title: The environmental "riskscape" and social inequality: implications for explaining maternal and child health disparities.
abstract: BACKGROUND
  Research indicates that the double jeopardy of exposure to environmental hazards combined with place-based stressors is associated with maternal and child health (MCH) disparities.
  Our aim is to present evidence that individual-level and place-based psychosocial stressors may compromise host resistance such that environmental pollutants would have adverse health effects at relatively lower doses, thus partially explaining MCH disparities, particularly poor birth outcomes. Allostatic load may be a physiologic mechanism behind the moderation of the toxic effect of environmental pollutants by social stressors. We propose a conceptual framework for holistic approaches to future MCH research that elucidates the interplay of psychosocial stressors and environmental hazards in order to better explain drivers of MCH disparities.
  
  
  CONCLUSIONS
  Given the complexity of the link between environmental factors and MCH disparities, a holistic approach to future MCH research that seeks to untangle the double jeopardy of chronic stressors and environmental hazard exposures could help elucidate how the interplay of these factors shapes persistent racial and economic disparities in MCH.
authors.affiliation: Center for Environmental Studies and Department of Community Health, School of Medicine, Brown University, Providence, Rhode Island 02912, USA. rmf@brown.edu
authors.forename: Rachel
authors.initials: R
authors.lastname: Morello-Frosch
authors.forename: Edmond D
authors.initials: ED
authors.lastname: Shenassa
mesh_terms: D002648:Child; D002669:Child Welfare / Q000191:economics / Q000706:statistics & numerical data*; D004781:Environmental Exposure / Q000009:adverse effects* / Q000706:statistics & numerical data*; D004782:Environmental Health / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008429:Maternal Welfare / Q000191:economics / Q000706:statistics & numerical data*; D011247:Pregnancy; D011610:Psychosocial Deprivation; D018570:Risk Assessment; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology