An Integrated Socio-Environmental Model of Health and Well-Being: a Conceptual Framework Exploring the Joint Contribution of Environmental and Social Exposures to Health and Disease Over the Life Span

Álvarez, Héctor A. Olvera; Appleton, Allison A.; Fuller, Christina H.; Belcourt, Annie; Kubzansky, Laura D.

doi:10.1007/s40572-018-0191-2

Cited by 32 publications

(29 citation statements)

References 104 publications

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“…Interdisciplinary research is urgently needed to determine how exposures, as they occur in the real world rather than in the siloed world of epidemiology, contribute to social disparities in health and, most importantly, how data along these lines can help scientists identify the factors that can be modified to prevent or manage these problems. To this end, we recently proposed a broad framework that accounts for a wide range of overlapping social and environmental exposures across the lifespan and delineates underlying biobehavioral pathways that lead to chronic illness (Olvera Alvarez et al, 2018). Along with this framework, a roadmap for research in this area was also delineated.…”

Section: Future Directionsmentioning

confidence: 99%

Early life stress, air pollution, inflammation, and disease: An integrative review and immunologic model of social-environmental adversity and lifespan health

Álvarez

Kubzansky

Campen

et al. 2018

Neuroscience & Biobehavioral Reviews

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100

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Socially disadvantaged individuals are at greater risk for simultaneously being exposed to adverse social and environmental conditions. Although the mechanisms underlying joint effects remain unclear, one hypothesis is that toxic social and environmental exposures have synergistic effects on inflammatory processes that underlie the development of chronic diseases, including cardiovascular disease, diabetes, depression, and certain types of cancer. In the present review, we examine how exposure to two risk factors that commonly occur with social disadvantage-early life stress and air pollution-affect health. Specifically, we identify neuroimmunologic pathways that could link early life stress, inflammation, air pollution, and poor health, and use this information to propose an integrated, multi-level model that describes how these factors may interact and cause health disparity across individuals based on social disadvantage. This model highlights the importance of interdisciplinary research considering multiple exposures across domains and the potential for synergistic, cross-domain effects on health, and may help identify factors that could potentially be targeted to reduce disease risk and improve lifespan health.

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Section: Future Directionsmentioning

confidence: 99%

Early life stress, air pollution, inflammation, and disease: An integrative review and immunologic model of social-environmental adversity and lifespan health

Álvarez

Kubzansky

Campen

et al. 2018

Neuroscience & Biobehavioral Reviews

Self Cite

100

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“…While developing a conceptual model is not necessary for problem formulation, it can serve as a blueprint to inform various aspects of CRAs pertaining to the stakeholders and indicators that should be used when developing EJ screening tools to address health inequities. Current frameworks have tried to address many of the deficient characteristics of CRAs by considering the joint contribution of socio-environmental factors that may affect health and wellbeing throughout the trajectory of the life course [32]. Nevertheless, we continue to build upon these conceptual frameworks to improve the screening tools that are used to identify inequities, plan public health interventions, and change policies.…”

Section: Introductionmentioning

confidence: 99%

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

Burwell-Naney

Wilson

Whitlock

et al. 2019

IJERPH

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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.

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“…We utilize the Integrated Socio-Environmental Model of Health and Wellbeing (ISEM) as the conceptual model for this analysis (Olvera Alvarez, Appleton, Fuller, Belcourt, & Kubzansky, 2018). The ISEM describes how social and environmental factors combine and potentially interact, via multi-factorial pathways, to affect health and well-being over the life span.…”

Section: Methodsmentioning

confidence: 99%

Sex differences in the interaction of short-term particulate matter exposure and psychosocial stressors on C-reactive protein in a Puerto Rican cohort

Fuller

Appleton

Bulsara

et al. 2019

SSM - Population Health

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There is substantial evidence linking particulate matter air pollution with cardiovascular morbidity and mortality. However, health disparities between populations may exist due to imprecisely defined non-innate susceptibility factors. Psychosocial stressors are associated with cardiovascular disease and may increase non-innate susceptibility to air-pollution. We investigated whether the association between short-term changes in ambient particulate matter and cardiovascular health risk differed by psychosocial stressors in a Puerto Rican cohort, comparing women and men. We used data from the Boston Puerto Rican Health Study (BPRHS), a longitudinal study of cardiovascular health among adults, collected between 2004 and 2013. We used mixed effect models to estimate the association of current-day ambient particle number concentration (PNC) on C-reactive protein (CRP), a marker of systemic inflammation, and effect modification by psychosocial stressors (depression, acculturation, perceived stress, discrimination, negative life events and a composite score). Point estimates of percent difference in CRP per interquartile range change in PNC varied among women with contrasting levels of stressors: negative life events (15.7% high vs. 6.5% low), depression score (10.6% high vs. 4.6% low) and composite stress score (16.2% high vs. 7.0% low). There were minimal differences among men. For Puerto Rican adults, cardiovascular non-innate susceptibility to adverse effects of ambient particles may be greater for women under high stress. This work contributes to understanding health disparities among minority ethnic populations.

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An Integrated Socio-Environmental Model of Health and Well-Being: a Conceptual Framework Exploring the Joint Contribution of Environmental and Social Exposures to Health and Disease Over the Life Span

Cited by 32 publications

References 104 publications

Early life stress, air pollution, inflammation, and disease: An integrative review and immunologic model of social-environmental adversity and lifespan health

Early life stress, air pollution, inflammation, and disease: An integrative review and immunologic model of social-environmental adversity and lifespan health

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

Sex differences in the interaction of short-term particulate matter exposure and psychosocial stressors on C-reactive protein in a Puerto Rican cohort

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