Maryland Institute for Applied Environmental Health, University of Maryland School of UMD Public Health, College Park, Maryland, USA.
University of Rochester School of Medicine, Rochester, New York, USA.
Environ Health Perspect. 2021 Mar;129(3):35001. doi: 10.1289/EHP7333. Epub 2021 Mar 10.
The combined effects of multiple environmental toxicants and social stressor exposures are widely recognized as important public health problems contributing to health inequities. However cumulative environmental health risks and impacts have received little attention from U.S. policy makers at state and federal levels to develop comprehensive strategies to reduce these exposures, mitigate cumulative risks, and prevent harm. An area for which the inherent limitations of current approaches to cumulative environmental health risks are well illustrated is children's neurodevelopment, which exhibits dynamic complexity of multiple interdependent and causally linked factors and intergenerational effects.
We delineate how a complex systems approach, specifically system dynamics, can address shortcomings in environmental health risk assessment regarding exposures to multiple chemical and nonchemical stressors and reshape associated public policies.
Systems modeling assists in the goal of solving problems by improving the "mental models" we use to make decisions, including regulatory and policy decisions. In the context of disparities in children's cumulative exposure to neurodevelopmental stressors, we describe potential policy insights about the structure and behavior of the system and the types of system dynamics modeling that would be appropriate, from visual depiction (i.e., informal maps) to formal quantitative simulation models. A systems dynamics framework provides not only a language but also a set of methodological tools that can more easily operationalize existing multidisciplinary scientific evidence and conceptual frameworks on cumulative risks. Thus, we can arrive at more accurate diagnostic tools for children's' environmental health inequities that take into consideration the broader social and economic environment in which children live, grow, play, and learn. https://doi.org/10.1289/EHP7333.
多种环境毒物和社会压力源暴露的综合影响已被广泛认为是导致健康不平等的重要公共卫生问题。然而，累积的环境健康风险和影响在美国州和联邦各级的政策制定者中很少受到关注，他们没有制定全面的战略来减少这些暴露，减轻累积风险，并防止伤害。一个很好地说明了当前累积环境健康风险方法存在固有局限性的领域是儿童神经发育，它表现出多种相互依存和因果相关因素以及代际效应的动态复杂性。
我们阐述了复杂系统方法，特别是系统动力学，如何解决针对多种化学和非化学应激源暴露的环境健康风险评估中的不足之处，并重塑相关公共政策。
系统建模通过改进我们用于做出决策的“思维模型”来帮助解决问题，包括监管和政策决策。在儿童对神经发育应激源的累积暴露存在差异的背景下，我们描述了关于系统结构和行为的潜在政策见解，以及适合的系统动力学建模类型，从可视化描述（即非正式地图）到正式定量模拟模型。系统动力学框架不仅提供了一种语言，还提供了一套方法学工具，可以更方便地操作关于累积风险的现有多学科科学证据和概念框架。因此，我们可以为儿童的环境健康不平等问题提供更准确的诊断工具，这些工具考虑到了儿童生活、成长、玩耍和学习的更广泛的社会和经济环境。https://doi.org/10.1289/EHP7333.
