What can we learn from Latin American cities to make our own more healthy? Thanks to a new $12 million grant, an international team led by one of Drexel University's deans will use the next five years to find out.
Ana Diez Roux, MD, PhD, dean of Drexel's Dornsife School of Public Health and Director of the Urban Health Collaborative at the school, led an interdisciplinary team that secured one of the Wellcome Trust's Our Planet, Our Health initiative grants. The team will use it to study how the governance, design, organization and environment of Latin American cities affect population health, as well as health inequities within cities. Importantly, the project also has a distinct focus on understanding the links between health and environmental sustainability of cities.
"This is critical because health and environmental sustainability are closely entwined," Diez Roux said. "This is because the environment affects health -- for example, levels of air pollution and heat have especially strong health impacts in cities --but many of the things we can do to make people healthier, like promoting active travel and consumption of fruits and vegetables, also have favorable implications for the environment. We need to think of these things as synergistic, and that is a key goal of the project."
Diez Roux will lead an interdisciplinary team that spans 11 Latin American and 3 U.S. institutions. The project grew out of the previously established Urban Health Network For Latin America and the Caribbean, an initiative of the Dornsife School of Public Health co-sponsored by the United Nations University and the Economic Commission for Latin America and the Caribbean.
The researchers will study hundreds of cities located throughout Latin America and the Caribbean, and partner with policy makers and other stakeholders throughout the region. The project is based at the Urban Health Collaborative in the Dornsife School of Public Health and includes Drexel investigators and a large international team of collaborators. It will create multiple opportunities for engagement of additional investigators, trainees, and stakeholders including policy makers.
Partner institutions and lead investigators include:
- National University of Lanus, Buenos Aires, Argentina; Marcio Alazraqui and Hugo Spinelli
- Federal University of Minas Gerais, Belo Horizonte, Brazil; Waleska Caiaffa and Augusta de Lima Friche
- Universidad de Sao Paulo, Sao Paulo Brazil; Nelson Gouveia
- Oswaldo Cruz Foundation; Salvador Bahia and Mauricio Barreto
- Oswaldo Cruz Foundation, Rio de Janeiro; Maria de Fatima de Pina and Leticia Cardoso
- Universidad de Chile, Santiago, Chile; Patricia Frenz
- Pontifica Universidad Catolica de Chile, Santiago, Chile; Alejandra Vives
- Universidad de los Andes, Bogota, Colombia; Olga Lucia Sarmiento
- Instituto Nacional de Salud Publica, Mexico City, Mexico; Tonatiuh Barrientos
- Universidad Peruana Cayetano Heredia, Lima, Peru; Jaime Miranda
- Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala; Fernanda Kroker and Manuel Ramirez Zea
- University of California at Berkeley; Daniel Rodriguez
- Washington University in St Louis; Joaquin Barnoya
- UNU International Institute for Global Health (UNU-IIGH) United Nations University; Jose Siri
- Economic Commission for Latin America and the Caribbean (ECLAC); Ricardo Jordan
Along with Diez Roux, collaborators from Drexel will include Amy Auchincloss, Brett Langellier, Gina Lovasi, Leslie McClure, Yvonne Michael, Harrison Quick, and Jose Tapia.
"I suspect we will find that cities vary quite a bit in health and health equity and that there are real things cities can do to improve the health of residents," Diez Roux said. "I also suspect that many of the most promising interventions and policies we find will focus on 'upstream determinants' and factors outside the traditional health sector -- like social policy or urban planning."
The project's funder, the Wellcome Trust, is a global charity focused on improving public health around the world. Its Our Planet, Our Health initiative is designed to fund research aimed at understanding the changing Earth, how it affects our health, and coming up with solutions beneficial to both.
Latin America is an ideal place to study the impact of urbanization on health, as it is one of the most urbanized places in the world: 80 percent of its population lives in cities.
By 2050, Latin America is projected to be the most urbanized region.
It is also a region of large social inequities: of the world's 30 most unequal cities in health and social measures, 19 are in Latin America.
"We will tap into the conditions and experience of Latin American cities -- something that has not been done before at this scale -- in order to understand how we can improve the health, health equity, and environmental sustainability of cities all over the world," Diez Roux explained. "This is a unique opportunity because many of these cities have implemented innovate policies that we can examine."
The key to this study will be its applicability, not just to the United States, but worldwide abroad, Diez Roux believes.
"There will be ways in which Latin American cities and U.S. cities are similar and ways in which they are different," she said. "But what is clear is that many of the lessons we draw from this study will be relevant not only to U.S. cities but also to cities all over the world."