Abstract
Purpose of reviewEarly-life social and environmental expo-sures have independent effects on many child health out-comes. Increasingly, investigators have suggested that these exposures, which commonly co-occur, may have synergistic effects and have thus begun to evaluate if environmental and social factors jointly contribute to child health. This systemat-ic review summarizes findings and methodological ap-proaches across studies examining the interplay between en vironmental and social exposures in relation to commonly assessed childhood health outcomes: asthma, cognition and behavior, perinatal outcomes, and obesity. Recent findingsForty-one studies met the search criteria and were reviewed. Of these, 37, 34, and 29%of studies focused on
asthma, cognition/behavior, and perinatal outcomes, respective-ly. No study focused on obesity. Across all studies reviewed, 72 % observed significant synergistic associations between so-cial and environmental exposures. Air pollution was the most frequently studied environmental exposure, and socioeconomic status was the most commonly studied social factor. SummaryThe emerging evidence suggests that social and risks may jointly affect child health.
Recommendations for future research are discussed, including enhancing characterization of the social environment and broadening the types of environmental risks assessed.