Conceptual models for cumulative risk assessment.
In the absence of scientific consensus on an appropriate theoretical framework, cumulative risk assessment and related research have relied on speculative conceptual models. We argue for the importance of theoretical backing for such models and discuss 3 relevant theoretical frameworks, each supporting a distinctive "family" of models. Social determinant models postulate that unequal health outcomes are caused by structural inequalities; health disparity models envision social and contextual factors acting through individual behaviors and biological mechanisms; and multiple stressor models incorporate environmental agents, emphasizing the intermediary role of these and other stressors. The conclusion is that more careful reliance on established frameworks will lead directly to improvements in characterizing cumulative risk burdens and accounting for disproportionate adverse health effects.
Institute for Health Policy, The University of Texas School of Public Health, Houston TX 77030, USA. stephen.h.linder@uth.tmc.edu
Stephen H
SH
Linder
Ken
K
Sexton
D004781:Environmental Exposure / Q000009:adverse effects / Q000032:analysis*; D054624:Health Status Disparities; D006801:Humans; D008962:Models, Theoretical; D018570:Risk Assessment / Q000379:methods*; D012959:Socioeconomic Factors; D013315:Stress, Psychological