Poor children confront widespread environmental inequities. Compared with their economically advantaged counterparts, they are exposed to more family turmoil, violence, separation from their families, instability, and chaotic households. Poor children experience less social support, and their parents are less responsive and more authoritarian. Low-income children are read to relatively infrequently, watch more TV, and have less access to books and computers. Low-income parents are less involved in their children's school activities. The air and water poor children consume are more polluted. Their homes are more crowded, noisier, and of lower quality. Low-income neighborhoods are more dangerous, offer poorer municipal services, and suffer greater physical deterioration. Predominantly low-income schools and day care are inferior. The accumulation of multiple environmental risks rather than singular risk exposure may be an especially pathogenic aspect of childhood poverty.

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This study merged two theoretical constructs: cumulative risk and allostatic load. Physical (crowding, noise, housing quality) and psychosocial (child separation, turmoil, violence) aspects of the home environment and personal characteristics (poverty, single parenthood, maternal highschool dropout status) were modeled in a cumulative risk heuristic. Elevated cumulative risk was associated with heightened cardiovascular and neuroendocrine parameters, increased deposition of body fat, and a higher summary index of total allostatic load. Previous findings that children who face more cumulative risk have greater psychological distress were replicated among a sample of rural children and shown to generalize to lower perceptions of self-worth. Prior cumulative risk research was further extended through demonstration of self-regulatory behavior problems and elevated learned helplessness.

Key Words environmental justice, income, socioeconomic status, poverty, environmental risk s Abstract Among several viable explanations for the ubiquitous SES-health gradient is differential exposure to environmental risk. We document evidence of inverse relations between income and other indices of SES with environmental risk factors including hazardous wastes and other toxins, ambient and indoor air pollutants, water quality, ambient noise, residential crowding, housing quality, educational facilities, work environments, and neighborhood conditions. We then briefly overview evidence that such exposures are inimical to health and well-being. We conclude with a discussion of the research and policy implications of environmental justice, arguing that a particularly salient feature of poverty for health consequences is exposure to multiple environmental risk factors. SOCIOECONOMIC STATUS AND HEALTH: THE POTENTIAL ROLE OF ENVIRONMENTAL RISK EXPOSURESatisfactory explanation for the ubiquitous socioeconomic status-health gradient remains elusive, suggesting, in part, that an adequate model of this relation is probably complex and multifaceted (1, 81). In this paper we provide an overview of data indicating that income is inversely correlated with exposure to suboptimal environmental conditions. By environmental conditions we mean the physical properties of the ambient and immediate surroundings of children, youth, and families, including pollutants, toxins, noise, and crowding as well as exposure to settings such as housing, schools, work environments, and neighborhoods. We also briefly cite evidence that each of these environmental factors, in turn, is linked to health. The implicit conceptual model under discussion is as follows (Figure 1): As can be seen above, what we discuss is evidence for two necessary prerequisites for this model to be valid-namely that socioeconomic status (SES) is associated with environmental quality and, in turn, that environmental quality affects health. This is not equivalent, however, to the conclusion that SES effects on health are caused

The built environment has direct and indirect effects on mental health. High-rise housing is inimical to the psychological well-being of women with young children. Poor-quality housing appears to increase psychological distress, but methodological issues make it difficult to draw clear conclusions. Mental health of psychiatric patients has been linked to design elements that affect their ability to regulate social interaction (e.g., furniture configuration, privacy). Alzheimer's patients adjust better to small-scale, homier facilities that also have lower levels of stimulation. They are also better adjusted in buildings that accommodate physical wandering. Residential crowding (number of people per room) and loud exterior noise sources (e.g., airports) elevate psychological distress but do not produce serious mental illness. Malodorous air pollutants heighten negative affect, and some toxins (e.g., lead, solvents) cause behavioral disturbances (e.g., self-regulatory ability, aggression). Insufficient daylight is reliably associated with increased depressive symptoms. Indirectly, the physical environment may influence mental health by altering psychosocial processes with known mental health sequelae. Personal control, socially supportive relationships, and restoration from stress and fatigue are all affected by properties of the built environment. More prospective, longitudinal studies and, where feasible, randomized experiments are needed to examine the potential role of the physical environment in mental health. Even more challenging is the task of developing underlying models of how the built environment can affect mental health. It is also likely that some individuals may be more vulnerable to mental health impacts of the built environment. Because exposure to poor environmental conditions is not randomly distributed and tends to concentrate among the poor and ethnic minorities, we also need to focus more attention on the health implications of multiple environmental risk exposure.

Poverty is a powerful factor that can alter lifetime developmental trajectories in cognitive, socioemotional, and physical health outcomes. Most explanatory work on the underlying psychological processes of how poverty affects development has focused on parental investment and parenting practices, principally responsiveness. Our primary objective in this article was to describe a third, complementary pathway—chronic stress and coping—that may also prove helpful in understanding the developmental impacts of early childhood poverty throughout life. Disadvantaged children are more likely than their wealthier peers to confront a wide array of physical stressors (e.g., substandard housing, chaotic environments) and psychosocial stressors (e.g., family turmoil, separation from adult caregivers). As exposure to stressors accumulates, physiological response systems that are designed to handle relatively infrequent, acute environmental demands are overwhelmed. Chronic cumulative stressors also disrupt the self‐regulatory processes that help children cope with external demands.

The purpose of this study was to examine the impact of cumulative risk exposure in concert with maternal responsiveness on physiological indicators of chronic stress in children and youth. Middle-school children exposed to greater accumulated psychosocial (e.g., family turmoil, poverty) and physical (e.g., crowding, substandard housing) risk factors manifested higher levels of allostatic load, a physiological marker of cumulative wear and tear on the body caused by the mobilization of multiple, physiological response systems. This effect was longitudinal, residualizing allostatic load 3-4 years earlier when the youth were in elementary school. This effect, however, occurred only among adolescents with mothers low in responsiveness. Cumulative risk was also associated with dynamic cardiovascular processes in response to an acute stressor (mental arithmetic). Higher risk was associated with muted reactivity and slower, less efficient recovery in blood pressure. These dynamic cardiovascular effects occurred irrespective of maternal responsiveness.