Research Questions/Intro
This research kit was created to explore the question: what public health issues exist among Latin American cities? Even further: what steps should future urban designers implement into Latin American cities to promote the health of its inhabitants? It is imperative that these questions are researched in response to the eighty percent of the Latin American population living in urbanized regions (Bilal, et. al) and the quickly increasing rates of obesity in Latin American regions since the 1990s (Jiwani, et. al). Through the accumulation of relevant resources will awareness, and hopefully change, be brought to this important and widely applicable issue.
Narrative/Overview
A health concern specific to the urban population is the impacts of pollution. The ever-rising urban population and modernization of said spaces leads to an increased use of transportation and creates a high demand for industrial services (Bell, et. al, 2006). According to a twenty-year long study focused on Mexico City, Santiago, and São Paulo, more than one-hundred-million Latin American and Caribbean residents are living in an area with higher pollution concentrations than the World Health Organization’s suggested guidelines (Bell, et. al, 2006). High concentrations of air pollution can lead to chronic respiratory and cardiac issues such as asthma and chronic bronchitis. These toxins within the air can also cause low birth weight (Bell, et. al, 2006). The study found that implementing stricter pollution policy could prevent “156,000 deaths, 4 million asthma attacks, 300,000 children’s medical visits, and almost 48,000 cases of chronic bronchitis” in the span of twenty years (Bell, et. al, 2006). Alongside decreasing said health issues is the corresponding twenty-one to one-hundred-sixty-five billion US dollars that would be saved paying for medical office appointments, hospital visits, pharmaceuticals, and other therapeutic interventions (Bell, et. al, 2006). The policies put into place for this study called for a decrease in use of motorized vehicles, which is the cause of forty to eighty-six percent of emissions in the studied cities (Bell, et. al, 2006). The study also mentioned that those more susceptible to this pollution were those with limited access to quality health care and proper nutrition (Bell, et. al, 2006).
A vulnerable population at an increased risk of health issues related to urban air pollution is infants and children, who make up almost nine percent of the Latin American population (Gouveia & Junger, 2018). A 2018 study focused on the air pollution in Mexico City, Santiago, Chile, São Paulo, and Rio de Janeiro as well as the impact it has on the respiratory health of urban infants and children. (Gouveia & Junger, 2018). Continuous exposure of heavily polluted air increases infants’ and children’s likelihood of having impaired lung function, respiratory illness, and even childhood mortality (Gouveia & Junger, 2018). This study is relevant information to include in the discussion of future policies as preventing health issues in children will allow this susceptible population the opportunity to properly develop into healthy adults.
Another form of harmful pollution is the health issues correlated with urban water. A study focused on, but not limited to Brazil and Mexico, looked into the way water is treated in urban settings as well as the impacts of this management (Peña-Guzmán et. al, 2019). This study pays particular attention to the urban water cycle which includes the movement of drinking water, waste water, ground water, and surface water (Peña-Guzmán et. al, 2019). This study found the common micropollutants of city water, including drinking water, included pharmaceuticals, personal care products, illicit drugs, food additives, fire retardants, pesticides, and UV filters (Peña-Guzmán et. al, 2019). According to the United States Environmental Protection Agency, intake of contaminated water can put an individual at risk for “gastrointestinal illnesses, nervous system or reproductive effects, and chronic diseases such as cancer” (EPA, 2021), not to mention the impact on the health of surrounding ecosystems, particularly aquatic life (Peña-Guzmán et. al, 2019). The high cost of implementing monitoring systems as well as the lack of political interest and involvement restricts the ability for cities to have proper surveillance and stricter regulations over their water systems (Peña-Guzmán et. al, 2019). Through increased allowance of research and monitoring in these areas can the urban population be made aware of the impact these polluted waters are making and further, advocate for change (Peña-Guzmán et. al, 2019).
Latin American city populations and productivity are also threatened is through chronic illnesses. Chronic Obstructive Pulmonary Disease is highly prevalent throughout Latin American regions with rates up to sixt
een percent of the population over forty (Perez-Padilla & Menezes, 2018). According to the World Health Organization, COPD is the third leading cause of death worldwide, it has no cure, and ninety percent of COPD deaths occur in those under age seventy in low and middle income countries (World Health Organization, 2022). A 2018 study found that the top causes for developing COPD in Latin American regions were: consistent and frequent tobacco use, high body mass index, and exposure to air pollutants associated with urban areas (Perez-Padilla & Menezes, 2018). It was also found that underdiagnosis was common in these regions (Perez-Padilla & Menezes, 2018). Of the regions studied, the prevalence of smoking reached as high as almost forty percent of the adult population (Perez-Padilla & Menezes, 2018). This condition is costly to these regions in more ways than one. For example, in Mexico, their widely used health insurance pays over one hundred fifty seven million US dollars each year towards the treatment of COPD and it’s related issues (Perez-Padilla & Menezes, 2018). It is essential that cities begin to politically and financially support the education and prevention of tobacco use as well as spread information regarding COPD and when to seek medical attention.
