Updated January 2004

Introduction

The HEED Program is an innovative initiative designed to explore the linkages between health, environment and economic development.  The Fogarty International Center, the National Institute of Environmental Health Sciences, the National Institute of Child Health and Human Development, the National Institute of Aging, the NIH Office of Behavioral and Social Science Research, Consejo Nacional de Ciencia y Technologia (CONACYT) of Mexico, and the United States Geological Survey co-sponsor the program.  

The scientific and public policy communities are increasingly recognizing that the interrelationships between health, environment and economic development need to be understood and addressed if the problems associated with these issues are to be ameliorated in a significant way. To contribute to this effort, HEED provides funding for interdisciplinary exploratory research projects that integrate approaches from the health, social, and natural sciences. The program gives particular attention to research that focuses on developing a better understanding of the economic behavior and incentives of individuals and groups that affect health outcomes through changes in environmental conditions. In addition to increasing scientific understanding of the linkages between these issues, HEED grantees are striving to formulate real and implementable recommendations for public health, environmental, and economic policy decision makers.

The mission of the Fogarty International Center is to promote and support scientific research and training internationally to reduce disparities in global health. To this end, the HEED program supports innovative developmental and exploratory research and research capacity-building projects in developing countries conducted by teams comprised of researchers from both developed and developing countries. Developing country research capacity is increased when developed and developing country investigators collaborate to collect and analyze data using the most sophisticated techniques available. Skills and insights gained by developing country researchers translate into developing countries being better able to understand and address the health, environmental, and economic development challenges they face. 

In addition to scientific capacity-building, program goals address related information, communication, and policy needs in the environment and health field. Many HEED funded projects result in the establishment or expansion of on-site data collection and analysis centers and generation of original data.  HEED projects examine local and national policy issues and communicate with policymakers while the research is on-going about these issues. Finally, the interdisciplinary nature of HEED research projects leads to the establishment of partnerships among scientists in developing countries that have significant potential for future scientific collaborations.  

Partners

The Health, Environment, and Economic Development program is a collaboration among:

Five National Institutes of Health (NIH) co-sponsors — 
* Fogarty International Center (FIC)
* National Institute of Environmental Health Sciences (NIEHS)
* National Institute of Child Health and Human Development (NICHD)
* National Institute on Aging (NIA)
* Office of Behavioral and Social Sciences Research (OBSSR)
and
Consejo Nacional de Ciencia y Technologia (CONACYT)

Background & Program Structure

 The HEED program was developed through a partnership between the Fogarty International Center and the National Institute of Environmental Health Sciences at NIH. The impetus was the need to understand the growing influence of global and national economic processes on the natural environment and its impacts on human health. Consultations were conducted with a broad spectrum of scientists from social, health, and environmental fields and from developed and developing countries. These conversations confirmed that the processes linking health, environment, and socio-economic development can best be unraveled through inter-disciplinary research teams, coordinated collection of environmental and health data, and rigorous and diverse analytical approaches. Improving understanding of these processes, and testing alternative interventions is expected to lead to improvements in human health and the environment.  

The program was first competed in 2003 using the R21 mechanism which supports exploratory or developmental research. This approach was selected in recognition of the novel approaches sought in this program and the expectation that most of the research teams supported by the HEED would be embarking on original and complex projects. Further, the Fogarty International Center wished to support a wide range of exploratory/developmental grants. Therefore, the first set of 11 grants are two years in duration and intended to demonstrate the range of issues and diverse analytical approaches to research on health, environment and development.  

Pending the availability of funding, the FIC plans to recompete the HEED program in late 2005 or early 2006 using both an R21 for exploratory research grants and an R01 research mechanism which would support larger-scale, 5-year awards.

HEED Awards  

Africa

“The Chad Pipeline Project: Local Ecologies and Health (Chad)"
Dr. Lori Leonard of Johns Hopkins University and Dr. Grace Kodindo of the University of N’Djamena are studying the impact of the Chad-Cameroon Petroleum Development and Pipeline Project on household economies, production activities, decision-making and health in three types of communities (a rural village, a local town with worker in-migration, and a peri-urban area of the capital city) in Chad. The oil pipeline has drawn considerable attention as a potential model for future projects in developing countries due to the involvement of the World Bank and the earmarking of approximately 70% of Chad’s revenues from the pipeline for health, education, and rural and infrastructure development. While previous investigations of the impact of large-scale infrastructure projects on local communities have relied on aggregate economic, health, and environmental indication, this study will examine the impact at the household level. The study will also provide a valuable independent assessment as to whether the social and economic programming imposed on the pipeline consortium and Government of Chad by the World Bank will accomplish the stated health benefits.

