The Communication-Endocrine-Stress Adaptive Regulation (CESAR) Model: A Biopsychosocial Framework for Understanding Health Outcomes in Sensory Impairment

Sensory impairment affects over 1.3 billion people worldwide, yet the field still lacks a mechanistically specified theoretical framework explaining how communication inaccessibility contributes to stress-related health disparities in these populations. Existing models remain fragmented, addressing biological, psychological, and social factors in isolation rather than as interconnected systems. This concept paper presents the Communication-Endocrine-Stress Adaptive Regulation (CESAR) Model, an integrative biopsychosocial framework that integrates communication access, social support, stress regulation, and neuroendocrine function into a unified causal pathway. The CESAR model proposes that sensory impairment creates communication barriers may reduce social support, increase perceived stress, dysregulate the hypothalamic–pituitary–adrenal (HPA) axis, and ultimately impact reproductive health and psychological well-being. This integrative framework synthesizes evidence from disability studies, stress physiology, and communication sciences to provide a comprehensive theoretical foundation for understanding adaptation in sensory-impaired populations. The model incorporates feedback loops, moderating factors (sex, age, impairment type, duration), and environmental contexts (accessibility policies, healthcare access) that influence adaptive outcomes. By proposing specific causal pathways and testable hypotheses, the CESAR model provides a roadmap for future empirical research and targeted interventions that address the root causes of health disparities in sensory-impaired populations rather than merely treating symptoms.