Being

Abstract

The complexity of the components and their interactions that characterize children's health and well-being are not adequately captured by current public health paradigms. Children are exposed to combinations of chemical and non-chemical stressors from their built, natural, and social environments at each lifestage throughout their lifecourse. Children's inherent characteristics (e.g., sex, genetics and epigenetic factors) and their activities and behaviors also influence their exposures to stressors from these environments. We describe a conceptual framework that illustrates the interrelationships between inherent characteristics, activities and behaviors, and stressors from the built, natural and social environments in influencing children's health and well-being as they progress through various stages of development. We demonstrate the use of this framework for two major public health concerns: childhood obesity and diminished general cognitive ability. Systematic reviews of the literature found a limited number of studies that evaluated both chemical and non-chemical stressors. For example, neighborhood-level socioeconomic factors and chlorpyrifos exposure were shown to interact to impact cognitive function and maternal self-esteem was found to modify vulnerability to prenatal lead. By better understanding these complex interactions, decision makers can make informed choices for child-specific environments that optimize health and well-being within the home and community.

Chemical and non-chemical stressors affecting childhood obesity: a systematic scoping review

“…We recognize that other organizational methods could have been used to present the information but found separating them into four major categories that coincide with the conceptual framework outlined in Tulve et al 33 allowed for clear organization and focus to present the information. A holistic understanding of childhood obesity begins with the individual child and their behaviors/habits formed as a result of their surroundings.…”

“…To accomplish this, researchers need to take into account the well-being of the child through various lifestages, from early child development through adolescence. Tulve et al 33 has designed a conceptual framework where a child's health and well-being is influenced by all the components of the built, natural, and social environments. A child's holistic health extends beyond a child's physical and mental health to include emotions, learning and development, physical safety, relationships, and material well-being.…”

“…[31][32][33] Non-chemical stressors are factors found in the built, natural, and social environments such as noise, temperature, humidity, stress from the built environment, social factors, and lack of health care. 24,26,33 Using PubMed and Google Scholar, we identified relevant literature articles using several search strings ( Figure 1-Step 1). More information on the search strings (including specific stressor terms) can be found in the Supplementary Information.…”

“…These neighborhood characteristics can promote physical activity by increased active transport to work, school, and food sources. 33,35,38,94 Much research pertaining to the BE is focused on the importance of community level factors in explaining dietary choices or physical activity, and links to various health outcomes, including obesity. Studies examining aspects of the BE found that property disorder, nuisances, violent and total crime were all associated with increased weight, while factors such as housing damage, vacancy, bars on doors/windows, and warning signs had no association with childhood obesity.…”

“…Aspects of the natural environment are often considered within BE research studies, where they examine accessibility to recreational facilities and schools. 33,94,97,102,116,117 The literature indicates that greenness has many beneficial factors when it comes to influencing childhood obesity and activity levels. In a study that followed 9-10 year olds for 8 years, increased green space was significantly associated with lower BMI z-scores, suggesting that greener neighborhoods led to higher activity levels or more time spent outside.…”