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Unformatted text preview: Annu. Rev. Public Health 2002. 23:30331 DOI: 10.1146/annurev.publhealth.23.112001.112349 Copyright c 2002 by Annual Reviews. All rights reserved S OCIOECONOMIC S TATUS AND H EALTH : The Potential Role of Environmental Risk Exposure Gary W. Evans and Elyse Kantrowitz Departments of Design and Environmental Analysis and of Human Development, College of Human Ecology, Cornell University, Ithaca, NY 14853-4401; e-mail: email@example.com Key Words environmental justice, income, socioeconomic status, poverty, environmental risk Abstract Among several viable explanations for the ubiquitous SES-health gra- dient is differential exposure to environmental risk. We document evidence of inverse relations between income and other indices of SES with environmental risk factors including hazardous wastes and other toxins, ambient and indoor air pollutants, water quality, ambient noise, residential crowding, housing quality, educational facilities, work environments, and neighborhood conditions. We then briefly overview evidence that such exposures are inimical to health and well-being. We conclude with a discus- sion of the research and policy implications of environmental justice, arguing that a particularly salient feature of poverty for health consequences is exposure to multiple environmental risk factors. SOCIOECONOMIC STATUS AND HEALTH: THE POTENTIAL ROLE OF ENVIRONMENTAL RISK EXPOSURE Satisfactory explanation for the ubiquitous socioeconomic status-health gradient remains elusive, suggesting, in part, that an adequate model of this relation is prob- ably complex and multifaceted (1, 81). In this paper we provide an overview of data indicating that income is inversely correlated with exposure to suboptimal environ- mental conditions. By environmental conditions we mean the physical properties of the ambient and immediate surroundings of children, youth, and families, in- cluding pollutants, toxins, noise, and crowding as well as exposure to settings such as housing, schools, work environments, and neighborhoods. We also briefly cite evidence that each of these environmental factors, in turn, is linked to health. The implicit conceptual model under discussion is as follows (Figure 1): As can be seen above, what we discuss is evidence for two necessary prerequisites for this model to be validnamely that socioeconomic status (SES) is associated with environmental quality and, in turn, that environmental quality affects health. This is not equivalent, however, to the conclusion that SES effects on health are caused 0163-7525/02/0510-0303$14.00 303 304 EVANS KANTROWITZ Figure 1 Basic underlying conceptual model. by differential exposure to environmental quality. There are few if any data directly testing this proposition. What is necessary to verify the model shown in Figure 1 is that the SES health link is mediated by environmental quality....
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