An Integrated Socio-Environmental Model of Health and Well-Being: a Conceptual Framework Exploring the Joint Contribution of Environmental and Social Exposures to Health and Disease Over the Life Span
Purpose of the review
Environmental and social determinants of health often co-occur, particularly among socially disadvantaged populations, yet because they are usually studied separately, their joint effects on health are likely underestimated. Building on converging bodies of literature, we delineate a conceptual framework to address these issues.
Previous models provided a foundation for study in this area, and generated research pointing to additional important issues. These include a stronger focus on biobehavioral pathways, both positive and adverse health outcomes, and intergenerational effects. To accommodate the expanded set of issues, we put forward the Integrated Socio-Environmental Model of Health and Well-Being (ISEM), which examines how social and environmental factors combine and potentially interact, via multi-factorial pathways, to affect health and well-being over the life span. We then provide applied examples including the study of how food environments affect dietary behavior.
The ISEM provides a comprehensive, theoretically informed framework to guide future research on the joint contribution of social and environmental factors to health and well-being across the life span.
KeywordsTotal environment Social determinants Cumulative exposures Life course Health disparities
This work was funded by the JPB Environmental Health Fellowship Program granted by The JPB Foundation and managed by the Harvard T.H. Chan School of Public Health. The authors thank the JPB fellows for the helpful discussion in developing the ideas put forward here. The authors also thank Nicolle Tulve (EPA), Rachel Morello-Frosch (UC-Berkeley), Madeleine Scammell (Boston University), and Jose Ricardo Suarez (SDSU) for their helpful comments on the manuscript.
Compliance with Ethical Standards
Conflict of Interest
Hector A. Olvera Alvarez, Allison A. Appleton, Christina H. Fuller, Annie Belcourt, and Laura D. Kubzansky declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
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