Directed by Dr. Gary Adamkiewicz at the Harvard T.H. Chan School of Public Health, Healthy Cities Lab is motivated by a desire to improve health and alleviate environmental health disparities. A question we frequently ask in public health is: Why does place matter? To answer this question, our work aims to identify the specific aspects of housing, communities, and neighborhoods that shape an individual’s health and thus, population health. Much of our work is focused on urban environments, where the key drivers of health vary by household and also vary in space and time in ways that we can quantify using modern tools and technologies. It is also clear that, from the household to the building to the neighborhood, many of these exposures leave an undeniable imprint on health disparities.
According to a recent estimate by the United Nations, 68% of the world’s population is projected to live in urban areas by 2050. This unprecedented shift presents significant environmental challenges locally and globally. Cities have often been compared to living systems—they live, grow, breathe, consume, evolve, and produce waste. How is this growth and evolution putting pressure on the environments that surround us? While we collectively benefit from the efficiencies and synergies that cities provide, these gains are not distributed equitably. How can we urbanize sustainably and fairly?
Our lab is working to develop and improve the methods of quantifying environmental exposures and health risk in ways that inform outreach, intervention and public policy. This work, conducted in the lab and in the field, includes the application of exposure assessment methods, data science, statistical methods, sensing technologies and other diagnostic tools.
Our mission is to use the tools of research to inform interventions that improve health. Both theoretical models and empirical evidence reveal that disparities in environmental exposures can be significant determinants of health disparities globally. Understanding the key determinants of multiple exposures can aid in developing policies to reduce these disparities. We aim to identify the specific aspects of housing, communities, and neighborhoods that shape an individual’s health.
Brief descriptions of our current research initiatives are listed below:
HOUSING-RELATED EXPOSURE DISPARITIES
This work aims to identify the proximate and contextual factors that shape environmental exposures, especially those related to housing. We have long known that poor housing conditions can be associated with poor health outcomes, but these risks cannot be alleviated without understanding the mechanisms that shape exposures. We also need to understand the social, physiological and behavioral vulnerabilities, which may amplify the health effects associated with these exposures. These questions lie at the intersection of environmental, occupational, social and behavioral health. We have conducted studies that quantify and examine exposures to secondhand smoke, pesticides, endocrine disrupting chemicals, nitrogen dioxide, mold and allergens. All of these studies were conducted in low-income communities or within public housing developments. Most recently, we have looked at how these multiple exposures co-exist in these settings, which sheds light on the importance of cumulative risks in our discussion of health disparities. We are also very interested in examining how environmental risks align and/or interact with other risk factors, such as psychosocial influences, the food environment, access to care, etc.
We are interested in research that can be translated directly into action. This can be accomplished through interventions that employ the principles of engineering and building design, as well as policies implemented through institutional and community-based approaches. Through collaborations with policymakers and practitioners, my team is developing ways to directly apply research to public health action and intervention. For example, over the past ten years, the Boston Housing Authority (BHA) has changed many policies and practices aimed at improving the health of their residents. Our group has conducted key research on many of these changes. Specifically, BHA has changed their pest-control practices (adopting Integrated Pest Management, or IPM), instituted a ban on smoking within apartments, and moved families from conventional apartments to those designed to be healthy and energy efficient. Now, we must ask: What are the benefits of these green interventions? Do we see reductions in environmental exposures and improvements in health? What are the relevant physical, physiological or psychosocial pathways? Are the costs offset by the benefits? Through several funded studies, we are currently addressing these questions.
In addition to examining environmental problems facing residents of U.S. cities, we are interested in the challenges of creating healthy and sustainable cities worldwide in the coming century. We are working to provide primary and translational research that addresses issues related to housing, land use changes, the built environment, construction practices, water quality and food systems.
FOOD AND OUR FUTURE
Our day-to-day decisions surrounding the consumption of food can have important personal, local and global consequences. We are interested in informing better decisions by examining the implications of food choices through the lenses of nutrition, human health, environmental degradation, occupational health, climate change and sustainability.