The Environmental “Riskscape” and Social Inequality: Implicationsfor Explaining Maternal and Child Health Disparities

Abstract

BackgroundResearch indicates that the double jeopardy of exposure to environmental hazards combined with place-based stressors is associated with maternal and child health (MCH) disparities.Objective and DiscussionOur aim is to present evidence that individual-level and place-based psychosocial stressors may compromise host resistance such that environmental pollutants would have adverse health effects at relatively lower doses, thus partially explaining MCH disparities, particularly poor birth outcomes. Allostatic load may be a physiologic mechanism behind the moderation of the toxic effect of environmental pollutants by social stressors. We propose a conceptual framework for holistic approaches to future MCH research that elucidates the interplay of psychosocial stressors and environmental hazards in order to better explain drivers of MCH disparities.ConclusionGiven the complexity of the link between environmental factors and MCH disparities, a holistic approach to future MCH research that seeks to untangle the double jeopardy of chronic stressors and environmental hazard exposures could help elucidate how the interplay of these factors shapes persistent racial and economic disparities in MCH.

An Index for Assessing Demographic Inequalities in Cumulative Environmental Hazards with Application to Los Angeles, California

“…To simplify our analysis, we assumed that each environmental hazard had an equal contribution to the cumulative impact, so a mean value of 1 was used to normalize each environmental hazard for the additive approach. For policy making, the weighting scheme might need to be modified by expert opinions or through a deliberative process (1).…”

Using exposure biomarkers in children to compare between-child and within-child variance and calculate correlations among siblings for multiple environmental chemicals

“…contributor to health disparities for many disadvantaged children (Sexton, 1997;Morello-Frosch and Shenassa, 2006;Sexton et al, 2006;Sexton and Linder, 2010). Yet, many questions remain about how to design and implement costeffective studies involving biologic markers of exposure (Needham and Sexton, 2000;Barr et al, 2005;Needham et al, 2005).…”

“…They were apt to reside in poor-quality housing, live in neighborhoods with comparatively high crime rates, lack access to health care, and generally have more stressful and less healthful lives . Although the cumulative effects on their health and wellbeing of continued exposure to a mixture of chemical and non-chemical (e.g., psychosocial) stressors is unknown, the potential threat is both real and immediate (Morello-Frosch and Shenassa, 2006;Sexton et al, 2006;Larson et al, 2009;Sexton and Linder, 2010).…”

Air Quality, Health and Community Action

“…The health impacts associated with air pollution may be difficult to measure because of other factors that also affect health such as level of education, psychosocial stressors and quality of medical care [56]. Air quality varies within cities and low income communities often have higher air pollutant concentrations in their neighborhoods.…”