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Early life stress, air pollution, inflammation, and disease: An integrative review and immunologic model of social-environmental adversity and lifespan health
Open accessAbstract
Socially disadvantaged individuals are at greater risk for simultaneously being exposed to adverse social and environmental conditions. Although the mechanisms underlying joint effects remain unclear, one hypothesis is that toxic social and environmental exposures have synergistic effects on inflammatory processes that underlie the development of chronic diseases, including cardiovascular disease, diabetes, depression, and certain types of cancer. In the present review, we examine how exposure to two risk factors that commonly occur with social disadvantage-early life stress and air pollution-affect health. Specifically, we identify neuroimmunologic pathways that could link early life stress, inflammation, air pollution, and poor health, and use this information to propose an integrated, multi-level model that describes how these factors may interact and cause health disparity across individuals based on social disadvantage. This model highlights the importance of interdisciplinary research considering multiple exposures across domains and the potential for synergistic, cross-domain effects on health, and may help identify factors that could potentially be targeted to reduce disease risk and improve lifespan health.
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“SCI during pregnancy and childhood can have serious developmental consequences that include elevating the risk of non-communicable diseases over the life span7,8,26,27.”
From Chronic inflammation in the etiology of disease across the life span (2019) · cites this paper as [27]
In the citing paper
“childhood circumstances significantly impact metabolic and immune responses later in life, which in turn promote SCI in adulthood8,26,27,168,169”
From Chronic inflammation in the etiology of disease across the life span (2019) · cites this paper as [27]
In the citing paper
“exposure to psychological stress early in life—for example, in the form of abuse, neglect, maltreatment, bullying or living in a low socioeconomic environment—can heighten neural responses to threat that can upregulate inflammatory activity170, alter immuno-competence and lead to SCI throughout the lifecycle27,169”
From Chronic inflammation in the etiology of disease across the life span (2019) · cites this paper as [27]
In the citing paper
“Early life and childhood exposure to antibiotics, vaccination, diet, smoke, and psychosocial stress seems to lead to a long-term adverse influence throughout life.”
From Stress triggers flare of inflammatory bowel disease in children and adults (2019) · cites this paper as [72]
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Why nature contact is good for us
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Nasb, M., Li, F., Dayoub, L., Wu, T., Wei, M., & Chen, N. (2024) · Journal of Advanced Research · doi:10.1016/j.jare.2024.04.034 · Cited by 9
Kim, L. Y., Rose, S. M. S., Mengelkoch, S., Moriarity, D. P., Gassen, J., Alley, J. C., Roos, L. G., Jiang, T., Alavi, A., Thota, D. D., et al. (2024) · Stress · doi:10.1080/10253890.2024.2401788 · Cited by 7
“…rates of aces also have higher rates of exposure to chemicals, air pollution, discrimination, and general unpredictability (Gladieux et al., 2023; Olvera alvarez et al., 2018), almost no research has examined how the combination of these various risk factors, in conjunction with aces, predicts…”
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Karki, B., Ali, A. B. M., PadmaPriya, G., Ray, S., Pal, A., Arora, V., Smerat, A., Saydullaev, B., Latipova, M., Jumanazarov, D., et al. (2026) · Materials Chemistry and Physics · doi:10.1016/j.matchemphys.2026.132234 · Cited by 5
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Effects of higher dietary acid load: a narrative review with special emphasis in children
Luzardo, M. L. (2024) · Pediatric Nephrology · doi:10.1007/s00467-024-06466-7 · Cited by 5
“Other examples are the association of greater exposure to microbial agents during childhood, with a reduced risk of chronic inflammation in adults and of early exposure to psychological stress, with immunocompetence alteration that can lead to CSI during the rest of the life cycle [125–127].”
Deconstructing sex differences in C‐reactive protein trends over time
Kranjac, A. W., Kranjac, D., & Lounsbury, O. (2021) · American Journal of Human Biology · doi:10.1002/ajhb.23705 · Cited by 5
“Similarly, the sometimes-crude nature of measures available in the NHANES for several key concepts (e.g., lack of information on childhood adversity and trauma; Alvarez et al., 2018; Fagundes et al., 2013; Lin et al., 2016) may influence estimates presented here.”
