What Is “Socioeconomic Position (SEP),” and How Might It Modify Air Pollution-Health Associations? Cohering Findings, Identifying Challenges, and Disentangling Effects of SEP and Race in US City Settings

Abstract

Purpose of Review Environmental epidemiology has long considered socioeconomic position (SEP) to be an important confounder of pollution effects on health, given that, in the USA, lower-income and minority communities are often disproportionately exposed to pollution. In recent decades, a growing literature has revealed that lower-SEP communities may also be more susceptible to pollution. Given the vast number of material and psychosocial stressors that vary by SEP, however, it is unclear which specific aspects of SEP may underlie this susceptibility. As environmental epidemiology engages more rigorously with issues of differential susceptibility, it is pertinent to define SEP more clearly, to disentangle its many aspects, and to move towards identifying causal components. Myriad stressors and exposures vary with SEP, with effects accumulating and interacting over the lifecourse. Here, we ask: In the context of environmental epidemiology, how do we meaningfully characterize”SEP”? Recent Findings In answering this question, it is critical to acknowledge that SEP, stressors, and pollution are differentially distributed by race in US cities. These distributions have been shaped by neighborhood sorting and race-based residential segregation rooted in historical policies and processes (e.g., redlining), which have served to concentrate wealth and opportunities for education and employment in predominantly-white communities. As a result, it is now profoundly challenging to separate SEP from race in the urban US setting. Summary Here, we cohere evidence from our recent and on-going studies aimed at disentangling synergistic health effects among SEP-related stressors and pollutants. We consider an array of SEP-linked social stressors, and discuss persistent challenges in this epidemiology, many of which are related to spatial confounding among multiple pollutants and stressors. Combining quantitative results with insights from qualitative data on neighborhood perceptions and stress (including violence and police-community relations), we offer a lens towards unpacking the complex interplay among SEP, community stressors, race, and pollution in US cities.

Spatialized PM 2.5 during Covid-19 Pandemic in Brazil’s most populous Southern City: Implications for Post-Pandemic Era

“…In general, regions that attained higher averages of particulate matter corresponded to areas with lower MHDI values (Fig. 3), aligning with previous studies (Clougherty et al, 2022;da Motta Singer et al, 2023).…”

Early-Life Exposure to Air Pollution and Childhood Asthma Cumulative Incidence in the ECHO CREW Consortium

“…We found that associations of air pollution exposure with asthma were elevated among Black children and children born to mothers without a high school diploma. These results are consistent with prior studies showing that socioeconomic position (SEP) and race are key drivers of elevated environmental exposures, including air pollution, and race and SEP, each of which can be independently or synergistically associated with elevated physiologic stress leading to inflammation that increases susceptibility to disease, including asthma . In addition, Black children are more likely to be exposed to adverse childhood experiences, poor housing quality and indoor environments, and have less access to healthy food and greenspace .…”

“…These results are consistent with prior studies showing that socioeconomic position (SEP) and race are key drivers of elevated environmental exposures, including air pollution, and race and SEP, each of which can be independently or synergistically associated with elevated physiologic stress leading to inflammation that increases susceptibility to disease, including asthma. 28 , 29 In addition, Black children are more likely to be exposed to adverse childhood experiences, poor housing quality and indoor environments, and have less access to healthy food and greenspace. 30 These factors, likely in combination, may inequitably affect Black children such that the negative health effects due to exposure to air pollution are heightened.…”

Air pollution perception for air quality management: a systematic review exploring research themes and future perspectives

“…Socio-economic position affects health via stress mechanisms and physical pathways (Clougherty et al 2022). At the same time, socio-cultural factors mediate the relation between actual pollution and risk perception .…”