Hybrid Resiliency-Stressor Conceptual Framework for Informing Decision Support Tools and Addressing Environmental Injustice and Health Inequities

Abstract

While structural factors may drive health inequities, certain health-promoting attributes of one’s “place” known as salutogens may further moderate the cumulative impacts of exposures to socio-environmental stressors that behave as pathogens. Understanding the synergistic relationship between socio-environmental stressors and resilience factors is a critical component in reducing health inequities; however, the catalyst for this concept relies on community-engaged research approaches to ultimately strengthen resiliency and promote health. Furthermore, this concept has not been fully integrated into environmental justice and cumulative risk assessment screening tools designed to identify geospatial variability in environmental factors that may be associated with health inequities. As a result, we propose a hybrid resiliency-stressor conceptual framework to inform the development of environmental justice and cumulative risk assessment screening tools that can detect environmental inequities and opportunities for resilience in vulnerable populations. We explore the relationship between actual exposures to socio-environmental stressors, perceptions of stressors, and one’s physiological and psychological stress response to environmental stimuli, which collectively may perpetuate health inequities by increasing allostatic load and initiating disease onset. This comprehensive framework expands the scope of existing screening tools to inform action-based solutions that rely on community-engaged research efforts to increase resiliency and promote positive health outcomes.

Urban Green Space and Subjective Well-Being of Older People: A Systematic Literature Review

“…The natural value of public green spaces is to provide space for plant and animal habitats while supporting sustainable urban development and enhancing the health of urban dwellers by purifying space, improving microclimate, and increasing stormwater retention. Green space is not only a valuable resource for community health-related activities [ 1 , 19 ], but it is also an important example of resilient buffering that can reduce the incidence of cardiovascular disease and diabetes [ 77 , 114 ].…”

Inclusion of Social and Structural Determinants of Health to Advance Understanding of their Influence on the Biology of Chronic Disease

“…Studies focused on geospatial variation in health outcomes highlight complex interactions between social and structural drivers of health disparities that impact urban and rural communities differently through diverse toxic exposures, including vast differences in quality of air, water, employment/income, housing, and access to quality food and education, among others (Burwell‐Naney, Wilson, Whitlock, & Puett, 2019). The co‐occurrence of overlapping social and environmental risks is inevitable, and readily demonstrated by EJScreen maps, indicating geospatial variation in income level and lead paint indicators (percent of housing built before 1960) that are clearly delineated in many metropolitan regions.…”

“…The co‐occurrence of overlapping social and environmental risks is inevitable, and readily demonstrated by EJScreen maps, indicating geospatial variation in income level and lead paint indicators (percent of housing built before 1960) that are clearly delineated in many metropolitan regions. Through the implementation of innovative data assessment and management that acknowledges synergistic or potentiating effects of socio‐environmental stressors on mechanisms of age‐associated disease, both environmental justice and health equity may be described and subsequently addressed (Burwell‐Naney et al., 2019).…”

Susceptibility Variations in Air Pollution Health Effects: Incorporating Neuroendocrine Activation

“…152,153 The concepts of chemical and nonchemical stressors, external and internal exposomes, and one health have already emerged. 154 Given the role of neuroendocrine system in processing all perceived stress signals centrally and producing stressor-specific metabolic and immune responses through coordination of all organ systems, one can presume that its malfunction can lead to abnormal stress response and increase in host susceptibility. Assessing the biological plausibility for interactive influence of each of these risk factors and identifying the biological indicators or group of indicators of stressor-induced susceptibilities with or without air pollutants will contribute to mechanistic understanding of the overall health outcomes.…”