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Studying the Emergence and Reproduction of Environmental Inequalities in Health through Agent-Based Modeling
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1  Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, Spain.


Despite the present acknowledgment by the scientific community on the relevance of environment to explain health inequalities, there is persistent uncertainty to explain how contextual and individual level factors are interrelated. Studies have revealed that the higher the socioeconomic status (SES), the lower the exposure to environmental hazards that may increase the prevalence of health problems, illness, disease and death. However, current works present contradictory findings when they attempt to describe and identify the complex conjunction of environmental and societal mechanisms that give rise to poor health outcomes and health inequalities. Although a wide attention has been dedicated to analyze the direct effect of socioeconomic indicators on health inequalities, the interaction effects with other related determinants such as environmental ones are not commonly described and/or nor totally captured. Considering the complex nature of determinants of health and the impossibility to understand the whole phenomenon from the isolated and decontextualized study of single components, recent studies have recognized the need for a complex systems approach to provide new evidence in public health. In this study, we use evidence-based knowledge and survey data to set an agent-based model (ABM) that is aimed to study the mechanism of reproduction of health inequalities among different population groups under different simulated scenarios composed by different environmental conditions and population groups. Our initial findings show that the combination of the most adverse environmental conditions (i.e. high environmental hazard and low healthcare provision) might drastically increase mortality and health inequalities. Therefore, considering that we have used a conservative model grounded on evidence-based knowledge and survey data from European societies, it is plausible that health disparities could be even higher in societies were social and economic conditions could be more unfavorable.

Keywords: Health inequalities, complex systems, emergence, simulation, ABM