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Global &Environmental 

Health Lab




Measuring environmental and disease vulnerability in urban slums

Our new study focused on measuring environmental and disease vulnerability (ENDIV) in urban slums and its associated health effects. ENDIV is a research area vital to the health and sustainable livelihood of WIC because of 1) diarrheal diseases associated with contaminated media (e.g. water) and overcrowded households; 2) lower respiratory and ischemic heart diseases as a result of poor indoor air quality and housing conditions; 3) an increase in noncommunicable diseases due to the lack of healthcare facilities and well trained health professionals; 4) exposure to food borne pathogens and child malnutrition due to inadequate sanitation; 5) the increase in economic burden due to increased medical costs and decreased wages as a result of frequent illness; 6) the physical and psychological burden associated with social exclusion and/or being assaulted or raped at night; and 7) the risk of gender based violence due to slum clearances or evictions and social upheavals.


This study is possible through collaborations with Dr. Frederick Armah at the University of Cape Coast and Dr. Reginald Quansah at the University of Ghana School of Public Health.

In this research stream, we focus on how changes in the physical and social environment influence chronic diseases and health outcomes, and how these changes exacerbate the health equity gap. Currently, we are focusing on how changes in the physical environment is influencing the health of older adults in sub-Saharan Africa. Through Remote sensing, we have been able to extract data on land use, forest covers, mineral exploration, temperature, rainfall, drought, particulate matter (PM2.5), and water bodies in most places in sub-Saharan Africa.

These data will be combined with the WHO Study on Global AGEing and Adult Health (SAGE) to assess how (1) changes in drought severity and its effect on the health of aging adults across low-and middle-income countries; (2) changes in exposure to ambient air pollution and its effect on the health of aging adults. Dr. Dozie Okoye of Dalhousie University, Dr. Paul Kowal of the World Health Organization, and Dr. Stella Lartey of Indiana University are collaborating on this project.

Environment and disease vulnerability (EPACC Study)



Resource insecurity, health and sustainable livelihoods

Measures developed on various components of resource insecurity such as food and water insecurity at the household level have provided key insights into the poor health outcomes of vulnerable populations; especially, women, infants, and children (WIC).

Current research in this area is aimed at developing housing and energy insecurity scales. In collaboration with Dr. Ellis Adams at the University of Notre Dame, a new study on resource insecurity and well-being in the slums of Ghana has been initiated. A second study, on energy insecurity, health and sustainable livelihoods in Colombia has also been initiated with Dr. Diego Lucumi at the Universidad de los Andes.





Scale development and the measurement of health indicators

This research contribution has a methodological significance and serves as the golden thread that ties together the development of scales for measuring behaviors, attitudes, lived experiences, and hypothetical scenarios that facilitates the assessment of health and health disparities among vulnerable populations. As science advances and novel research questions are put forth, new scales become necessary. The project has so far developed multiple scales published in Maternal & Child Nutrition, BMC pregnancy and Childbirth, and PLoS ONE.


Ongoing scale development projects include an Arabic language version of the Breastfeeding Self-Efficacy Scale; Postpartum Childcare Stress Checklist; and Postpartum Partner Support Scale. This research is possible through collaborations with faculty in the United Arab Emirates and Canada. We are in the initial phase of developing a new scale on Social Support for Refugees in Resettlement.