Increasing engagement and investment in social justice approaches to building health equity: The salience of environmental and biopsychosocial factors

In previous work we have introduced benchmarks for addressing Hispanic health disparities in the context of the U.S.-Mexico border region and advocated for the generalizability of our approach. We now focus on the translation and dissemination of research results and suggest that careful consideration of environmental and biopsychosocial factors can facilitate improved policies, programs, and resource allocation within communities. Using an ecological perspective, we highlight the salience of these factors on the border as a model for other communities seeking to engage societal sectors across all levels in efforts to build health equity. Specifically, we define and contextualize environmental and biopsychosocial factors that have been identified in the literature and recognize the sometimes paradoxical effect such factors may have on health in the border region. Environmental factors include transborder mobility, epidemiological characteristics of the region, low educational attainment, legal and economic barriers, immigration issues, employment insecurity, and lack of or inaccessibility of services. Biopsychosocial factors include population genetic factors, acculturative stress and changes, gender roles, health behavior norms (e.g. those related to substance use and sexual risk), familism, vulnerability and resilience, religiosity and spirituality, and norms related to health decision making. We aim to highlight the salience of these and other factors that can hinder or facilitate progress in addressing health disparities and suggest that community-level identification of environmental and biopsychosocial factors can increase engagement and investment in social justice approaches to building health equity.