School of Nursing, University of Texas at El Paso, Health Science and Nursing Building, Room 359, 500 West University Avenue, El Paso, TX, USA.
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Neurosci Biobehav Rev. 2018 Sep;92:226-242. doi: 10.1016/j.neubiorev.2018.06.002. Epub 2018 Jun 3.
Socially disadvantaged individuals are at greater risk for simultaneously being exposed to adverse social and environmental conditions. Although the mechanisms underlying joint effects remain unclear, one hypothesis is that toxic social and environmental exposures have synergistic effects on inflammatory processes that underlie the development of chronic diseases, including cardiovascular disease, diabetes, depression, and certain types of cancer. In the present review, we examine how exposure to two risk factors that commonly occur with social disadvantage-early life stress and air pollution-affect health. Specifically, we identify neuroimmunologic pathways that could link early life stress, inflammation, air pollution, and poor health, and use this information to propose an integrated, multi-level model that describes how these factors may interact and cause health disparity across individuals based on social disadvantage. This model highlights the importance of interdisciplinary research considering multiple exposures across domains and the potential for synergistic, cross-domain effects on health, and may help identify factors that could potentially be targeted to reduce disease risk and improve lifespan health.
社会弱势群体面临着同时暴露于不利社会和环境条件的更大风险。虽然联合效应的机制尚不清楚，但有一种假设是，有毒的社会和环境暴露对炎症过程具有协同作用，而这些炎症过程是导致慢性疾病（包括心血管疾病、糖尿病、抑郁症和某些类型的癌症）发展的基础。在本综述中，我们研究了两种常见的社会劣势风险因素（即早期生活压力和空气污染）如何影响健康。具体来说，我们确定了可能将早期生活压力、炎症、空气污染和健康不良联系起来的神经免疫途径，并利用这些信息提出了一个综合的、多层次的模型，描述了这些因素如何相互作用，并基于社会劣势导致个体之间的健康差异。该模型强调了考虑多个领域的多种暴露以及对健康产生协同、跨领域影响的跨学科研究的重要性，并可能有助于确定可能成为减少疾病风险和改善寿命健康的目标因素。
