| Environmental Health Disparities: A Framework Integrating Psychosocial and Environmental Concepts Gilbert C. Gee1 and Devon C. Payne-Sturges2 1University of Michigan School of Public Health, Department of Health Behavior and Health Education, Ann Arbor, Michigan, USA; 2Office of Policy, Economics and Innovation, and Office of Children's Health Protection, U.S. Environmental Protection Agency, Washington, DC, USA 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. Keywords: environmental, environmental justice, ethnicity, framework, health disparities, psychosocial, race, review, stress. Environ Health Perspect 112:1645-1653 (2004) . doi:10.1289/ehp.7074 available via http://dx.doi.org/ [Online 16 August 2004]
Address correspondence to G.C. Gee, University of Michigan School of Public Health, Department of Health Behavior and Health Education, 1420 Washington Heights, Room M5224, Ann Arbor, MI 48109-2029 USA. Telephone: (734) 615-7825. Fax: (734) 763-7379. E-mail: gilgee@umich.edu We thank M. Zimmerman and O. Nweke for their helpful comments with previous drafts of the manuscript. The views expressed in this document are those of the authors and do not represent official U.S. Environmental Protection Agency policy. The authors declare they have no competing financial interests. Received 5 March 2004 ; accepted 16 August 2004. An erratum was published in Environ Health Perspect 113: A18(2005) .
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