A program of Breast Cancer Prevention Partners


Social, environmental and individual characteristics interact to both shape a person’s exposures and how their body responds to that exposure.


Age, gender, culture, identity and economic status impact the products people buy, and, as a result, the chemicals to which they are exposed. In addition, genetics, the cultural and environmental context of early life, diet, physical activity, alcohol use, and smoking may shape how one’s body reacts to those exposures.

Biology and Genetics

At the biological level, some genes may make some people more vulnerable to certain environmental exposures. For instance, the BRCA1 and BRCA2 mutations (the primary “breast cancer genes”) are mutations that affect gene repair. This means that women with these mutations are more vulnerable to exposures that lead to genetic mutations, since their body is less able to fix mistakes. Other genes can also make individuals more susceptible to different genetic, lifestyle, hormonal or environmental challenges.[1][2]

Cultural Beauty Norms

Culture and normative ideals of beauty influence the products people use and therefore their exposures. For instance, older women may use anti-aging creams to reduce signs of aging, given a cultural emphasis on youth. Some of these products have been found to contain chemicals such at PTFE (also known as Teflon®), which may be contaminated with PFOA, a chemical linked to mammary gland tumors and reproductive toxicity, and polyacrylamide, which may be contaminated with the carcinogen acrylamide.

Cultural norms that privilege lighter skin mean some women use skin lightening creams, which can contain mercury, formaldehyde-releasing preservatives (formaldehyde is a known carcinogen), and hormone disruptors such as hydroquinone and the UV filter, benzophenone. Preferences for straight hair mean some women use chemical hair straighteners and relaxers that can contain formaldehyde, hormone disruptors and carcinogens.

Race, Ethnicity, Socioeconomic Status

Race, ethnicity, socioeconomic status and other social factors can also shape health. These interactions are complex, because access to health care, exposures to environmental chemicals,[3][4][5] access to healthy foods and safe spaces for physical activity, occupation, and community stress and security are affected by the built environment, social networks, geographic location, poverty[6] and race.[7]

As a result, while health disparities associated with race, ethnicity and poverty are well-documented, the actual causes of these disparities likely emerge from the complex social dimensions of class and race in the United States.[8] Socioeconomic status, race and ethnicity probably serve as markers for other activities or circumstances that influence the level of exposures to potentially toxic chemicals.[9]


[1] Bradbury, A. R., & Olopade, O. I. (2007). Genetic susceptibility to breast cancer. Rev Endocr Metab Dis, 8(3), 255–267.

[2] Conde, J., Silva, S., Azevedo, A., Teixeira, V., Pina, J., Rueff, J., & Gaspar, J. (2009). Association of common variants in mismatch repair genes and breast cancer susceptibility: a multigene study. BioMed Cent, 9, 344.

[3] Evans, G. W., & Kantrowitz, E. (2002). Socioeconomic status and health: the potential role of environmental risk exposure. Annu Rev Publ Health, 23, 303–331.

[4] Forastiere, F., Stafoggia, M., Tasco, C., Picciotto, S., Agabiti, N., Cesaroni, G., & Perucci, C. A. (2007). Socioeconomic status, particulate air pollution, and daily mortality: differential exposure or differential susceptibility. Am J Ind Med, 50(3), 208–216.

[5] Quinn, M. M., Sembajwe, G., Stoddard, A. M., Kriebel, D., Krieger, N., Sorensen, G., … Barbeau, E. M. (2007). Social disparities in the burden of occupational exposures: results of a cross-sectional study. Am J Ind Med, 50(12), 861–875.

[6] Rauh, V. A., Landrigan, P. J., & Claudio, L. (2008). Housing and health: intersection of poverty and environmental exposures. Ann NY Acad Sci, 1136, 276–288.

[7] Brulle, R., & Pellow, D. (2006). Environmental justice: human health and environmental inequalities. Ann Rev Public Health, 27, 103–124.

[8] Krieger N, Löwy I, Aronowitz R, et al. (2005). Hormone replacement therapy, cancer, controversies, and women’s health: historical, epidemiological, biological, clinical, and advocacy perspectives. J Epidemiol Community Health, 59:740-748.

[9] Nelson, J. W., Scammell, M. K., Hatch, E. E., & Webster, T. F. (2012). Social disparities in exposures to bisphenol A and polyfluoroalkyl chemicals: a cross-sectional study within NHANES 2003-2006. Environ Health, 11, (10), art. No 10.

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