Community Assets as Protective Factors Buffering Health Effects of Environmental Hazards: Framework and Considerations for Environmental Epidemiologists.

Disparities in the adverse health effects due to ambient environmental exposures have long been documented in the environmental epidemiology literature. A growing body of environmental epidemiology literature has focused on how detrimental aspects of the physical environment (e.g., poor housing quality) and social environment (e.g., chronic social stressors) can exacerbate the adverse health effects of environmental exposures (e.g., air pollution, heat). However, the literature on protective factors which might mitigate adverse health effects of environmental exposure is more limited. We borrow from the climate resilience and disaster preparedness literature to discuss how protective community assets may be identified, operationalized, and understood in environmental epidemiologic research. We outline two major pathways through which community assets may protect environmental health: by reducing overall exposure (mediation) and by reducing susceptibility (effect modification). This framework can help environmental epidemiologists and other public health researchers select and understand appropriate community assets to test as effect modifiers or mediators of associations between environmental exposures and adverse health outcomes. We present examples of community assets organized into five domains and highlight pragmatic challenges that may arise when considering assets in large-scale epidemiologic research-for example, limitations on availability of publicly available data at meaningful spatial scales, and challenges interpreting available community asset data. Finally, we posit that research focused on community assets can inform scalable, impactful health-promoting interventions.