The Importance of Environmental Embodiment for Public Health Professionals: Stress Triggers, Environmental Toxicants, and Strategies for Education
Walker, Lorelei E.
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Human bodies exist as part of ecosystems and can be altered by environmental exposures. Environmental embodiment, the conceptual model described in this work, demonstrates how external exposures can shift body systems in ways that foster disease. Epigenetic mechanisms operate at the interface between externally-derived stimuli and the body’s physiologic response making the epigenome especially relevant to explore health implications of adverse environmental exposures. New evidence suggests chronic exposure to psychosocial stress or to common environmental toxicants can disrupt epigenetic processes important for health. The scale of such daily exposures merits closer investigation, especially since epigenetic disruption during fetal development is known to increase a person’s disease risk over the life span. Epigenetic disruption is of special importance to public health professionals as we have an ethical obligation to protect the most vulnerable individuals in our communities, in this case our developing children. While psychosocial stress and toxicant exposures often co-exist, researchers tend to study them as separate phenomena. To facilitate cross-disciplinary collaboration, I describe epigenetic mechanisms that are common to both exposures. Within the context of chronic disease etiology, I reviewed the literature for human examples of environmental embodiment across a range of common environmental toxicants. This synthesis indicates that four exposure groups (air pollution, endocrine disrupting chemicals, heavy metals, and persistent organic pollutants) can disrupt epigenetic mechanisms in humans and pose a special threat to in-utero development. I also developed an integrated theoretical model to understand the embodiment of chronic stress by drawing on three theories of stress to illustrate the pathway from external stress exposures to epigenetic action and embodiment. I further investigate the current challenges for understanding, surveying, researching, intervening, and regulating some of the previously-identified epigenetic disruptors. I argue that current environmental policy prioritizes human-centric values that foster false assumptions regarding the safety of low-dose exposures to toxicants and reductionist approaches to investigating risks, thus enabling further exposure. I make recommendations for regulation and public health to take action to address these community-level drivers and provide more support for an already-sufficient body of evidence calling for a precautionary approach to chemical policy. I then focus on community engagement strategies to inform risk assessment regarding environmental toxicants and to exercise power in pressing for social policy change. The scientific community has a duty to disseminate our new understanding of epigenetic embodiment and use this information to change policy. Our health sciences professions can greatly facilitate this dissemination through community engagement of educational media and through exercising community power. I discuss two cases of community engagement, first the creation of an epigenetic educational video, and second the work of Health Equity Circle. A broader understanding of this embodiment process can support the health equity movement by equipping public health professions with tools and experience to educate policy makers, educate the public, inform surveillance and research activities, support population-wide interventions, and work with community institutions to change policy. I specifically call for public health support of stronger chemical policy regulation and changes to social policy to reduce environments shaped by the contamination, pollution, threat, unpredictability, and lack of control for all environments that increase the risk for epigenetic disruptors. I call on academia to provide community engagement opportunities for health sciences students to act on the knowledge they have gained.