Hector A Olvera Alvarez1, Allison A Appleton2, Christina H Fuller3, Annie Belcourt4, Laura D Kubzansky5. 1. School of Nursing, University of Texas El Paso, 500 W. University Ave, El Paso, TX, 79968, USA. holvera@utep.edu. 2. School of Public Health, Department of Epidemiology and Biostatistics, University at Albany, 1 University Place, Rensselaer, NY, 12144, USA. 3. School of Public Health, Division of Environmental Health, Georgia State University, P.O. Box 3995, Atlanta, GA, 30302, USA. 4. School of Community and Public Health Sciences/Pharmacy Practice, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA. 5. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
Abstract
PURPOSE OF THE REVIEW: Environmental and social determinants of health often co-occur, particularly among socially disadvantaged populations, yet because they are usually studied separately, their joint effects on health are likely underestimated. Building on converging bodies of literature, we delineate a conceptual framework to address these issues. RECENT FINDINGS: Previous models provided a foundation for study in this area, and generated research pointing to additional important issues. These include a stronger focus on biobehavioral pathways, both positive and adverse health outcomes, and intergenerational effects. To accommodate the expanded set of issues, we put forward the Integrated Socio-Environmental Model of Health and Well-Being (ISEM), which examines how social and environmental factors combine and potentially interact, via multi-factorial pathways, to affect health and well-being over the life span. We then provide applied examples including the study of how food environments affect dietary behavior. The ISEM provides a comprehensive, theoretically informed framework to guide future research on the joint contribution of social and environmental factors to health and well-being across the life span.
PURPOSE OF THE REVIEW: Environmental and social determinants of health often co-occur, particularly among socially disadvantaged populations, yet because they are usually studied separately, their joint effects on health are likely underestimated. Building on converging bodies of literature, we delineate a conceptual framework to address these issues. RECENT FINDINGS: Previous models provided a foundation for study in this area, and generated research pointing to additional important issues. These include a stronger focus on biobehavioral pathways, both positive and adverse health outcomes, and intergenerational effects. To accommodate the expanded set of issues, we put forward the Integrated Socio-Environmental Model of Health and Well-Being (ISEM), which examines how social and environmental factors combine and potentially interact, via multi-factorial pathways, to affect health and well-being over the life span. We then provide applied examples including the study of how food environments affect dietary behavior. The ISEM provides a comprehensive, theoretically informed framework to guide future research on the joint contribution of social and environmental factors to health and well-being across the life span.
Keywords:
Cumulative exposures; Health disparities; Life course; Social determinants; Total environment
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