Results and Recommendations on Health effects: Findings and Calls to Action of an Exposome project

Background

The Equal-Life project investigated the complexities of the physical and social exposome and their interplay in young peoples’ mental health and cognitive development. Data come from 11 European cohorts and school studies with nearly 250,000 children, enriched by exposure data of both physical and social environment.

Analysis

Untargeted analyses using Random Forest, Targeted analysis using Structural Equation Modeling, tailored in-depth studies.

Results

The findings highlight environmental aspects on children’s mental health and cognitive development, and the mediating role of sleep, stress, restoration, and self-regulation. Core findings and calls to action are listed for the three main aspects of environments identified: ‘places’, ‘age of exposure’, and ‘equity’.

Recommendations

Stakeholders should remain aware of equity in all stages of planning and implementation of interventions and research, and inter-disciplinary collaboration is necessary to improve actions and outcomes. Equal-Life tools like the “conceptual frameworks”, “exposome clusters”, “logic models” can be used in future actions. Unravelling the complexity of factors affecting children’s mental and cognitive health requires sustained efforts and comprehensive high-quality evidence. Consequently, the appropriate use of Equal-Life findings is to generate strategic and broad policies and actions, instead of firm, highly practical, step-by-step advice. Recommendations are tailored to specific contexts and interventions and should be population-, age-, and location-specific. Three overarching guidelines of action are proposed, including 1) “Work together” encouraging applying Equal-Life tools to perform muti-discipline collaborations, urban/rural perspectives, and data sharing; 2) “Act local” -always involve the community and local people in intervention designing; 3) “Keep going”- Findings should be further validated, investigated, and expanded, such as the novel findings on potential biomarkers.

Key messages

• Equity concerning environmental injustice is detected via identifying “exposome clusters” in children sharing similar disadvantaged or advantaged physical and social exposures.

• Improving population health while addressing health inequities is a key challenge for policy makers, particularly in urban settings.