“Urbanization, Health, and the Environment in Coastal Ghana” (Ghana)
Dr. Michael White of Brown University and Dr. Kofi Awusabo-Asare of the University of Cape Coast are examining how urbanization in Ghana influences environmental health risks, and how these in turn influence local thinking about environmental issues. As increasing numbers of developing country populations migrate into urban environments, the need to understand the linkages between demographic transition, health, environment, and development becomes more acute. The team is surveying focus groups to address questions of health behavior and demographic activity; conducting exploratory drinking water quality measurements at the household and community level; delineating watersheds of coastal water bodies; developing a population growth and land use profile for the study area; and conducting preliminary analysis of the interrelationships among urbanization, lagoon water quality, fish catches and human health.

“Community Empowerment for Malaria Control in Africa” (Kenya)
Dr. Burton Singer of Princeton University and Dr. Richard Mukabani of the University of Nairobi, are focusing on the challenge of getting proven cost-effective malaria control interventions adopted and sustainably utilized at the community level in an isolated community in Kenya. While much attention has been focused on the promise that future drugs and vaccines hold for fighting malaria, vector control methods, such as environmental management and systematic larviciding, have proved highly effective in a number of regions across the globe and can be just as valuable against African vectors. This study builds upon recently established community-based initiatives in the Suba District to implement vector control on Rusinga Island through community awareness, participation, behavioral changes, and systematic implementation. A training, education, local policy development and technology transfer program will be implemented through a novel institutional framework that connects local decision making and action to the most relevant and up-to-date information and skills in the national and international healthcare community.

“Health, Pollution and Economic Development in South Durban” (South Africa)
Dr. Stuart Batterman of the University of Michigan and Dr. Rajen Naidoo of the University of Natal are examining risk perceptions, values and decision-making surrounding individual and institutional health behaviors in the South Durban Industrial Basin, a residential-industrial complex that has one of the highest concentrations of industrial activity in Africa. Despite much attention from the community and the media, scientifically rigorous information regarding health and socio-economic impacts of pollution in south Durban is scarce: no comprehensive longitudinal health study has been conducted in the region, and no empirical data regarding the social, economic or quality-of-life morbidity and mortality resulting from environmental exposure and related diseases are available. Focusing on environmental health conditions, this project seeks to develop indicators associating health and environmental factors with socio-economic status, education, underlying value systems and other factors that affect decision-making at the personal and institutional levels.

“Health and Economic Consequences of Pesticide Use” (Tanzania and South Africa)
Dr. Leslie London of the University of Capetown is collaborating with Dr. Melissa Perry of the Harvard School of Public Health on a project to collect data on pesticide use in Tanzania and South Africa.  Many pesticides which are banned or restricted in developed countries continue to be used in developing countries because of their low cost, lack of institutional capacity to regulate, lack of awareness, and perceptions of low risk. Insufficient health outcome and environmental impact data in developing countries is one of the principal reasons why externalities related to human health resulting from pesticide use are typically ignored in national and international agricultural policy in these countries.  This study aims to assemble data to characterize human exposure, develop tools to assess the neurobehavioral and childhood developmental impacts of these exposures, and assess risk perception and decision-making among farmers.  Additionally, it will estimate the financial and social costs of pesticide use in rural areas.  The project is taking place in tandem with, and is closely integrated with other well-defined capacity building initiatives underway in Southern Africa.  The project’s policy focus will enable the establishment of networks to facilitate the dissemination of findings to policy makers in addition to reporting in scientific journals and at conferences.

Asia

“Reducing SO2 Emissions in Taiyuan, China” (China)
Drs. Alan Krupnick and Ramanan Laxminarayan of Resources for the Future, and Dr. Zou Shoumin of the Chinese Research Academy of Environmental Sciences are utilizing an on-going project commissioned by the Asian Development Bank to implement tradeable emissions permits in a heavily polluted city in China to determine whether health outcomes improve as a result. High concentrations of particulates and sulfur dioxide have been significantly implicated in premature death and serious morbidity. Tradeable emission permits are used in the U.S. as a cost-effective way to reduce sulfur dioxide, but it is unclear whether this policy tool is transferable to developing countries. This landmark study can help answer this question. Researchers are taking advantage of the unique opportunity to track the policy process surrounding the intervention. A second aim of the study is to determine whether the cost of large interventions to improve health and economic outcomes are economically justifiable. Researchers will compare the health and other benefits to the costs of achieving improvements in ambient air quality. Finally, the project aims to use the results to facilitate a dialogue between local governments, environmental protection bureaus, citizen groups and the media.

