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Environmental Exposure and Social Inequalities in Health

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences & Services".

Deadline for manuscript submissions: closed (31 December 2020) | Viewed by 11330

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Special Issue Editors

Prof. Dr. Séverine Deguen

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Guest Editor

EHESP School of Public Health, Institut Pierre Louis d'Epidémiologie et de Santé Publique - INSERM - UMRS, 1136 Paris, France
Interests: environmental exposure; social health inequalities; health disparities; spatial analysis; environmental epidemiology; biostatistic
Special Issues, Collections and Topics in MDPI journals

Dr. Wahida Kihal-talantikite

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Guest Editor

Laboratoire Image Ville Environnement (LIVE) UMR 7362 CNRS, University of Strasbourg, 6700 Strasbourg, France
Interests: environmental exposure; cluster analysis; geography; spatial epidemiology; social health inequalities
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Social determinants of health have a strong influence on a diversity of health outcomes. A similar influence has been observed regarding the field of environmental health. Socioeconomic inequalities are associated with unequal exposure to environmental risk factors which could contribute to health inequalities.

For a number of years, the scientific literature has been advancing the hypothesis by which environmental exposures might be linked with social determinants.

The first hypothesis is differential exposure: The most deprived populations (or populations living in deprived areas) are more likely to be exposed to a higher number of environmental nuisances or to a higher level of environmental exposure.
The second hypothesis, the vulnerability differential, suggests that the most deprived populations (or populations living in deprived areas) have increased susceptibility and vulnerability to poor health as a consequences of more psychosocial stressors, fewer opportunities to choose health promoting behaviors, and poorer health status.

Both differential exposure and vulnerability result in health disparities that are driven by environmental determinants.

COVID-19: We encourage articles investigating social and environmental inequalities with respect to the risks associated with COVID-19 as a current illustration of this crucial public health issue.

The outbreak of the disease associated with the novel coronavirus, COVID-19, is an ongoing global epidemic that was declared a pandemic by the World Health Organization in March 2020. Recent works revealed several risks factors for the development of the disease, including older age, smoking history, as well as hypertension and heart disease. A recent hypothesis suggests that long-term exposure to air pollution could play a key role in the risk of death caused by COVID-19 as it has been documented that exposure to air pollution (NO₂ and PM particularly) causes inflammation in the lungs. In addition, one may not exclude that due to socioeconomic deprivation, certain populations could be more vulnerable to COVID-19.

The current sanitary crisis reminds us of how unequal we all are in facing this disease. Building a healthy environment for all, and especially for the most vulnerable population, is a crucial issue if we want to design and implement measures for a greener and more equitable territory.

This Special Issue wishes to present epidemiological studies which provide evidence regarding the current status of environmental health inequalities and quantification of different environmental health risk such as air pollution, noise, water quality, etc. Of particular interest are studies which investigate how individual differences in exposure and vulnerability may determine health inequalities. We particularly encourage studies that examine these issues in relation to COVID-19.

Prof. Dr. Séverine Deguen
Dr. Wahida Kihal-talantikite
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

social health inequalities
environmental inequalities
differential exposure
vulnerability
deprived population
COVID-19

Published Papers (3 papers)

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Research

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12 pages, 476 KiB

Open AccessArticle

Socioeconomic Differences in Walking Time of Children and Adolescents to Public Green Spaces in Urban Areas—Results of the German Environmental Survey (2014–2017)

by Julia Rehling, Christiane Bunge, Julia Waldhauer and André Conrad

Int. J. Environ. Res. Public Health 2021, 18(5), 2326; https://doi.org/10.3390/ijerph18052326 - 26 Feb 2021

Cited by 14 | Viewed by 3233

Abstract

Public green spaces have a high potential for a positive impact on people’s health and wellbeing, especially in urban areas. Studies on environmental justice indicate socially unequal access possibilities to urban green spaces. This article presents results on associations between individual socioeconomic position (SEP) and walking time from home to public green spaces in young people living in urban areas with more than 20,000 inhabitants in Germany. Data were derived from the German Environmental Survey for Children and Adolescents 2014–2017 (GerES V), the environmental module of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 2). The sample comprises 1149 participants aged 3 to 17 years. A total of 51.5% of the participants reach a public green space on foot within five and 72.8% within ten minutes from home. The lower the participant’s SEP, the longer the walking time. Logistic regression models controlling for age group, sex, migration background, and region of residence show that participants with a low SEP have a significantly higher risk (odds ratio = 1.98; 95% confidence interval: 1.31–2.99) of needing more than ten minutes to walk from home to a public green space than participants with a high SEP. GerES V data indicate that young people living in urban areas in Germany do not equally benefit from the health-promoting potential of green spaces, which is an important aspect of environmental health inequalities. Full article