BackgroundCohort Profile: China Southwest Birth Cohort (CSBC)
Zhao, Z., Liu, W., Hu, J., Chen, S., Gao, Y., Wang, H., Luo, M., Zhou, T., & Zhang, G. (2023) · International Journal of Epidemiology · doi:10.1093/ije/dyad103 · Cited by 5
Sphingosine kinase-dependent regulation of pro-resolving lipid mediators in Alzheimer's disease
Ayub, M., Jin, H. K., & Bae, J. (2022) · Biochimica et Biophysica Acta (BBA) - Molecular and Cell Biology of Lipids · doi:10.1016/j.bbalip.2022.159126 · Cited by 5
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Associations Between Early-Life Adversity, Ambient Air Pollution, and Telomere Length in Children
de la Rosa, R., Le, A. D., Holm, S. M., Ye, M., Bush, N. R., Hessler, D., Koita, K., Bucci, M., Long, D., & Thakur, N. (2024) · Psychosomatic Medicine · doi:10.1097/psy.0000000000001276 · Cited by 4
“It is hypothesized that exposure to early-life adversity may heighten an individual ’ s inflammatory response to environmental hazards, such as ambient air pollution (44).”
BackgroundHealth and Environmental Justice Strategies for Mitigating Air Pollution
Izah, S. C., Onwudiegwu, C. A., Sylva, L., & Etim, N. G. (2024) · The handbook of environmental chemistry · doi:10.1007/698_2024_1121 · Cited by 4
Special Issue: Social Determinants of Health: What we still need to know
Fagundes, C. P., Wu‐Chung, E. L., & Christian, L. M. (2022) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2022.105713 · Cited by 5
Robles, T. F., Bai, S., & Meng, Y. (2022) · International Journal of Behavioral Medicine · doi:10.1007/s12529-022-10103-8 · Cited by 4
“In unadjusted models, consistent with prior theories [5, 6, 9, 10], among adolescents with 12-month average O3 exposure greater than 48.”
ResultStress Reduction Potential in Mice Ingesting DNA from Salmon Milt
Unno, K., Taguchi, K., Fujita, M., Sutoh, K., & Nakamura, Y. (2023) · Biology · doi:10.3390/biology12070978 · Cited by 4
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Sensitivity to Environmental Stress and Adversity and Lung Cancer
Chen, Y., Qing Lan, B., Yu, J., Godbole, D., Byun, J., Amos, C. I., & Zhang, H. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.57079 · Cited by 3
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“…inflammation in the upper and lower respiratory tract resulting in increased levels of pro-inflammatory mediators (e.g., IL-6, IL-8, and of tumor necrosis factor alpha (TNF-α) following into the circulatory system inducing low-grade peripheral inflammation (see Figure 3) (Olvera et al., 2018).”
Modulation of Epigenetic Profiles in Traffic Workers Exposed to Car Fumes in Egypt
Shaat, R., Abdel-Ghany, S., Nasr, G. M., Sabit, H., & El-Zawahry, M. M. (2019) · Molecular Biology · doi:10.4172/2168-9547.1000225 · Cited by 3
“Diabetes as an indicator Air pollution, the most pervasive environmental concern, is estimated to cause around 800,000 deaths every year worldwide [30,31].”
BackgroundImmune-mediated inflammatory diseases (IMIDs) in children: key research questions and some answers
Kallinich, T., & Mall, M. A. (2024) · Molecular and Cellular Pediatrics · doi:10.1186/s40348-024-00177-7 · Cited by 3
“In addition, obesity [3], a low exposure to microbes (`hygiene hypoth-esis´) [4] and stress [5, 6] are associated with the upregulation of the immune response and the development of systemic chronic inflammation in children.”
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Lifetime employment trajectories and cancer
Cullati, S., Sieber, S., Gabriel, R., Studer, M., Chioléro, A., & van der Linden, B. W. A. (2024) · Scientific Reports · doi:10.1038/s41598-024-70909-2 · Cited by 3
“Exposure to more or less long-term poor working conditions 90 may dysregulate physiological systems (e.g., immunity 91,92 ), or the general physiological wear and tear 19 and DNA methylation 93,94 , and predict the onset of cancer 95,96 .”
