Abstract
Children’s environmental health is shaped by the interaction between environmental, social, and territorial conditions that generate differentiated exposures from early stages of the life course. In contexts characterized by poverty, social marginalization, and specific productive activities, these exposures tend to accumulate and become normalized, producing persistent health inequalities. This study analyzes inequalities in children’s environmental health from an intersectional approach, considering the articulation between age, gender, and territory, through the application of the Humanitarian Scenarios Index (HSI) in two rural communities in Mexico with contrasting characteristics.
The HSI integrates structural, environmental, direct, and cultural components, allowing the identification of complex territorial configurations of environmental and health-related demand. The results show that, although the global HSI values do not always differ significantly between women and men, there are differentiated internal configurations of risk according to age group and territory. Childhood presents particular characteristics within the Humanitarian Scenario, with relevant burdens in the cultural and environmental dimensions. Through an intersectional reading, the analysis transcends sex disaggregation and positions gender as a socially organized experience of risk, linked to everyday practices, care arrangements, and differentiated positions within the territory.
Additionally, the integration of child perception tools through the analysis of drawings reveals processes of normalization of environmental risk in the imaginaries of girls and boys, complementing the quantitative reading of the HSI and reinforcing the need for community-based interventions sensitive to territory, gender, and the life course.
References
Gorman JF, Bruné Drisse MN. La salud ambiental de los niños importa. Rev Salud ambient. 2024; 24(2):234-238.
¡No contamines mi futuro! El impacto de los factores medioambientales en la salud infantil. Ginebra: Organización Mundial de la Salud; 2017. Licencia: CC BY-NC-SA 3.0 IGO.
World Health Organization. Preventing disease through healthy environments: a global assessment of the burden of disease from environmental risks. Geneva: WHO; 2016.
Landrigan PJ, Fuller R, Acosta NJR, Adeyi O, Arnold R, Baldé AB, et al. The Lancet Commission on pollution and health. Lancet. 2018;391(10119):462–512.
World Health Organization. WHO global strategy on health, environment and climate change. Geneva: WHO; 2020.
Programa de las Naciones Unidas para el Medio Ambiente (PNUMA). UN Environment Assembly advances collaborative action on triple planetary crisis [actualizado en 2024; citado el 1 de mayo de 2024] Disponible en: https://www.unep.org/news-and-stories/press-release/un-environment-assembly-advances-collaborative-action-triple.
León Arce M, Van-Brussel E, Torres Díaz A, Meléndez Moreno A, Ávila García IP, Díaz-Barriga Martínez F. Construcción de Espacios Cívicos Ambientales para afrontar las sindemias en escenarios vulnerables. Rev Salud ambient. 2024(2):224-233.
Richardson K, Steffen W, Lucht W, Bendtsen J, Cornell SE, Donges JF, Drüke M, Fetzer I, Bala G, von Bloh W, Feulner G, Fiedler S, Gerten D, Gleeson T, Hofmann M, Huiskamp W, Kummu M, Mohan C, Nogués-Bravo D, Petri S, Porkka M, Rahmstorf S, Schaphoff S, Thonicke K, Tobian A, Virkki V, Wang-Erlandsson L, Weber L, Rockström J. Earth beyond six of nine planetary boundaries. Sci Adv. 2023 Sep 15;9(37)
Mendenhall E. Syndemics: a new path for global health research. Lancet. 2017;389(10072):889–91.
Instituto Nacional de Salud Pública. Salud ambiental infantil en México. Cuernavaca: INSP; 2020.
Schilmann Halbinger A, Quintanilla Vega B, Hernández Bonilla D, García-Vargas G, Díaz-Barriga F, Riojas Rodríguez H, Rojas Bracho L, Del Razo LM, Téllez-Rojo MM. Propuesta para un programa de salud ambiental infantil en México sindemias de las infancias. Rev. Salud ambient. 2025; 25(1):90-96.
León-Arce M, Flores-Ramírez R, Paz-Tovar C, Palacios-Ramírez A, Pérez-Vázquez FJ, Ramírez-Landeros LM, Van Brussel E, Díaz-Barriga F. Unidades RISC: una estrategia para evaluar riesgos de salud en la población infantil de comunidades contaminadas Rev Panam Salud Publica. 2023.
Zajac L, Landrigan PJ; the Council On Environmental Health and Climate Change. Environmental issues in global pediatric health: Technical report. Pediatrics 2025;155:e2024070076.
Pan American Health Organization. Health, environment and climate change in the Americas. Washington DC: PAHO; 2019.
Consejo Nacional de Evaluación de la Política de Desarrollo Social. Medición de la pobreza en México 2022. Ciudad de México: CONEVAL; 2023.
Morello-Frosch R, Zuk M, Jerrett M, Shamasunder B, Kyle AD. Understanding the cumulative impacts of inequalities in environmental health. Annu Rev Public Health. 2011;32:173–90.
Pullen A, Linstead S. Gender as multiplicity: Desire, displacement, difference and dispersion. Hum Relat. 2006;59(5):619–40. doi:10.1177/0018726706069772
Bearer CF. How are children different from adults? Environ Health Perspect. 2000;108(Suppl 3):471–4.
National Research Council. Science and decisions: advancing risk assessment. Washington DC: National Academies Press; 2009.
World Health Organization. Children’s environmental health. Geneva: WHO; 2018.
Grandjean P, Landrigan PJ. Developmental neurotoxicity of industrial chemicals. Lancet. 2014;368(9553):2167–78.