“Health, Environment, and Social Structure in India” (India)
Dr. Reeve Vanneman and Dr. Sonalde Desai of the University of Maryland are working with Dr. Abusaleh Shariff of NCAER and Dr. R. Uma of TERI in New Delhi on a study that examines the effects of indoor air and water quality on maternal and child health, assesses how social inequalities, gender and poverty affect environmental exposures, as well as how public policy impacts those health risks.  Water and indoor air pollution are leading sources of disease in high mortality developing countries, where large segments of the population cook with biomass in unventilated areas and do not have access to clean water and sanitation networks.  This project will build the research capacity to examine poverty, gender inequality and public policies to determine the impact of air and water pollution on maternal and child health in India.  This project augments a major panel survey funded by NICHD that will collect second-wave data on demographic behavior across India. The HEED study adds an environmental assessment for a sub-set of rural and urban residents. This project is supported by the National Institute of Aging.

Middle East

“Health/Environmental Risks in Informal Urban Settlements” (Syria)
Dr. Kenneth Ward of the University of Memphis and Dr. Wasim Maziak of the Syrian Society Against Cancer are examining the health status of urban dwellers in informal settlements in Aleppo, Syria, focusing on respiratory and water-related diseases.  Rural-urban migration has risen dramatically in many parts of the developing world, including in Syria, as a result of economic development trends. This has created large informal settlements around major urban centers, where poverty, poor housing conditions, and lack of services, in combination with environmental risks such as unsafe water, poor sanitation, and air pollution, are thought to have major adverse effects on health and well being. Researchers are gathering a wide range of social, economic, and environmental data in order to identify intervention strategies that will be most effective in relieving the environmental health risks facing these communities. The results of this study may be relevant to other developing countries where unchecked urban growth has overwhelmed local authorities’ ability to provide services and manage urban development.   

South and Central America

“Health and Environmental relationships in the Brazilian Amazon” (Brazil)
Dr. Max Pfeffer of Cornell University and Dr. Diana Sawyer of CEDPLAR, Federal University of Minas Gerais, are examining the effects of changes in climate and environment in the Amazonia in Brazil on malaria transmission and treatment.  Awareness of the resurgence of malaria epidemics in a number of areas in the developing world is high among the scientific and policy communities.  Less well understood, however, are the linkages between economic development, environment, and malaria.  Economic development such as investment in road networks, hydroelectric dams, mining complexes, and settlement project produces environmental stress and exposes specific social groups to the health consequences of natural systems disruptions.  This project is designed to further understanding of how socio-economic conditions mediate the dynamics of health-environment relationships.  Researchers are investigating how changes in land use and cover in frontier areas of Brazilian Amazonia impact human health.  In particular, they are identifying the risks of malaria transmission related to specific changes in the landscape, and determining how these risks vary over time and across space.  Additionally, researchers are studying how social networks, organizational structure, social stratification, and government programs influence the effectiveness of health care providers in dealing with regional health problems like malaria.

“The Quito Integrated Environment and Policy Study” (Ecuador)
Dr. Jeffrey Griffiths of Tufts University and Dr. Fernando Sempertegui of the Ecuador Biotechnology Center are generating original data for analysis of the costs/risks and benefits of public policy responses to air and water quality problems in Quito, a heavily polluted urban area facing unusual environmental conditions - volcanic activity, El Nino effects, high altitude, and frequent atmospheric inversions. Current empirical and observational evidence, coupled with the basic economic theories of externalities and public goods, suggest that public policy intervention is required to manage Quito’s increasingly severe urban air and water quality conditions. This study will begin to address the lack of necessary data on environmental exposures and health outcomes needed to design, implement, and evaluate appropriate and effective public policies. Intrinsic in the project is significant research capacity building that will be used to integrate high-quality meteorological, climatological, and air and water quality data with rigorous human health outcome studies. This increased research capacity will allow Ecuadorian agencies and authorities to continue to collect and analyze these types of data in the future, and indeed ask and answer new questions as they arise in a changing economic, institutional, and environmental setting.

“Mexico: Maquila, Environmental Vulnerability and Health” (Mexico)
Dr. Sioban Harlow of the University of Michigan and Dr. Catalina Denman of El Colegio de Sonora are investigating a paradox identified in the maquiladora communities along the Mexico-U.S. border: while average economic indicators have improved, infant mortality rates have risen in the period since the maquila were established in these communities. A pilot study in Sonora will explore whether emerging disparities in infant mortality are associated with the accumulated deficit in urban environmental infrastructure while developing policy tools that can facilitate timely identification of at-risk populations and mitigation strategies. Employing a hypothesis-based approach, the researchers will use spatial and ethnographic data to develop a socio-economic vulnerability index with which to analyze the combination of development, environment and economic pressures and their impact on health outcomes. The researchers expect to develop a conceptual and methodological framework for characterizing and evaluating the socio-environmental vulnerability of urban neighborhoods that can be used by regional policy makers in their efforts to identify and mitigate urban health concerns. Additionally, this study may shed light on the “vicious cycle” theory of poverty and environmental degradation in developing countries.

          2003 Request for Applications (TW-03-005)