Environmental factors shaping cancer outcomes in Alabama: A scoping review.

Joint Toxicant and Psychosocial Exposures and Health: A Scoping Review of Evidence and Analytic Approaches.

Early life environmental toxicant exposure is associated with adverse physical and mental health, yet individual susceptibility varies. Psychosocial exposures, like socioeconomic disadvantage and stress, frequently co-occur with toxicant exposure and also influence health outcomes, but are often studied in isolation. This scoping review maps existing literature examining joint environmental toxicant and psychosocial exposures and health outcomes across the life course. Following PRISMA-ScR guidelines, we searched PubMed, PsycINFO, Web of Science, and Embase in July 2025 using terms related to toxicants and psychosocial exposures. Two reviewers independently screened titles/abstracts and full texts. Inclusion/exclusion criteria were defined a priori using a Population, Concept, and Context (PCC) framework. We included original human studies examining joint toxicant and psychosocial exposures in relation to physical or mental health outcomes. We excluded air pollution, animal models, interventions, and neurocognitive and genetic outcome studies. Findings were synthesized narratively. Fifteen studies met inclusion criteria. Metals and phthalates were most commonly assessed. Psychosocial exposures were typically operationalized as socioeconomic disadvantage, perceived stress, or discrimination. Evidence was concentrated in prenatal exposures and pregnancy or birth, with few studies evaluating childhood, adolescent, or adult health. Most studies used interaction or stratified regression approaches and few employed mixture or cumulative risk methods. This review highlights important methodological opportunities for future research, including integrating environmental toxicant and psychosocial exposures and applying analytical methods that better capture real-world co-exposures across the life course. Such approaches may strengthen understanding of how multiple environmental and social exposures jointly influence health and inform future policy and intervention efforts.

Structural Racism and Head and Neck Cancer Risks and Outcomes: A Scoping Review.

OBJECTIVE Persistent health inequities exist in Head and Neck Cancer (HNC) outcomes among racial and ethnic minority populations. Structural racism creates inequitable population-level risk for health conditions, including cancer. This study is the first to review the effects of structural racism on HNC risk factors and outcomes. DATA SOURCES PubMed, Embase, Scopus, ProQuest, PapersFirst, MedNar, and Open Access Theses and Dissertations. REVIEW METHODS PRISMA guidelines were utilized to search 7 databases from inception to May 6, 2024. 6734 deduplicated titles and abstracts were screened, of which 45 underwent full-text review. Thirty-one studies met the inclusion criteria of reporting a domain of structural racism impacting head and neck cancer risk factors or outcomes. RESULTS Survival outcomes of HNC in racial and ethnic minority populations were associated with and compounded by neighborhood factors and socioeconomic status. Insurance status affected survival disproportionately in Black compared to White participants. Black participants demonstrated stronger estimates of association for higher intensity and duration of cigarette smoking. Perceived barriers to access to care among Black males contributed to delays in seeking treatment. Native Hawaiian and other Pacific Islanders were more likely to present with advanced-stage disease and had worse disease-specific survival compared to White populations. CONCLUSION Structural racism significantly contributes to disparities in HNC risk factors and treatment outcomes experienced by racial and ethnic minorities in the United States. Further research is needed to evaluate structural racism domains to inform multi-level interventions to eliminate inequities in HNC among racial and ethnic minority populations.

Mapping global media and communication strategies in adolescent reproductive health promotion: A scoping review

Mercury presents a significant environmental health hazard due to its ability to bioaccumulate in the food chain, posing risks through the consumption of contaminated fish. This systematic review aims to analyze and compare mercury levels in human populations, specifically focusing on the health risks associated with fish consumption in urban versus rural areas. The review followed PRISMA guidelines and included articles published between January 1, 2020 and March 15, 2025 from PubMed, Scopus, and ScienceDirect. A total of 768 articles were identified, and seven studies met the inclusion criteria. Data extraction was performed, and study quality was assessed using the JBI checklist and risk of bias assessment with ROBINS-E. Data were extracted and synthesized using RevMan 5.4 for the meta-analysis. The meta-analysis showed substantially higher mercury levels in rural populations (SMD 2.76; 95% CI: 2.63–2.89), largely influenced by dietary patterns, predominant fish species, and environmental contamination levels. Health effects associated with elevated mercury exposure included neurodevelopmental risks, elevated mercury levels in pregnant women, and increased vulnerability among populations with high reliance on freshwater fish. These findings highlight the need for targeted public health strategies to mitigate mercury exposure while maintaining the nutritional benefits of fish consumption.