Another unique aspect of health and wellness specific to the urban population is the consideration of city life on mental health. More than twenty percent of Latin American disease is related to neurological or mental health issues, particularly anxiety and depression, which are heavily prevalent in low and middle income countries (Wang, et. al, 2019). A 2019 study surveyed these Latin American cities: Buenos Aires, Bogotá, Caracas, Fortaleza, La Paz, Lima, Mexico City, Montevideo, Panamá, Quito, and São Paulo. This study was focused on how commuting can influence one’s mental health. It was found that with increased commute due to traffic delay increases the likelihood of screening positive for depression (Wang, et. al, 2019). It was also found that those who commute via private transportation (personal automobiles), as well as those with difficulty accessing formal transportation (buses and subways) were more likely to screen positive for depression than those who rely on formal transportation (Wang, et. al, 2019). This also applied to those who had over a ten-minute walk to the nearest form of formal transportation (Wang, et. al, 2019). Through these findings does it become imperative that cities must provide solutions such as promoting use of formal transit use as well as increasing accessibility to all residents (Wang, et. al, 2019). While this facet of one’s health is heavily under-researched in Latin American regions, mental health has a large influence on one’s ability to lead a productive and meaningful life (Wang, et. al, 2019). In order for a city to achieve and maintain growth and development, it must make living conditions sustainable for its residents.
Primary Sources Annotated Bibliography
El-Sheikh, Sharm. “Highlights of some key health events at COP27.” WHO, https://www.who.int/news/item/03-11-2022-highlights-of-some-health-key-health-events-at-cop27. Accessed 12 December 2022.
This primary source is a news post titled Highlights of Some Key Events at COP-27 posted November 3rd, 2022 on the World Health Organization website and written by Sharm El-Sheik. This post was created to discuss the itinerary for the (then) upcoming COP-27, or the 2022 United Nations Climate Change Conference. The particularly relevant item on the itinerary is titled “Strengthening Health and Climate Change in Latin America and the Caribbean Region with a specific focus on national adaptation plans” . The description of this event explains that the intention is for Latin American countries to discuss the success and barriers they have faced in attempting to improve public health. It shows that active attempts are being made towards this crucial issue.
Paul, Maria Luisa. “They dyed a waterfall for a gender reveal. An investigation followed.” The Washington Post,
https://www.washingtonpost.com/nation/2022/09/30/gender-reveal-waterfall-brazil-dyed. Accessed 13 December 2022.
This primary source is a Washington Post article published on September 3th, 2022 titled They dyed a waterfall for a gender reveal. An investigation followed. and written by María Luisa Paúl. This article describes a gender-reveal party, an increasingly popular tradition where friends and family gather to learn the gender of expected babies. This problematic reveal took place at the Cachoeira Queima-Pé waterfall in Mato Grosso, Brazil, where a blue powder cannon revealed the gender of their baby boy. This blue powder however, was shown in online videos to have dyed portions of the surrounding waterfall blue. This was a clear violation of Mato Grosso’s environmental rules and their environmental protection agency was soon alerted of the issue and the coordinator of the reveal party was charged for causing harm towards the environment.
This primary source was relevant to include as it showed that some regulations are in place in Latin America in regards to the environment. While this singular regulation is not enough to prevent water pollution for all the urban environments of Latin America, it shows that there is a base to build off of in future discussion and consideration of environmental and health policies. The positive benefits of current rulings could be compared to regions with fewer regulations to argue for these changes.
Carrington, Damian. “Air pollution linked to almost a million stillbirths a year” The Guardian,
https://www.theguardian.com/environment/2022/nov/29/air-pollution-million-stillbirths-study. Accessed 13 December 2022.
This primary source is a news article published in the Guardian on November 29th, 2022 titled Air pollution linked to almost a million stillbirths a year and written by Damian Carrington. It reveals some interesting statistics including that 98% of still births take place in Asian, African, and Latin American regions. It discusses a recent study which used data from over 45,000 births and found a strong correlation with reduction of air pollution and reduction of miscarriages. The article argues this as a reason governments, particularly urban governments, need to take action to reduce air pollution to the levels recommended by the World Health Organization. The article also suggests that individuals are educated to use masks, air purifiers, and limit time outside when pollution levels are high.
News articles with these topics can contribute to the beginning of change. While this is an english-written article, awareness is the start of change and it is encouraging that money is being allotted towards studies such as the one discussed in the article.
Young, John Q. “Lessons from Ecuador on responding to the mental health crisis in the U.S and around the world”, STAT news, https://www.statnews.com/2022/12/13/ecuador-lessons-increasing-access-mental-health-care/, Accessed 13 December 2022.
This primary source is a news article published by STAT news on December 13th, 2022 called Lessons from Ecuador on responding to the mental health crisis in the U.S and around the world and written by John Q. Young. The article discusses the increasing need for mental health as evidenced by suicide being the fourth leading cause of death among fifteen to twenty-nine year olds. It discusses that while movements are being made, many countries are not meeting the demand of their population. Ecuador is used as a positive example with handling mental health as they offer flexible and evidence-based assistance from trained clinicians and baccalaureate-level psychologists, referring those who need more assistance to resident psychiatrists. This process has increased the number of Ecuadorians seeking help, therefore improving mental health.
