Planetary Health Alliance

Dec 5, 2019

4 min read

Alli Abosede Sarah Spotlights Howard Frumkin

By Alli Abosede Sarah, Travel Scholar and Speaker Ambassador at the 2019 Planetary Health Annual Meeting

At the 2019 Planetary Health Annual Meeting, Dr. Howard Frumkin gave an intriguing plenary lecture focused on “Non-communicable diseases and planetary health: Urbanization, air pollution, energy, and the built environment.” He reiterated that non-communicable diseases (NCDs) have a massive impact on human health, accounting for about 40 million deaths annually and 80% of years lived with disability, with low and middle income countries (LMICs) being disproportionately impacted. He noted that unsustainable types of energy, modes of travel, and materials in the built environment not only drive global environmental change, but are also risk factors for many NCDs.

Dr. Frumkin holds an MD in Medicine from University of Pennsylvania School of Medicine, an MPH in Occupational Health, and a DrPH in Epidemiology from Harvard University School of Public Health. Prior to his most recent position as head of the “Our Planet, Our Health” program at the UK-based philanthropic organization Wellcome Trust, Dr. Frumkin served as the Dean of Environmental and Occupational Health Sciences at the University of Washington School of Public Health. Additionally, he was a former Director of the National Center for Environmental Health and Agency for Toxic Substances and Disease Registry at the US Centers for Disease Control (CDC) and Prevention and Chair of Environmental and Occupational Health at Emory University’s Rollins School of Public Health. Additionally, Dr. Frumkin serves on various committees and advisory boards such as the National Academy of Sciences, Committee on Measuring Community Resilience.

During his plenary, Dr. Frumkin elaborated that rapid urbanization results in a series of environmental challenges linked to increased risk of NCDs. For instance, urban sprawl limits the incorporation of efficient transport systems thus resulting in automobile dependence and sedentary lifestyles. Similarly, rural to urban migration in LMICs is associated with changes in dietary habits, including the adoption of processed foods associated with increased obesity prevalence. Furthermore, the concentration of industrial and domestic energy needs in cities often translates to the combustion of large quantities of fossil fuels — thus increasing air pollution levels and related risk factors for cardiovascular diseases. Additionally, fossil fuel combustion contributes directly to climate change, thereby increasing the intensity and frequency of extreme weather events that could trigger or exacerbate existing health condition, as well as limit access to healthcare facilities.

A slide from Dr. Frumkin’s plenary presentation at the 2019 Planetary Health Annual Meeting, entitled “Non-communicable diseases and planetary health: Urbanization, air pollution, energy, and the built environment.”

Dr. Frumkin stressed that while many risk factors for NCDs are of environmental origin, much of the current discourse on NCD prevention has been focused on changing health behaviors without tackling risk factors related to environmental and planetary health. He added that while behavioral changes are important in reducing NCDs, the strategies needed to effectively tackle risk factors for NCDs should include carbon pricing to reduce greenhouse gas emissions, increased political response to planetary health, building greener cities, reforming unsustainable food production, and celebrating activism. He further emphasized the importance of multi-sectoral collaboration and investment in policies geared towards the reduction of environmental pollution with potential to improve human and planetary health.

Particularly interesting was the fact that Dr. Frumkin’s lecture touched on many of the challenges faced by Sub-Saharan African (SSA) countries — many of which are currently experiencing a double burden of both infectious and NCDs that can be partly explained by rapid urban population booms outpacing urban structural transformation, resulting in elevated pollution levels and other planetary health hazards. My personal research entails a high-resolution assessment of air and noise pollution in Accra, Ghana, with the development of a monitoring protocol that is scalable and adaptable to other SSA cities. This is part of the Pathways to Equitable Healthy Cities (http://equitablehealthycities.org/) effort to provide scientific evidence on how urban development and policy change can be directed to enhance healthy living. My main takeaway from Dr. Frumkin’s talk is that proposed solutions for NCD treatment and mitigation must take into account the complex and interrelated pathways through which drivers of global environmental change affect NCDs risk.

A review paper written by Dr. Howard Frumkin and Dr. Andy Haines on Global environmental change and non-communicable disease risks can be found here: https://doi.org/10.1146/annurev-publhealth-040218-043706

Disclaimer: The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the Planetary Health Alliance or its members.