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      Environmental Health Disparities: A Framework Integrating Psychosocial and Environmental Concepts

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          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.

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          Protective and damaging effects of stress mediators.

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            Review of community-based research: assessing partnership approaches to improve public health.

            Community-based research in public health focuses on social, structural, and physical environmental inequities through active involvement of community members, organizational representatives, and researchers in all aspects of the research process. Partners contribute their expertise to enhance understanding of a given phenomenon and to integrate the knowledge gained with action to benefit the community involved. This review provides a synthesis of key principles of community-based research, examines its place within the context of different scientific paradigms, discusses rationales for its use, and explores major challenges and facilitating factors and their implications for conducting effective community-based research aimed at improving the public's health.
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              Dynamic models of segregation†


                Author and article information

                Environ Health Perspect
                Environmental Health Perspectives
                December 2004
                16 August 2004
                : 112
                : 17
                : 1645-1653
                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
                Author notes

                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@

                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.

                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.


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