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      Vulnerability as a Function of Individual and Group Resources in Cumulative Risk Assessment

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          Abstract

          Background

          The field of risk assessment has focused on protecting the health of individual people or populations of wildlife from single risks, mostly from chemical exposure. The U.S. Environmental Protection Agency recently began to address multiple risks to communities in the “Framework for Cumulative Risk Assessment” [EPA/630/P02/001F. Washington DC:Risk Assessment Forum, U.S. Environmental Protection Agency (2003)].

          Simultaneously, several reports concluded that some individuals and groups are more vulnerable to environmental risks than the general population. However, vulnerability has received little specific attention in the risk assessment literature.

          Objective

          Our objective is to examine the issue of vulnerability in cumulative risk assessment and present a conceptual framework rather than a comprehensive review of the literature. In this article we consider similarities between ecologic and human communities and the factors that make communities vulnerable to environmental risks.

          Discussion

          The literature provides substantial evidence on single environmental factors and simple conditions that increase vulnerability or reduce resilience for humans and ecologic systems. This observation is especially true for individual people and populations of wildlife. Little research directly addresses the topic of vulnerability in cumulative risk situations, especially at the community level. The community level of organization has not been adequately considered as an end point in either human or ecologic risk assessment. Furthermore, current information on human risk does not completely explain the level of response in cumulative risk conditions. Ecologic risk situations are similarly more complex and unpredictable for cases of cumulative risk.

          Conclusions

          Psychosocial conditions and responses are the principal missing element for humans. We propose a model for including psychologic and social factors as an integral component of cumulative risk assessment.

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          Most cited references87

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          Stress, social support, and the buffering hypothesis.

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            Neighborhood of residence and incidence of coronary heart disease.

            Where a person lives is not usually thought of as an independent predictor of his or her health, although physical and social features of places of residence may affect health and health-related behavior. Using data from the Atherosclerosis Risk in Communities Study, we examined the relation between characteristics of neighborhoods and the incidence of coronary heart disease. Participants were 45 to 64 years of age at base line and were sampled from four study sites in the United States: Forsyth County, North Carolina; Jackson, Mississippi; the northwestern suburbs of Minneapolis; and Washington County, Maryland. As proxies for neighborhoods, we used block groups containing an average of 1000 people, as defined by the U.S. Census. We constructed a summary score for the socioeconomic environment of each neighborhood that included information about wealth and income, education, and occupation. During a median of 9.1 years of follow-up, 615 coronary events occurred in 13,009 participants. Residents of disadvantaged neighborhoods (those with lower summary scores) had a higher risk of disease than residents of advantaged neighborhoods, even after we controlled for personal income, education, and occupation. Hazard ratios for coronary events in the most disadvantaged group of neighborhoods as compared with the most advantaged group--adjusted for age, study site, and personal socioeconomic indicators--were 1.7 among whites (95 percent confidence interval, 1.3 to 2.3) and 1.4 among blacks (95 percent confidence interval, 0.9 to 2.0). Neighborhood and personal socioeconomic indicators contributed independently to the risk of disease. Hazard ratios for coronary heart disease among low-income persons living in the most disadvantaged neighborhoods, as compared with high-income persons in the most advantaged neighborhoods were 3.1 among whites (95 percent confidence interval, 2.1 to 4.8) and 2.5 among blacks (95 percent confidence interval, 1.4 to 4.5). These associations remained unchanged after adjustment for established risk factors for coronary heart disease. Even after controlling for personal income, education, and occupation, we found that living in a disadvantaged neighborhood is associated with an increased incidence of coronary heart disease.
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              The development of competence in favorable and unfavorable environments. Lessons from research on successful children.

              The development of competence holds great interest for parents and society alike. This article considers implications from research on competence and resilience in children and adolescents for policy and interventions designed to foster better outcomes among children at risk. Foundations of competence in early development are discussed, focusing on the role of attachment relationships and self-regulation. Results from studies of competence in the domains of peer relations, conduct, school, work, and activities are highlighted. Lessons are drawn from studies of naturally occurring resilience among children at risk because of disadvantage or trauma and also from efforts to deliberately alter the course of competence through early childhood education and preventive interventions. Converging evidence suggests that the same powerful adaptive systems protect development in both favorable and unfavorable environments.
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                Author and article information

                Journal
                Environ Health Perspect
                Environmental Health Perspectives
                National Institute of Environmental Health Sciences
                0091-6765
                May 2007
                24 January 2007
                : 115
                : 5
                : 817-824
                Affiliations
                [1 ] Virginia Commonwealth University, Richmond, Virginia, USA
                [2 ] Cornell University, Ithaca, New York, USA
                [3 ] U.S. Environmental Protection Agency, National Center for Computational Toxicology, Research Triangle Park, North Carolina, USA
                [4 ] University of California Berkeley, Berkeley, California, USA
                [5 ] Brown University, Providence, Rhode Island, USA
                [6 ] Harvard School of Public Health, Boston, Massachusetts, USA
                Author notes
                Address correspondence to P.L. deFur, Virginia Commonwealth University, P.O. Box 843050, Richmond, VA 23284 USA. Telephone: (804) 828-1760. Fax: (804) 828-1622. E-mail: pldefur@ 123456vcu.edu

                P.D. has a private environmental consulting business in addition to working as a part-time faculty member. All other authors declare they have no competing financial interests.

                Article
                ehp0115-000817
                10.1289/ehp.9332
                1867984
                17520073
                4612beaa-bccc-4e75-a7a1-e361a8fb3f36
                This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original DOI
                History
                : 15 May 2006
                : 4 December 2006
                Categories
                Research
                Mini-Monograph

                Public health
                communities,vulnerability,environmental justice,public health,cumulative risk
                Public health
                communities, vulnerability, environmental justice, public health, cumulative risk

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