摘要：Objectives . We documented inequitable, cumulative environmental risk exposure and health between predominantly White low-income and middle-income children residing in rural areas in upstate New York. Methods . Cross-sectional data for 216 third- through fifth-grade children included overnight urinary neuroendocrine levels, noise levels, residential crowding (people/room), and housing quality. Results . After control for income, maternal education, family structure, age, and gender, cumulative environmental risk exposure (0–3) (risk >1 SD above the mean for each singular risk factor [0, 1]) was substantially greater for low-income children. Cumulative environmental risk was positively correlated with elevated overnight epinephrine, norepinephrine, and cortisol in the low-income sample but not in the middle-income sample. Conclusions . Cumulative environmental risk exposure among low-income families may contribute to bad health, beginning in early childhood. Environmental risks are not randomly distributed in the population; instead, they are inversely correlated to income. 1 Economically disadvantaged children live in noisier 2 and more crowded homes 3 and are exposed to more environmental toxins 1 than their middle-income counterparts. Housing quality is also inversely related to income. 4, 5 Ethnic minorities also suffer disproportionate environmental risk, 6 and a few studies reveal no income–environmental quality link. 7 Although poor children are substantially more likely to confront singular environmental risks in their immediate environments, exposure to cumulative environmental risks may be a particularly important and unstudied aspect of environmental justice and health. If the ecology of childhood poverty is characterized by the confluence of environmental risks, examination of the health consequences of singular risks may underestimate the true environmental risk profile of low-income children. We examined how exposure to residential crowding, interior noise levels, and housing problems, singularly and in combination, related to chronic physiological stress in a sample of low- and middle-income children in rural upstate New York.
