MCW Researcher Develops Framework to Examine Impact of Climate Change on Human Health

For Jean Bikomeye, a third-year PhD student at the Medical College of Wisconsin (MCW), the issue of climate change is very personal.

Bikomeye, who joined MCW as a student in 2019, grew up in poverty in a small rural area of Rwanda in East Africa. His mother struggled as a farmer there, working on a very small piece of land in a tough climate.

“Farm production is very low in rural areas of Rwanda and other low income settings, and unpredictable climate and weather exacerbates the situation and makes the land less productive,” Bikomeye explains, adding that climate change has made the weather tougher to predict. “I know this was somehow related to health outcomes.” “Less farm productivity means less food, more kids going hungry, and household food insecurity,” concluded Bikomeye.

“Human-Made” Health Stressors

Addressing the adverse impact of climate change on diseases and injuries and looking at solutions became the basis of a study Bikomeye conducted under the mentorship of Kirsten Beyer, PhD, MPH, MS, associate professor in the Division of Epidemiology at MCW and director of the PhD Program in Public & Community Health.

That study, titled, “Positive Externalities of Climate Change Mitigation and Adaptation for Human Health: A Review and Conceptual Framework for Public Health Research,” was published in the International Journal of Environmental Research and Public Health in 2021. The study examined the impact of mitigation strategies to reduce future greenhouse gas emissions and other adaptation strategies to reduce the adverse effects of climate change and increase systems’ resilience.

The goal was to harness that knowledge to produce a blueprint of sorts that could be used to improve global health among vulnerable populations. This involved looking closely at many different examples of inputs, Bikomeye explains, such as how programs aimed at creating cleaner air impacted a neighborhood.

“If you’re talking about cleaner air, that means you are impacting all diseases that come through air quality, like respiratory diseases,” he says. “You will probably be more active there because it affects physical activity.”

By looking at these outcomes and those from many other climate change inputs, Bikomeye’s goal is to guide a concept that brings different disciplines together to improve health.

“We’re talking about agriculture and food systems, we’re talking about healthcare and hospital systems, we’re talking about transportation and green infrastructure; in any sector, there are pathways to outcomes, and I wanted to make it easier for people to understand it,” he says.

The study was conducted using literature reviews, including data on the impact of greening projects, such as urban bike lanes, and other greenspace interventions. Bikomeye looked at the process of implementing these projects and their impact to determine how they could affect different health outcomes.

Other researchers have already shown interest in translating the model he created to look at specific outcomes and adapt it in translational and implementation science. On a personal level, Bikomeye hopes that the model can help find innovative ways of farming that is less destructive to the environment.

“I want my mother to be able to produce enough food for herself and her grand kids,” he says. “It is very personal to me.”

Existing Health Threats to Local Environmental Health

Here in Milwaukee, Bikomeye is furthering his research by examining the impact of tree canopy coverage on health disparities and equity in different Milwaukee census tracts. Specifically, he is looking at its impact on chronic illnesses including cancer and heart disease, something that he is also doing across all US census tracts; thanks to a grant from the American Heart Association.

“It’s essential to look at how we can leverage the environment where we live and be able to improve everything around us in a way that we impact our lives and health and reduce the risk for different diseases,” he says.

Bikomeye has received strong support during the project from Dr. Beyer. Dr. Beyer, whose work focuses on the intersection of place, health and social justice, is also currently conducting studies on the impacts of neighborhood environmental characteristics such as green space on cancer outcomes.

“Climate change is most likely the greatest public health challenge of our time, although we may not yet realize it. It has been an honor to work with Jean over the past few years. He has an unbridled sense of curiosity and energy, and his passion and commitment to the work is inspiring,” Dr. Beyer says. “We need more young scholars like Jean in this field. Thanks also to Dr. Caitlin Rublee for her steadfast and enthusiastic mentorship of Jean as he engages in this climate health equity work.”

Bikomeye says Dr. Beyer has played a major role in guiding and helping to overcome challenges during the project.

“She’s the type of advisor who would work with you through anything,” he says. “No matter how hard it is, no matter how tough it is, you will troubleshoot things and always have a product at the end of the day.”

Eventually, Bikomeye hopes that their work will inform evidence-based decision- and policy-making processes toward equity in different sectors on an international level. Doing so, he says, will help others more quickly implement effective interventions in their own regions.

“It’s something that could put together a concept in a way that would leverage all of these positive things in the climate change world, and also investigate how all those led to positive health outcomes.”