DEVELOPMENT OF A CONCEPTUAL FRAMEWORK DEPICTING A CHILDS TOTAL (BUILT, NATURAL, SOCIAL) ENVIRONMENT IN ORDER TO OPTIMIZE HEALTH AND WELL-BEING

The complexity of the components and their interactions that characterize children's health and well-being are not adequately captured by current public health paradigms. Children are exposed to combinations of chemical and non-chemical stressors from their built, natural and social environments at each lifestage throughout their lifecourse. Children's inherent characteristics (e.g., sex, genetics and epigenetic factors) and their activities and behaviors also influence their exposures to stressors from these environments. We describe a conceptual framework that illustrates the interrelationships between inherent characteristics, activities and behaviors, and stressors from the built, natural and social environments in influencing children's health and well-being as they progress through various stages of development. We demonstrate the use of this framework for two major public health concerns: childhood obesity and diminished general cognitive ability. Systematic reviews of the literature found a limited number of studies that evaluated both chemical and non-chemical stressors. For example, neighborhood-level socioeconomic factors and chlorpyrifos exposure were shown to interact to impact cognitive function, and maternal self-esteem was found to modify vulnerability to prenatal lead. By better understanding these complex interactions, decision makers can make informed choices for child-specific environments that optimize health and well-being within the home and community.