Environmental Health Disparities: A Framework Integrating Psychosocial and Environmental Concepts

University of Michigan School of Public Health, Department of Health Behavior and Health Education, Ann Arbor, Michigan, USA.
Environmental Health Perspectives (Impact Factor: 7.03). 01/2005; 112(17):1645-53. DOI: 10.1289/ehp.7074
Source: PubMed

ABSTRACT Although it is often acknowledged that social and environmental factors interact to produce racial and ethnic environmental health disparities, it is still unclear how this occurs. Despite continued controversy, the environmental justice movement has provided some insight by suggesting that disadvantaged communities face greater likelihood of exposure to ambient hazards. The exposure-disease paradigm has long suggested that differential "vulnerability" may modify the effects of toxicants on biological systems. However, relatively little work has been done to specify whether racial and ethnic minorities may have greater vulnerability than do majority populations and, further, what these vulnerabilities may be. We suggest that psychosocial stress may be the vulnerability factor that links social conditions with environmental hazards. Psychosocial stress can lead to acute and chronic changes in the functioning of body systems (e.g., immune) and also lead directly to illness. In this article we present a multidisciplinary framework integrating these ideas. We also argue that residential segregation leads to differential experiences of community stress, exposure to pollutants, and access to community resources. When not counterbalanced by resources, stressors may lead to heightened vulnerability to environmental hazards.

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Available from: Gilbert Gee, Aug 12, 2015
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    • "Firstly race, as a social, but certainly not biological construct, existed in a very concrete way during the apartheid era in South Africa, and the individuals included in this study were separated and segregated in every aspect of life according to their government-designated racial category of either black or white. In addition race, as a sociocultural construct (and distinct from biological or genetic ancestry) has been shown to have a profound impact on health and health outcomes worldwide and is an important factor in the social determinants of health and environmental epidemiology (Dressler et al., 2005; Gee and Devon, 2004; Gravlee, 2009; Gravlee and Dressler, 2005; Gravlee et al., 2005; Hicken et al., 2012; Williams and Collins, 2001). As such, race is often used as a categorical variable in epidemiological studies as it is here, and the terms " black " and " white " are common categorical designations. "
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    ABSTRACT: Manganese is a potent environmental toxin, with significant effects on human health. Manganese exposure is of particular concern in South Africa where in the last decade, lead in gasoline has been replaced by methylcyclopentadienyl manganese tricarbonyl (MMT). We investigated recent historical levels of manganese exposure in urban Gauteng, South Africa prior to the introduction of MMT in order to generate heretofore non-existent longitudinal public health data on manganese exposure in urban South Africans. Cortical bone manganese concentration was measured by inductively coupled plasma mass spectrometer in 211 deceased adults with skeletal material from a fully identified archived tissue collection at the University of Pretoria, South Africa. All tissues came from individuals who lived and died in urban Gauteng (Transvaal), between 1958 and 1998. Median Mn concentration within the sampled tissues was 0.3 μg g−1, which is within reported range for bone manganese concentration in non-occupationally exposed populations and significantly below that reported in individuals environmentally exposed to MMT. No significant differences were seen in bone Mn between men and women or in individuals of different ethnicity, which further suggests environmental, as opposed to occupational exposure. There were no significant temporal or geographic differences in bone Mn. The results suggest that Mn exposure was low and uniformly distributed across the whole population prior to the introduction of MMT as a gasoline additive. In addition, should manganese exposure follow the same patterns as vehicle-emitted lead, a clear pattern of exposure will emerge with individuals in the urban core facing the greatest manganese exposure.
    03/2015; 8. DOI:10.1016/j.ijpp.2014.09.005
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    • "Our aim is for this review to be a resource for researchers interested in environmentalperinatal epidemiology. Understanding how correlated social and environmental exposures at times overlap to produce potentially synergistic and modifiable effects will help guide future research and intervention strategies with the aim to improve the overall health of the population [36] [37] [38] [39] [40] "
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    ABSTRACT: Exposure to particulate air pollution and socioeconomic risk factors are shown to be independently associated with adverse pregnancy outcomes; however, their confounding relationship is an epidemiological challenge that requires understanding of their shared etiologic pathways affecting fetal-placental development. The purpose of this paper is to explore the etiological mechanisms associated with exposure to particulate air pollution in contributing to adverse pregnancy outcomes and how these mechanisms intersect with those related to socioeconomic status. Here we review the role of oxidative stress, inflammation and endocrine modification in the pathoetiology of deficient deep placentation and detail how the physical and social environments can act alone and collectively to mediate the established pathology linked to a spectrum of adverse pregnancy outcomes. We review the experimental and epidemiological literature showing that diet/nutrition, smoking, and psychosocial stress share similar pathways with that of particulate air pollution exposure to potentially exasperate the negative effects of either insult alone. Therefore, socially patterned risk factors often treated as nuisance parameters should be explored as potential effect modifiers that may operate at multiple levels of social geography. The degree to which deleterious exposures can be ameliorated or exacerbated via community-level social and environmental characteristics needs further exploration.
    Journal of Environmental and Public Health 11/2014; 2014. DOI:10.1155/2014/901017
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    • "For example, African Americans exhibit higher level of disabilities compared to Whites [7] [8]. Different factors, including physical inactivity, have been suggested to explain health disparities, such as higher rates of diseases in African Americans [9] [10] [11] [12]. African American women are a particular vulnerable group to unhealthy lifestyles, such as physical inactivity, and the resultant chronic diseases and conditions. "
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    ABSTRACT: Public health actions endorsed by the federal government, for instance, health promotion initiatives, usually have greater impact at population level compared to other types of initiatives. This commentary aims to instigate debate on the importance and necessity of producing federally endorsed Brazilian physical activity guidelines as a strategy for health promotion
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