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Future-Proofing Health Against Climate Catastrophe

Erin Coughlan de Perez was living in New York City when Hurricane Sandy struck in 2012. One of the largest storms ever to hit the city, Sandy killed 44 residents, displaced thousands, and caused billions of dollars in damage. “To be a part of the community and to see what went well and what didn’t—that had an effect on me,” Coughlan de Perez says.

Now a research director and the Dignitas Professor at the Feinstein International Center at the Friedman School of Nutrition Science and Policy at Tufts University, Coughlan de Perez is leading an international, interdisciplinary team of researchers in identifying methods to prevent negative health outcomes after climate-related disasters like floods, typhoons, and droughts. 

The group, Center for Climate and Health glObal Research on Disasters (CORD), includes more than 25 named researchers and 10 doctoral students spread across seven universities in the United States, Bangladesh, Lesotho, Namibia, Mozambique, the Philippines, and Uganda. 

CORD recently received a $3 million grant from the National Institute of Environmental Health Sciences. Over the course of three years, researchers will use the grant to analyze vast amounts of data and identify pragmatic steps that can be taken ahead of predicted hazards to reduce, or ideally prevent, dangerous health outcomes for particular communities affected by environmental catastrophes. 

The hope is ultimately to help put in place protocols that will head off occurrences of cholera, malnutrition, and diseases like dengue. 

“Part of the idea behind this grant, and what makes it so exciting,” Coughlan de Perez says, “is that we’re not just studying how bad climate change is. The point is not to write more studies saying sea levels are rising or floods are devastating. It’s to help future-proof health against climate catastrophe.” 

Tufts Now sat down with Coughlan de Perez to find out more about how her group will identify anticipatory actions, what role data will play, and how the findings might help prevent human health disasters.

Tufts Now: What exactly does it mean to future-proof health against climate catastrophe?

Erin Coughlan de Perez: It means anticipating specific disasters in specific places and breaking the link between those disasters and harmful human health outcomes.

Climate catastrophes are terrible, and they vary around the world, both in the shapes they take and in the outcomes they lead to. Initially, we’re going to look at six case studies, each led by researchers at one of the collaborating universities. Our aim is to build three different methodological approaches. 

The first case study looks at cholera and other diarrheal diseases in refugee populations in Uganda. Floods and other climate-related hazards have large impacts on these refugee populations, because they are often living in hazard-prone areas and have less access to services. We want to investigate how floods might affect health in refugee populations differently, and what might need to be done differently to prepare for them and avoid negative health impacts. 

The second looks at maternal and fetal health in Bangladesh. With rising oceans, water sources there are becoming salty, and that’s having terrible impacts, especially on pregnant women. 

Then, two universities in southern Africa are researching the links between drought and food insecurity, malnutrition, and mental health. The mental health aspect in particular is under-researched. We want to investigate what it means to be living through climate-related crises that just don’t seem to stop—how do people cope? 

And, finally, we have case studies examining cholera in Mozambique and dengue in the Philippines, both induced by cyclones. 

It is, of course, extremely important that we continue taking steps to stop climate change, including reducing emissions and using green energy. 

But this project is not focused on controlling or stopping climate disasters. We already live in a changed climate, and things are going to get worse. What we need to know is how we can survive and thrive in this changed climate, especially for under-served and at-risk communities globally. How do we manage the current situation and the situation 20 years from now? What choices can reduce outbreaks and snap the link between storms and human health outcomes? 

Will the methodologies that you build for creating anticipatory actions apply only to the places you’re studying?

No—the goal is to create methodologies that can be applied to a range of places. Here in New England, for example, we’re very worried about Lyme disease. You could apply some of the same strategies and analytical techniques we’re using in this project to understand how to successfully anticipate and protect against increases in Lyme disease.

What is the role of data in this work?

There are two ways we’re thinking about data. One relates to data we already have or can get over the course of the project to help us understand what’s going on. For example, through interviews, focus groups, and dialogues among experts, the studies in the Philippines and Mozambique will be getting in-depth qualitative data from politicians and people working in health ministries. 

In other places, we’ll be getting survey data on populations to understand their experiences. Then, we will link this data about people with data about climate. This is the part I’m especially excited about: we’re going to look at huge amounts of climate data. Because weather extremes don’t happen very frequently, the more data you have, the better able you are to understand them. Then, we’ll use innovative techniques to link climate data to social data and health outcome data. The overlap of those three research areas should give us a great deal of information.

But another big goal of this grant is to build the capacity to bring data sets together. That’s the other way we’re thinking about data in this project. We intend to build more partnerships and data-use agreements with people who hold important data so that we have as much information as possible to look at—for example, how heat waves affect under-studied populations. 

There’s one more important thing to note about the data we’ll be analyzing: For this project, Tufts isn’t flying around the world extracting data from people; the studies are led locally. That’s part of what makes this grant exciting. 

What are some of the real-world impacts you hope this work will have?

A major component of this project is working with humanitarian decision-makers at all levels in the affected countries, globally and locally, to help them change their protocols about how to anticipate disasters. 

We’re aiming to work with policymakers in each country—sharing our findings, and using them to recommend issues to consider and actions to take. 

We’re also working with the affected communities themselves, which is crucial. We want to understand what people are already doing to manage these crises, and how we can support their current efforts. For example, if the Mozambique Red Cross sees a storm warning about an impending cyclone, they have a protocol in place that outlines what steps to follow. We intend our research to improve such community-led protocols—or to help build them where they don’t exist. 

Finally, we’re focusing on the next generation and guiding the next group of leaders, and closely involving our Ph.D. cohorts in all of the work. How do we train a new generation that already has a global, transdisciplinary perspective to continue this work—and continually refine and improve it?