Digging for answers: a narrative review unearthing ground pollution and child development

Social Normalization of Young Cancer Survivors: A Scoping Review Using Meleis' Transitions Theory.

AIM(S) To synthesize existing evidence on social normalization among young cancer survivors aged 10-24 years and to identify transition conditions and patterns of response shaping their transitional experiences. DESIGN A scoping review using Arksey and O'Malley's methodological framework. METHODS Two reviewers independently screened, extracted, and synthesized data using a reviewer-developed data extraction form, with decisions documented through an audit trail. Findings were synthesized according to Meleis' Transitions Theory. DATA SOURCES Five databases (Embase, PubMed, CINAHL, Scopus, PsycINFO) and key journals were searched between January 2015 and July 2025, with the search last updated in August 2025. Eligibility criteria were defined using the PCC (Population, Concept, Context) framework. RESULTS Thirty-two studies were included. Within transition conditions, four personal factors (identity formation and recurring inner conflicts, psychological and emotional state, physical and cognitive functioning, and adaptation and perceptual strategies), three environmental factors (peer relationships, family functioning and relationships, and support and collaboration from professionals and schools) were identified. Patterns of response included both process and outcome indicators across individual, interpersonal, and functional levels. Social normalization was shaped by double transitions-simultaneous developmental and illness-related shifts, and by cascading effects wherein disruptions like social isolation or neurocognitive challenges affect multiple aspects of functioning. Protective mechanisms included autonomy-supportive environments and coordinated communication among families, schools, and healthcare teams. CONCLUSION Social normalization among young cancer survivors is an ongoing developmental process shaped by intersecting illness and life transitions. The findings show that normalization unfolds through interdependent mechanisms across individual, interpersonal, and functional levels, involving identity integration, relational negotiation, and role participation. These ongoing processes require autonomy-supportive environments and system-level coordination among healthcare, school, and community settings. These insights extend current understanding of how developmental and illness-related transitions intersect to shape young survivors' social trajectories and inform developmentally attuned, socially responsive survivorship care. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Research should conceptualize social normalization as a dynamic process of developmental and illness-related transitions, rather than a fixed outcome. Healthcare professionals should monitor survivors' transition trajectories and deliver autonomy-supportive, developmentally responsive, and socially contextualized interventions throughout survivorship. Policymakers and healthcare systems should coordinate efforts across healthcare, family, educational, and community settings to sustain adaptive transitions and support social normalization. IMPACT This review addressed the limited understanding of social normalization in young cancer survivors aged 10-24, where research has largely focused on physical late effects over social outcomes. By applying Meleis' Transitions Theory to synthesize evidence across 32 studies, this review demonstrates that social normalization is an ongoing process shaped by double transitions, cascading effects, and protective mechanisms. These findings provide process-oriented guidance for healthcare professionals, educators, families, and policymakers to support reintegration and long-term well-being in this population REPORTING METHOD: PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. PATIENT OR PUBLIC CONTRIBUTION No Patient or Public Involvement.

Understanding the Effects of Collective Allostatic Load on Maternal Health

Black women in the United States experience disproportionately high rates of maternal and infant mortality, reflecting persistent racial inequities in healthcare. Problem Statement: The primary objective of this literature synthesis was to explore how pregnant Black women experience and interpret psychosocial stressors that contribute to elevated allostatic load, defined as the cumulative “wear and tear” on the body and brain due to chronic exposure. This includes sociocultural identity stressors, healthcare discrimination, systemic inequities, and anticipatory trauma in adverse maternal health outcomes. A literature synthesis was conducted using PRISMA guidelines across PubMed, Google Scholar, EBSCO, SpringerLink, and ProQuest databases. Six peer-reviewed studies published between 2020 - 2025 met inclusion criteria and were critically appraised using the Joanna Briggs Institute (JBI) and ConQual tool. Findings revealed three major themes: police and healthcare violence, interpersonal violence, and the psychological burden of survival. Participants described chronic exposure to racism, unsafe neighborhoods, intimate partner violence, financial instability, lack of social support, and dismissal by healthcare providers, contributing to chronic stress and increased allostatic load. Additional stressors included internalized racism, stereotype pressure, hair texture bias, and the “Strong Black Woman” expectation, which often normalized pain endurance and delay care/diagnosis. Black maternal health disparities are deeply rooted in structural and psychosocial inequities that extend beyond biomedical risk factors. Healthcare organization policy and practice should address black maternal care interventions that are accessible, cost effective, and community centered to combat elevated allostatic load and adverse health outcomes.