Ecologies of Exposure and Resistance (EER): A Novel Framework for Understanding Health Inequalities in Marginalized Communities

Health inequalities remain widespread in marginalized communities despite decades of research on the social determinants of health. This paper introduces the Ecologies of Exposure and Resistance (EER) framework to better explain how culture, community, and psychological processes shape health outcomes in contexts of structural disadvantage. Rather than relying solely on biomedical universalism, EER examines how culturally grounded meaning systems, collective resources, and identity processes mediate the relationship between structural harm and embodied health. The framework integrates three core concepts. First, Exposure Fields refer to the multidimensional and intersecting risks that marginalized groups face, including poverty, discrimination, and environmental hazards. Second, Resistance Ecologies describe the collective systems of cultural support, meaning-making, and action that buffer these risks, including family networks, spiritual practices, and community organizations. This concept recognizes both protective and potentially harmful dimensions of collective resistance. Third, Health Transmutation captures how exposure and resistance interact over time through psychological and biological pathways to produce health trajectories. EER addresses theoretical gaps by integrating structural analysis with cultural insight and psychological mechanisms, moving beyond static models to examine cumulative, dynamic processes. Real-world applications including Indigenous youth suicide prevention, the Latino health paradox, and high-effort coping under racism demonstrate the framework’s explanatory value. This interdisciplinary theory offers a culturally responsive approach to understanding health disparities through the lens of lived experience, community resilience, and symbolic meaning while explicitly theorizing the psychological processes through which social conditions become embodied.