Moving towards making social toxins mainstream in children's environmental health

Purpose of review Although traditional disciplinary research theory and methods have focused separately on how social and physical environmental factors affect children's health, evolving research underscores important integrated effects. Recent findings This review outlines the specific reasons why social determinants should be considered mainstream in children's environmental health research with particular focus on interactive effects between social and physical hazards. These include sensitivity of overlapping physiological systems, via epigenesis, programming, and plasticity to social and physical environmental moderation that may impact health across the life span; ways in which social environmental vulnerabilities moderate the effects of physical environmental factors, providing specific examples related to respiratory health and neurodevelopment; overlapping exposure distribution profiles; and relevance to pediatric health disparities. Summary Because of the covariance across exposures, and evidence that social stress and other environmental toxins (e.g., pollutants, tobacco smoke) may influence common physiological pathways (e.g., oxidative stress, proinflammatory immune pathways, autonomic disruption), understanding the potential synergistic effects promises to more completely inform children's environmental health risk. Although this discussion focuses around the respiratory and neurological systems, these concepts extend more broadly to children's psychological and physical development.