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. 2023 Mar 15:221:115295.
doi: 10.1016/j.envres.2023.115295. Epub 2023 Jan 18.

Making the invisible visible: Using a qualitative system dynamics model to map disparities in cumulative environmental stressors and children's neurodevelopment

Devon C Payne-Sturges  1 , Ellis Ballard  2 , Deborah A Cory-Slechta  3 , Stephen B Thomas  4 , Peter Hovmand  5
Affiliations

Making the invisible visible: Using a qualitative system dynamics model to map disparities in cumulative environmental stressors and children's neurodevelopment

Devon C Payne-Sturges et al. Environ Res. .

Abstract

Background: The combined effects of multiple environmental toxicants and social stressor exposures are widely recognized as important public health problems, likely contributing to health inequities. However, US policy makers at state and federal levels typically focus on one stressor exposure at a time and have failed to develop comprehensive strategies to reduce multiple co-occurring exposures, mitigate cumulative risks and prevent harm. This research aimed to move from considering disparate environmental stressors in isolation to mapping the links between environmental, economic, social and health outcomes as a dynamic complex system using children's exposure to neurodevelopmental toxicants as an illustrative example. Such a model can be used to support a broad range of child developmental and environmental health policy stakeholders in improving their understanding of cumulative effects of multiple chemical, physical, biological and social environmental stressors as a complex system through a collaborative learning process.

Methods: We used system dynamics (SD) group model building to develop a qualitative causal theory linking multiple interacting streams of social stressors and environmental neurotoxicants impacting children's neurodevelopment. A 2 1/2-day interactive system dynamics workshop involving experts across multiple disciplines was convened to develop the model followed by qualitative survey on system insights.

Results: The SD causal map covered seven interconnected themes: environmental exposures, social environment, health status, education, employment, housing and advocacy. Potential high leverage intervention points for reducing disparities in children's cumulative neurotoxicant exposures and effects were identified. Workshop participants developed deeper level of understanding about the complexity of cumulative environmental health risks, increased their agreement about underlying causes, and enhanced their capabilities for integrating diverse forms of knowledge about the complex multi-level problem of cumulative chemical and non-chemical exposures.

Conclusion: Group model building using SD can lead to important insights to into the sociological, policy, and institutional mechanisms through which disparities in cumulative impacts are transmitted, resisted, and understood.

Keywords: Chemicals; Cumulative risk; Environmental exposures; Group model building; Neurodevelopment; System dynamics.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1
Figure 1
Relationships between different categories of insights (with permission)[59]
Figure 2.
Figure 2.
Group Model Building Activities
Figure 3:
Figure 3:
Synthesized Stock and Flow Diagram
Figure 3:
Figure 3:
Synthesized Stock and Flow Diagram
See this image and copyright information in PMC

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References

    1. National Research Council, Science and Decisions: Advancing Risk Assessment. 2009, Washington, DC: The National Academies Press. 424. - PubMed
    1. National Environmental Justice Advisory Council, Ensuring Risk Reduction in Communities with Multiple Stressors: Environmental Justice and Cumulative Risks/Impacts. 2004: Washington, D.C.
    1. Payne-Sturges DC, et al., Methods for Evaluating the Combined Effects of Chemical and Nonchemical Exposures for Cumulative Environmental Health Risk Assessment. Int J Environ Res Public Health, 2018. 15(12). - PMC - PubMed
    1. Huang H, et al., Cumulative Risk and Impact Modeling on Environmental Chemical and Social Stressors. Curr Environ Health Rep, 2018. 5(1): p. 88–99. - PMC - PubMed
    1. Appleton AA, Holdsworth EA, and Kubzansky LD, A Systematic Review of the Interplay Between Social Determinants and Environmental Exposures for Early-Life Outcomes. Curr Environ Health Rep, 2016. 3(3): p. 287–301. - PubMed

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