BackgroundSocial Determinants of Health and Pediatric Brain Tumor Neuropsychological Morbidities
Sharkey, C. M., Nielsen, J. D., Walsh, K. S., Weisman, H. S., & Hardy, K. K. (2025) · Pediatric Blood & Cancer · doi:10.1002/pbc.32050 · Cited by 1
“Extant literature on the negative effect of social disadvantage on child development emphasizes the interactions that occur between low SES, environmental risks, and neuroinflammation [48, 49].”
Davidson, N. V., Masese, C., Han, C., Massac, L. A., Ishikawa, Y., Reynolds, G., Smithson, C., Cook, J., Manners, M. T., & Robinson, S. A. (2025) · PLoS ONE · doi:10.1371/journal.pone.0328026 · Cited by 2
Alvarez, H. A. O., Cedeño-Laurent, J. G., Eisen, A. M., Campen, M. J., Slavich, G. M., Kubzansky, L. D., & Spengler, J. D. (2026) · Brain Behavior & Immunity - Health · doi:10.1016/j.bbih.2026.101244 · Cited by 1
Self-citationCancer Epigenetics: Shifting to More Deep Action
Sabit, H. (2019) · Novel Approaches in Cancer Study · doi:10.31031/nacs.2019.02.000548 · Cited by 1
“Other many diseases including respiratory diseases and heart disease are also correlated with prolonged exposure to polluted air [19,20].”
BackgroundA Biopsychosocial Framework to Examine Risk for Type 2 Diabetes in Asian Pacific Islander Immigrants
Connor, J., & Janusek, L. W. (2021) · Research and theory for nursing practice · doi:10.1891/rtnp-d-19-00132 · Cited by 1
Preliminary study on the effect of ozone exposure on blood glucose level in rats
Yang, H., Xiao, X., Chen, G., Chen, X., Gao, T., & Li, X. (2023) · Technology and Health Care · doi:10.3233/thc-236026 · Cited by 1
Packer, A. E., Corbett, A., Arathimos, R., Ballard, C. G., Aarsland, D., Hampshire, A., Dima, D., Creese, B., Malanchini, M., & Powell, T. R. (2023) · Frontiers in Dementia · doi:10.3389/frdem.2023.1093223 · Cited by 1
Investigation of the Effect of Aerosol Deposition by Applying Electrostatic Fields
UNDI, G. S. N. V. K. S. N. S., & Kantikar, R. (2024) · Advances in Environmental and Engineering Research · doi:10.21926/aeer.2401009 · Cited by 1
Chi, G.-Y. (2023) · 동의생리병리학회지 · doi:10.15188/kjopp.2023.10.37.5.121 · Cited by 1
Metadata
- Authors
- Olvera Alvarez, H. A., Kubzansky, L. D., Campen, M. J., & Slavich, G. M.
- Affiliations
- Harvard University (US)
- University of New Mexico (US)
- University of California, Los Angeles (US)
- Venue
- Neuroscience & Biobehavioral Reviews
- Publisher
- Elsevier BV
- Published
- 2018-09
- Volume
- 92
- Pages
- 226-242
- ISSN
- 0149-7634 (ISSN-L)
- PMC
- PMC6082389
- OpenAlex
- W2805640433
- Cited by
- 133
- References
- 226
- Citations by year
- 2026: 12 · 2025: 16 · 2024: 19 · 2023: 16 · 2022: 24 · 2021: 19 · 2020: 10 · 2019: 14 · 2018: 3
- FWCI
- 1.90
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Neuroscience & Biobehavioral Reviews (acceptedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- Branco Weiss Fellowship â Society in Science
- National Institute of Environmental Health Sciences (R01 ES014639, 3R01ES014639-09S1)
- National Alliance for Research on Schizophrenia and Depression (23958)
- Brain and Behavior Research Foundation (K08 MH103443)
- National Center on Minority Health and Health Disparities
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Social Sciences › Sociology and Political Science › Environmental Justice and Health Disparities
- Keywords
- early life stress, air pollution, inflammation, social deprivation, health disparities, neuroimmunology, chronic disease, cardiovascular disease, diabetes mellitus, depression, cancer, lifespan health, multi-level model
- MeSH terms
- Air Pollution, Humans, Inflammation, Longevity, Social Environment, Stress, Psychological, Models, Immunological
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