Research in Action
Individual well-being is increasingly affected by the harmful impacts of natural, social, physical, chemical, and biological factors. Environmental health impacts are especially severe on “the bottom billion” population residing in the poorest of nations; individuals earning “a dollar a day.” Poverty-related causes of morbidity and mortality are just beginning to be recognized. Environmental drivers not only affect the health of individuals directly, but may also erode the social and institutional fabric of communities and undercut sustainable development, thus contributing to a vicious cycle of poverty and deprivation.
Household Air Pollution from Cookstoves fueled with Biomass or Kerosene
Of the 7 million yearly premature deaths attributable to air pollution, over 60% are due to household air pollution (HAP). HAP accounts for about 4.8% of lost healthy life years (DALY), ranking it highest among environmental risk factors examined and one of the major risk factors of any type, globally. HAP is generated by the use of biomass- or kerosene-fueled stoves in poorly ventilated kitchens in many low- and middle-income countries (LMIC). Over 40% of households in LMIC, worldwide, cook with solid fuels such as firewood; 122 million in Nigeria alone. To mitigate these challenges and with funding from the United Nations Foundation, Dr. Sola Olopade led a randomized controlled intervention study in Nigeria to evaluate the effects of replacing traditional cookstoves with environmentally friendly ethanol stoves. He and a team of collaborators from University of Ibadan, Nigeria, and UChicago investigated the impact on lung health, intra-uterine growth during pregnancy, and epigenetic changes. This study’s outcomes have had both local and global impact. It illuminated a number of harms to maternal health due to use of kerosene stoves, prompting the Nigerian government to eliminate subsidies for kerosene. The World Health Organization then held its first ever workshop on climate change and health implications of HAP. Additional funding from the NIH is supporting the Consortium on Asthma among African-ancestry Populations in the Americas (CAAPA, of which Dr. Olopade is a member) for work in Nigeria to identify genes in people of African Ancestry that predispose to development of asthma in response to air pollution.
Promoting Health in LMIC through partnerships with NGOs
In Nigeria and Ghana, CGH has partnered with local NGOs, Healthy Life for All Foundation (HLF) and Family Succour Link (FASUL), together with the Kiphart family, to provide clean water, schools, and sanitary facilities to rural communities in southwest Nigeria and the Ashanti region of Ghana, respectively. As an extension of the well-established academic partnership with the Center for Reproductive and Population Health at UI, Nigeria, CGH has also partnered with the Kwame Nkrumah University of Science and Technology (KNUST) and the Maternal and Child Health Hospital (MCHH), a primary care clinic in Kumasi, to expand research and improve pregnancy outcomes and child survival. Collaborators are investigating methods to increase adoption of clean cookstoves and are training local personnel in quality improvements, targeting improved maternal and child health and reduced environmental degradation. Improved quality of drinking water and indoor air, sanitation, and hygiene not only reduce the burden of disease, interventions to support these also create jobs that sustain development in local communities. In collaboration with the Polsky Center for Entrepreneurship in the UChicago Booth School of Business, CGH works with interdisciplinary teams of students and faculty to develop sustainable social venture projects in the Discover, Design, Develop and Do (D4) laboratory. Seven years ago, Nancy Martin and Ann Herbert, alumna of the Harris School, developed the idea of fortifying tomatoes with iron. This followed a working visit to Nigeria, where iron deficiency anemia in women is a major challenge. The Fortify Food venture spun from that experience remains a viable enterprise today, seven years later (FortifyFood.Org). In October 2018, CGH organized a conference at the UChicago Center in Delhi on Interdisciplinary Global Environmental Health Collaborations. We convened academics from the University of Chicago and global partners from India and Bangladesh, coming from diverse sectors of policy, economics, behavior science, climate research, and medicine, to identify and create innovative solutions to build engines for better health and a cleaner environment.
CGH Associate Directors Habib Ahsan and Sola Olopade are building strong partnerships and scholarly programs in environmental health, well-funded by the National Institutes of Health (NIH), the United Nations Foundation (UNF) Cookstove Alliance, and other sources. They both have leadership roles in the Chicago Center for Health and Environment (CACHET), funded by the NIH to establish inter-institutional collaboration to reduce environment-related health disparities, especially on the Southside of Chicago. Additionally, the newly established Institute for Population and Precision Health, spearheaded by Dr. Ahsan, brings together researchers from multiple academic units across UChicago and provides them with population-based resources to tackle the most challenging biological, behavioral, and economic problems in preventive and population medicine. The University’s excellence across these disciplines provides an interdisciplinary Institute that has the capacity to focus its collective expertise on population and precision health research. Environmental and energy policy issues can provide interdisciplinary research opportunities for faculty in physical sciences as well as social scientists, including anthropologists, health economists, environmental economists, public policy and outcomes specialists, computer scientists using mathematical models, statisticians and experts in health informatics. Interdisciplinary efforts among scholars across these fields can lead to innovations in the delivery of valuable services at low cost. Michael Greenstone, Director, of the Energy Policy Institute whose Executive Director Sam Ori has served on the CGH Steering Committee, came to UChicago in 2014. His current work focuses on testing innovative ways to increase energy access and improve the efficiency of environmental regulations around the world (epic.uchicago.edu). Drs. Ahsan and Olopade continue to explore collaborative research opportunities to incorporate economic and behavior models in interventions to mitigate challenges due to air pollution, especially in India. Other examples include use of cell phones for electronic medical records and computer communications to develop robust data analytics and to deploy low cost air pollution monitors—implementations whose value has been clearly demonstrated by UChicago Research Bangladesh.