Where Climate Change and Public Health Converge
A talk with Kristen Malecki, the director of UIC’s new Center for Climate and Health Equity
Story Intro
For Kristen Malecki, one experience and curiosity sparked the next, fueling a research career she never saw coming. As an undergraduate student majoring in Metropolitan Studies and pre-med at New York University, Malecki learned of wildly varying asthma rates across New York City. The figures stirred curiosity – and concern. For instance, in the South Bronx, an area zoned not for daily living but industry and home to many factories, waste management shops, the majority of the city’s incinerators and but one hospital, resident asthma rates were 8-10 times higher than the national average. The South Bronx’s asthma rates also far outpaced the numbers found in other New York City neighborhoods, including Manhattan’s tony Upper East Side a few miles south which housed the 843-acre Central Park.
“That got me thinking about social and environmental factors long before I even knew the world of public health existed,” said Malecki, professor and director of the Division of Environmental and Occupational Health Sciences at the UIC School of Public Health.
During graduate School at Johns Hopkins University in the early 2000’s, Malecki studied environmental health policy and epidemiology and worked on the national Environmental Health Tracking program, an effort to bridge the gap between environmental and health agencies and improve the monitoring of health impacts from environmental factors. The research stirred Malecki’s interest in prevention and putting sound, evidence-based interventions into practice. In 2004, then, Malecki began a two-year applied epidemiology fellowship with the Wisconsin Department of Health Services’ Bureau of Environmental and Occupational Health. There, the Wisconsin native began working on state and national working groups anticipating health risks from climate impacts, then just a whisper of a public health threat.
“When people were talking about the climate back in the early 2000s, they were largely thinking about the impacts to the natural environment, like ecological changes in forests and the oceans or economic costs to agricultural production,” Malecki said. “Human health wasn’t on the radar as much.”
As environmental health impacts emerged an increasingly prominent topic over recent decades, Malecki’s interest in examining how social and physical environments intersect and impact human health accelerated alongside her passion for uncovering positive solutions. She captured competitive grants, co-authored more than 100 papers, penned policy reports and spoke at scientific conferences about the influence of chemical, physical, and social stressors on adult chronic disease, aging, and health disparities.
Every step ignited the next, all of it leading to Malecki working with colleagues across UIC and SPH to earn funding from the National Institutes of Health (NIH) to establish the new Center for Climate and Health Equity (CECHE) at UIC. The interdisciplinary center assembles experts from public health, medicine, engineering, urban planning, and biological sciences to explore environmental health and test nature-based interventions to minimize the impact extreme weather events and disruption to ecosystems have on human health. Malecki is serving as the center’s inaugural director. Malecki, who was recently appointed to the National Academies of Sciences’ standing committee on the Use of Emerging Science for Environmental Health Decisions, discusses how climate impacts a public health, the origins and mission of CECHE, and the critical importance of interdisciplinary collaboration to crafting interventions.
Q & A With Kristen
Viewing climate impacts as a public health issue is still a relatively new phenomenon. In what ways does the climate impact human health?
A warmer planet is sparking more extreme weather events, such as flooding and wildfires, and those events have human health impacts in both the short and long term. Take the recent wildfires in California as an example. You have the toxic air from wildfires to begin with as well as a different toxic mixture from homes, buildings and other manmade structures burning. Firefighters are on the frontline as residents struggle to save their homes, find safe lodging and determine how to rebuild or move on without economic stability or stable housing. The toxic exposures are one thing; the social and economic costs of rebuilding and starting over are another, including the toll of trauma and stress on mental health moving forward – for both those directly affected and those who live in fear of the next extreme weather event. Go further and other human health challenges, such as food safety concerns and the threat of more vector-borne diseases, come up. So, even if human health isn’t the first thing that jumps to mind when people think about the climate, it’s nevertheless tied to a diverse array of public health challenges.
Your initial research work didn’t necessarily explore the climate, so how does this all tie together for you?
After a tragic loss during my undergraduate years and working as a canoe guide in Northern Minnesota to heal from this loss, I became very interested in the biological benefits of exposure to nature, including how being in nature can support health and well-being. In 2014, my colleague and I published a paper in the International Journal of Environmental Research and Public Health examining the association between green space and mental health – one of the first published papers to ever address that topic. Today, it is well established that urban green space has the potential to help human health and well-being. Now, if you look at pollution and improving environmental health, nature-based solutions like increased parks, urban forests, and other green spaces are one intervention capable of creating a healthier ecosystem, particularly in urban environments. Already half of the world’s population lives in urban areas, and that’s estimated to grow to more than two-thirds of the global population by 2050. Thinking about how to design cities that can positively impact human health is an interesting question to me.
How did the CECHE come about?