(This article belongs to the Special Issue Environmental Exposure and Social Inequalities in Health)

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16 pages, 5579 KiB

Open AccessArticle

Spatial Inequity of Multi-Level Healthcare Services in a Rapid Expanding Immigrant City of China: A Case Study of Shenzhen

by Wei Hu, Lin Li and Mo Su

Int. J. Environ. Res. Public Health 2019, 16(18), 3441; https://doi.org/10.3390/ijerph16183441 - 17 Sep 2019

Cited by 19 | Viewed by 3720

Abstract

Since the onset of reform and opening up in China, large cities in the nation have been experiencing problems related to limited medical resources. These resource limitations are due to rapid population growth and urban expansion. As the country’s fastest growing city, Shenzhen has experienced a substantial misalignment between the supply and the demand of healthcare services. Numerous researchers have analyzed spatial inequity in healthcare services by focusing on the spatial accessibility of medical facilities, such as hospitals, clinics, and community health service centers (CHSCs). However, the issue of inequity in healthcare services for vulnerable groups has largely been ignored. We chose general hospitals (GHs) and CHSCs, which provide direct healthcare services to residents, as the study objects. By performing spatial accessibility analysis using the gravity model and the two-step floating catchment area method, we investigated healthcare services inequity for vulnerable groups based on four dimensions: residential type, age, education level, and occupation. We found that the services provided by GHs cannot meet the demand in Shenzhen. This inadequacy is characterized by spatial centralization and neglect of those who reside in urban villages, who have low education levels, and who are employed in the manufacturing industry. In contrast, CHSCs generally serve a relatively broad population. This phenomenon is related to differences in the land and capital needs between GHs and CHSCs. Our study reveals that an appropriate adjustment of GH location could significantly improve healthcare services inequity. Therefore, to alleviate this inequity, it is particularly necessary to increase the number of GHs in the peripheral circle and in areas with large vulnerable populations, accelerate the implementation of the hierarchical medical system, and promote the transfer of medical resources to grassroot institutes through CHSCs. This study helps improve our understanding of healthcare services inequity in rapid expanding cities, which is of substantial significance for improving the planning and construction of medical facilities, facilitating scientific decision-making, and promoting social equity. Full article

(This article belongs to the Special Issue Environmental Exposure and Social Inequalities in Health)

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Review

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70 pages, 6429 KiB

Open AccessReview

Adverse Birth Outcomes Related to NO₂ and PM Exposure: European Systematic Review and Meta-Analysis

by Valentin Simoncic, Christophe Enaux, Séverine Deguen and Wahida Kihal-Talantikite

Int. J. Environ. Res. Public Health 2020, 17(21), 8116; https://doi.org/10.3390/ijerph17218116 - 03 Nov 2020

Cited by 26 | Viewed by 3833

Abstract

There is a growing number of international studies on the association between ambient air pollution and adverse pregnancy outcomes, and this systematic review and meta-analysis has been conducted focusing on European countries, to assess the crucial public health issue of this suspected association on this geographical area. A systematic literature search (based on Preferred Reporting Items for Systematic reviews and Meta-Analyses, PRISMA, guidelines) has been performed on all European epidemiological studies published up until 1 April 2020, on the association between maternal exposure during pregnancy to nitrogen dioxide (NO₂) or particular matter (PM) and the risk of adverse birth outcomes, including: low birth weight (LBW) and preterm birth (PTB). Fourteen articles were included in the systematic review and nine of them were included in the meta-analysis. Our meta-analysis was conducted for 2 combinations of NO₂ exposure related to birth weight and PTB. Our systematic review revealed that risk of LBW increases with the increase of air pollution exposure (including PM₁₀, PM_2.5 and NO₂) during the whole pregnancy. Our meta-analysis found that birth weight decreases with NO₂ increase (pooled beta = −13.63, 95% confidence interval (CI) (−28.03, 0.77)) and the risk of PTB increase for 10 µg/m3 increase in NO₂ (pooled odds ratio (OR) = 1.07, 95% CI (0.90, 1.28)). However, the results were not statistically significant. Our finding support the main international results, suggesting that increased air pollution exposure during pregnancy might contribute to adverse birth outcomes, especially LBW. This body of evidence has limitations that impede the formulation of firm conclusions. Further studies, well-focused on European countries, are called to resolve the limitations which could affect the strength of association such as: the exposure assessment, the critical windows of exposure during pregnancy, and the definition of adverse birth outcomes. This analysis of limitations of the current body of research could be used as a baseline for further studies and may serve as basis for reflection for research agenda improvements. Full article

(This article belongs to the Special Issue Environmental Exposure and Social Inequalities in Health)

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