The Role of Non-Chemical Stressors in Mediating Socioeconomic Susceptibility to Environmental Chemicals

Abstract

Growing evidence suggests that lower socioeconomic position (SEP) communities may be more susceptible to environmental exposures. SEP, however, represents a complex mix of social and environmental exposures accumulating over the lifecourse, and those components that most impact susceptibility remain undetermined. One plausible hypothesis is that the chronic psychological stress associated with stressors in many lower-SEP communities (e.g., housing instability, food insecurity, fear of violence) may lead to altered immune, endocrine, and metabolic function. These alterations, together with environmental exposures, may ultimately contribute to increased risk of developing a variety of chronic diseases. Clearer insight into which specific components of SEP may magnify susceptibility to toxic environmental exposures is needed to improve epidemiologic analyses, and to design more effective environmental health policies and interventions. Here, we compile recent evidence published since 2009, when we conducted a similar review of this topic, towards developing a better understanding of chronic stress as a possible mediator of SEP-related pollution susceptibility. We discuss recent findings on common patterning (i.e., spatial correlation) between these exposures and methodological needs to facilitate disentangling health effects of non-chemical and chemical stressors. Finally, we briefly discuss the implications of disentangling SEP- and stress-related susceptibility for cumulative risk assessment.