UIC has researchers in the colleges of Liberal Arts and Sciences, Engineering, and Urban Planning researching climate impacts and working with communities to identify solutions, though human health was not part of the discussion. Then, in the School of Public Health and in the College of Medicine, we have individuals working on climate impacts to health and well-being. There’s great work going on across UIC, but these distinct efforts weren’t necessarily connected. For example, the Children’s Environmental Health Initiative led by Chancellor [Marie Lynn] Miranda provides valuable infrastructure for assembling diverse national and local datasets in one place as well as expertise in geospatial data analyses to evaluate and support cutting-edge research at a local and national scale. Then, we have the Community Research on Climate & Urban Science project in partnership with Argonne National Laboratory, which is conducting high-tech microenvironmental assessments of urban climate change, as well as CACHET (the ChicAgo Center for Health and EnvironmenT), which supports biomedical environmental research to action in high-risk communities in collaboration with the impacted communities themselves. Beyond that, UIC also maintains strong partnerships with local health agencies, including the City of Chicago and Cook County Departments of Public Health and the Illinois Department of Public Health, all of whom are working to build new infrastructure to address emerging challenges. We also know local and regional community partners and non-profit organizations, including the Morton Arboretum, are working to address health inequities through nature-based solutions. Finally, we have strong academic partners across Illinois and the country invested in addressing climate change and reducing health disparities. The center brings this all together and focuses on working collaboratively to find solutions. It is built to be a unifying agent for collaboration and solutions-oriented work and a nexus point for science and community engagement to combat climate change and develop innovative nature-based solutions to enhance public health. UIC is the right place to do it, and the time is right to leverage several ongoing efforts and create a cutting-edge program to help identify evidence-based solutions.
Why is that interdisciplinarity and collaboration so vital to CECHE and its goals?
Public health can’t do this alone, even if we need public health information and data to guide real-world solutions. In fact, some of the biggest improvements to public health came from outside the field. Tap water safety, for example, is an engineering feat informed by public health, but ultimately designed and executed by professionals from other disciplines. With enough scientific evidence showing that climate impacts public health, we need to focus on solutions, and interdisciplinary research has proven to be important to advancing public health solutions. If you’re going to plant trees to minimize the health impacts of flooding, then you need to involve engineers and urban planners. If you want to inform climate policy, then you need to lean on data scientists to help make the case to policymakers. The center is linking academic silos to devise innovative solutions and working with communities to advance health and well-being for everyone. We fully understand this is a layered issue demanding multidisciplinary expertise, and the center can help bridge different fields to power the research we’re all doing.
What has you most excited about the center and its prospects?
With this center, including funding from the National Institute of Environmental Health Sciences and the National Institute on Minority Health and Health Disparities, we have an opportunity to work with academic and community partners across the country to tackle one of the greatest challenges to public health right now. Research in this area has long focused on looking at problems and sources, but we’re focused on building evidence for sound decision making and solutions. We want to work toward translating science and impacting lives. The center also has a fantastic opportunity to create impact beyond Chicago. While climate impacts are often thought of at the global level, solutions can happen at the local level. There’s an exciting opportunity to prove things here that can be adapted and modeled elsewhere.
A Closer Look at the Center for Climate and Health Equity (CECHE)
CECHE at UIC is one of 22 National Institutes of Health-funded centers across the U.S. working on climate impacts and health. The federal project aims to stimulate research to reduce environmental health threats and build health resilience, particularly in vulnerable populations. CECHE aims to use team science and a cumulative impacts framework to advance innovative solutions-based research and policies to combat climate health inequity and fulfill its mission of responding to priorities of the most vulnerable communities in Chicago, the nation and beyond. The new center features three cores designed to propel its ambitious work:
- The Administrative Core (AC) plays a coordinating role at CECHE, tasked to provide overall management and evaluation of the center’s activities. Through an advanced health impacts approach and systems thinking framework, the AC will actively work to build and sustain a collaborative network of researchers and partners from the community, healthcare field, and civic world to address ongoing climate and health challenges and advance solutions. In addition, the AC will support communication across the center, career advancement initiatives and a pilot project program to accelerate innovative research. Dr. Malecki and Deputy Director Miquel Gonzalez-Meler will lead the AC. Dr. Mary Turyk will assist with program pilot grants, Dr. Eve Pinsker with evaluation, and Dr. Jeni Herbert-Beirne with community and partner guidance.
- Working in collaboration with community partners, healthcare providers and policymakers, the center’s Community Outreach and Engagement Core (COEC) will use an iterative process for capacity building and identification of climate solutions to turn research into action and address the needs of communities. Through its train-the-trainer model, COEC will establish a Climate Health Institute to heighten capacity and instruct community health ambassadors across Chicago. COEC leaders and partners will also conduct innovative urban health design studies to create nature-based toolkits for promoting health benefits of green infrastructure and policy development at local, regional and national levels. COEC will be led by Dr. Yamilé Moline and Dr. Jamie Chriqui, both from SPH. Also contributing are Drs. April Jackson and Sevin Yldiz (College of Urban Planning and Public Affairs) and Drs. Sheetal Rao and Andrea Pappalardo (College of Medicine).
- The Geospatial Data Analysis Core (GDAC) will leverage the mounting assortment of data related to climate, cities, and health to understand how climate affects health in Chicago communities. The GDAC will build robust data architecture linking green infrastructure in the city with environmental factors, electronic health records and more, acting as a hub to assemble relevant health and environmental data to facilitate effective solutions and action. GDAC will be co-led by Dr. Sanjib Basu (SPH) and Melissa Fiffer, a Scientist in the Children’s Environmental Health Initiative (a research group led by UIC Chancellor Dr. Miranda), along with Joshua Tottoo, and Aaron Lilienfield. The initial research project will be led by Dr. Honghyok Kim (SPH), as well as colleagues, Dr. Samuel Dorevitch (SPH), Sybil Derrible (College of Engineering), Max Berkelhammer (UIC), Lindsay Darling (Morton Arboretum). With its flagship research project, CECHE is linking data from emergency departments and hospitals to spatial data related to greenery and quality of life. The project will provide insight on how features of urban green infrastructure impact air quality and heat islands, mitigate flooding and influence cardio-respiratory outcomes, including emergency room visits and hospitalizations.