Freeman NCG, Sheldon L, Jimenez M, Melnyk L, Pellizzari E. Contribution of children's activities to pesticide exposure. J Expo Anal Environ Epidemiol. 2001;11(5):407–19.
Landrigan PJ, Goldman LR. Children’s vulnerability to toxic chemicals: a challenge and opportunity to strengthen health and environmental policy. Health Aff. 2011;30(5):842–50.
Krieger N. Embodiment: a conceptual glossary for epidemiology. J Epidemiol Community Health. 2005;59(5):350–5.
Diez Roux AV. Investigating neighborhood and area effects on health. Am J Public Health. 2001;91(11):1783–9.
Morello-Frosch R, Zuk M, Jerrett M, Shamasunder B, Kyle AD. Understanding the cumulative impacts of inequalities in environmental health. Annu Rev Public Health. 2011;32:173–90.
Braveman P, Gottlieb L. The social determinants of health: it’s time to consider the causes of the causes. Public Health Rep. 2014;129(Suppl 2):19–31.
Wakefield SEL, Elliott SJ, Cole DC, Eyles JD. Environmental risk perception and well-being: effects of the landfill siting process in two southern Ontario communities. Soc Sci Med. 2001;53(9):1139–54.
Hankivsky O, Reid C, Cormier R, Varcoe C, Clark N, Benoit C, et al. Exploring the promises of intersectionality for advancing women’s health research. Int J Equity Health. 2010;9:5.
Sen G, Östlin P, George A. Unequal, unfair, ineffective and inefficient: gender inequity in health. WHO Commission on Social Determinants of Health. Geneva: WHO; 2007.
Crenshaw K. Demarginalizing the intersection of race and sex. Univ Chicago Legal Forum. 1989;1989(1):139–67.
Hankivsky O, Reid C, Cormier R, Varcoe C, Clark N, Benoit C, et al. Exploring the promises of intersectionality for advancing women’s health research. Int J Equity Health. 2010;9:5.
Bauer GR. Incorporating intersectionality theory into population health research methodology. Soc Sci Med. 2014;110:10–7.
Bowleg L. The problem with the phrase women and minorities: intersectionality—an important theoretical framework for public health. Am J Public Health. 2012;102(7):1267–73.
Singer M, Clair S. Syndemics and public health: reconceptualizing disease in bio-social context. Med Anthropol Q. 2003;17(4):423–41.
Mendenhall E. Syndemics: a new path for global health research. Lancet. 2017;389(10072):889–91.
León-Arce M. Escenarios humanitarios: un modelo en salud y ambiente para prevenir la violencia multimodal en comunidades vulnerables. Universidad Autónoma de San Luis Potosí; 2023.
León Arce M, Torres Díaz A, Mendoza Pérez K, van ́t Hooft AJM, Flores Ramírez R, Díaz-Barriga Martínez F. Escenarios Humanitarios: Una herramienta para abordar las violencias como un problema asociado a la salud y al ambiente. Rev. Salud ambient. 2022; 22(1):21-34.
Barraza L. Children’s drawings about the environment. Int J Sci Educ. 1999;21(9):967–986.
Torres-Nerio, R., Domínguez-Cortinas, G., Van’t Hooft, A., Díaz-Barriga, F. y Cubillas-Tejeda, A. Análisis de la percepción de la exposición a riesgos ambientales para la salud, en dos poblaciones infantiles, mediante la elaboración de dibujos. Salud Colectiva. 2010; 6(1), 65-81.
US Environmental Protection Agency. Framework for Cumulative Risk Assessment. EPA; 2003.
Sexton K, Linder SH. The role of cumulative risk assessment in decisions about environmental justice. Int J Environ Res Public Health. 2011;8(2):403–432.
Porter ME, Stern S, Green M. Social Progress Index 2023. Social Progress Imperative; 2023.
Perera F. Children are likely to suffer most from our fossil fuel addiction. Environ Health Perspect. 2008;116(8):987–990.
Alfie M, Cruz-Bello G. Viviendo en riesgo: cambio climático y vulnerabilidad. Soc Ambiente. 2019;19:109–136.
Krieger N. Embodiment: a conceptual glossary for epidemiology. J Epidemiol Community Health. 2005;59:350–355.
Sen G, Östlin P. Gender inequity in health. WHO Commission on Social Determinants of Health. 2007.
Harding S. The Science Question in Feminism. Cornell University Press; 1986.
WHO. Children’s Environmental Health. Geneva: WHO; 2019.
Trasande L, Liu Y. Reducing the staggering costs of environmental disease in children. Health Aff. 2011;30(5):863–870.
Grandjean P, Landrigan PJ. Developmental neurotoxicity of industrial chemicals. Lancet. 2006;368:2167–2178.
Arias-Uriona, A. M., Losantos, M., & Bedoya, P. La interseccionalidad como herramienta teórico-analítica para estudiar las desigualdades en salud en las Américas: Revista Panamericana de Salud Pública. 2023.
Bauer GR. Incorporating intersectionality theory into population health research. Soc Sci Med. 2014;110:10–17.
Hankivsky O, et al. Intersectionality-based policy analysis. Int J Equity Health. 2014;13:119.
Evans CR, Williams DR. On intersectionality and health inequalities. Soc Sci Med. 2018;200:161–170.
Chawla L. Growing up green. J Environ Educ. 2009;40(4):5–15
León Arce M, Zapata Esparza IA. La Aldea de Koshol y la Leyenda de la Gallina Cantora. San Luis Potosí: Universidad Autónoma de San Luis Potosí; 2025. ISBN: 978-607-535-474-3.

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