The environmental "Riskscape" and social inequality: Implications for explaining maternal and child health disparities

Abstract

Background: Research indicates that the double jeopardy of exposure to enviromental hazards combined with place-based stressors is associated with maternal and child health (MCH) disparities. Objective and discussion: Our 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 enviromental hazards in order to better explain drivers of MCH disparities. Conclusion: Given the complexity of the link between environmental factors and MCH disparities, a holistic approach to future MCH research exposures could help elucidate how the interplay of these factors shapes persistent racial and economic disparities in MCH.