Hormonal Injustice Environmental Toxicants as Drivers of Endocrine Health Disparities

Multiple social and structural determinants of health undoubtedly contribute to the marked racial/ethnic-, gender-, and socioeconomic-based disparities in endocrine health; however, the contribution of environmental injustice is vastly underappreci-ated. Indeed, those groups disproportionately burdened by endocrine disorders are often exposed to higher levels of various EDCs, including PCBs, phthalates, bisphe-nols, OC pesticides, air pollutants, PFASs, toxic metals/metalloids, and BFRs. Furthermore, the contribution of disparate exposures to health disparities is likely underestimated because of a paucity of data examining the adverse effects of com-bined EDC exposures. As such, health equity requires interventions to address envi-ronmental injustice. Such approaches must include a complementary array of individual action and public policy,127 the latter of which is inadequately used.128 Based on the Developmental Origins of Health and Disease hypothesis that posits long-term health risks imposed by stressors during sensitive developmental windows (including EDC exposures), it is essential that interventions be targeted to those most vulnerable, including pregnant mothers and infants, among others. However, it is also critical to recognize that EDC exposures and their disproportionate burden on low in-come and communities of color is a systemic problem for which individual action is insufficient. Rather, policy interventions are required, including robust efforts to iden-tify EDCs before they enter commerce, eliminate EDCs already in use, mitigate contaminated sites, and develop socially just policies that end the discriminatory siting of polluting industries. Vigorously pursued, such efforts have the potential to improve endocrine health equity while reducing the burden of disease for everyone.