This article was relevant to include in order to acknowledge that some steps are being taken for the better are occurring within Latin American regions and success stories from certain countries or cities could be applied to other cities needing change. This is an especially impressive step considering that mental health is still a privy topic in many cultures.
Secondary Sources Annotated Bibliography
Bell, Michelle L., et. al, “The avoidable health effects of air pollution in three Latin American cities: Santiago, Sao Paulo, and Mexico City” Environmental Research, vol. 100, issue 3, 2006, https://www.sciencedirect.com/science/article/abs/pii/S001393510500109X. Accessed December 12th, 2022.
This paper “The avoidable health effects of air pollution in three Latin American cities: Santiago, São Paulo, and Mexico City ” written by Michelle Bell et. al and published in the journal Environmental Research in 2006 discusses the impacts of air pollution on the residents of these Latin American cities. The main point of the article is the statistical discussion of the negative impacts air pollution has on the individual health, the cities surrounding environment, and the cities economy. This makes it clear this issue is substantial and applicable to all city inhabitants. The paper also discusses the methods for their research as well as a call for action for increased policy regarding pollution control.
Gouveia, Nelson and Junger, Washington L. “Effects of air pollution on infant and children respiratory mortality in four large Latin-American cities” Environmental Pollution, volume 232, 2018, https://www.sciencedirect.com/science/article/abs/pii/S0269749117313568
This paper “Effects of air pollution on infant and children respiratory mortality in four large Latin-American cities” written by Nelson Gouveia and Washington Leite Junger and published in the journal Environmental Pollution in 2018 discusses the negative impact of pollution on the proper development among the vulnerable population of children. The study found that many children are exposed to above recommended levels of pollution. It was found that consistent exposure to these harmful toxins is correlated to the increase in pediatric respiratory death and disease.
Pena-Guzman, Carlos et. al, “Emerging pollutants in the urban water cycle in Latin America: A review of the current literature” Journal of Environmental Management, vol. 237, 2019, https://www.sciencedirect.com/science/article/pii/S0301479719302579. Accessed December 12, 2022.
This paper “Emerging pollutants in the urban water cycle in Latin America: A review of the current literature” written by Carlos Peña-Guzmán et. al and published in the Journal of Environmental Management in 2019 discusses data from varying sources regarding the pollution found in the different types of water in Latin American urban environments: surface, ground, drinking, and waste-water. This is looked at in the particular lens of the urban water cycle which includes consideration of how all this water is managed and all the ways in which pollution can occur. After provision of much supportive data is there a call for increased education and awareness to encourage political and economic attention to this dire issue.
Perez-Padilla, Rogelio and Menezes, Ana Maria B. “Chronic Obstructive Pulmonary Disease in Latin America” Annals of Global Health, vol. 85, issue 7, 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7052319/ Accessed December 12th, 2022.
This paper “Chronic Obstructive Pulmonary Disease in Latin America” written by Rogelio Perez-Padilla and Ana Maria B. Menezes and published in the journal Annuals of Global Health in 2019 discusses the prevalence of COPD in Latin America, as studies through cities. The high rates of this chronic illness are associated with some urban factors such as air pollution but also due to the heavy use of tobacco and the overall increasing body mass index among Latin American populations. This paper ends with a call to action that in order to see the rates of this illness decrease do these regions need to provide preventative and educational care.
Wang, X. et. al, “Commute patterns and depression: Evidence from eleven Latin American cities” Journal of Transport & Health, vol. 14, 2019, https://www.sciencedirect.com/science/article/pii/S2214140518306169#bib38. Accessed December 12th, 2022.
This article “Commute patterns and depression: Evidence from eleven Latin American cities” written by Xize Wang et. al, and published in the Journal of Transport and Health in 2019 was inclusive of the many factors that commuting could have on one’s mental health rather than the single idea of commuting. Research was focused on the impact of commuting, traffic delays, form of transportation, and surroundings of commute onto one’s mental health. It found that traffic delays, lack of access to public transportation, and use on personal vehicles all increased the likelihood of participants being depressed. This article is important to include because it adds more evidence to the argument of decreasing use of personal vehicles and increasing the need for public transportation and/or walking and biking. The potential to decrease car pollution while decreasing mental health issues all through the same efforts would be motivating to a variety of populations.
Glossary
-body mass index: “body Mass Index (BMI) is a person’s weight in kilograms (or pounds) divided by the square of height in meters (or feet). A high BMI can indicate high body fatness. BMI screens for weight categories that may lead to health problems, but it does not diagnose the body fatness or health of an individual.” https://www.cdc.gov/healthyweight/assessing/bmi/index.html
-low birth weight: Low birth weight babies weight less than five pounds, eight ounces and are usually premature. “Low-birth-weight babies often have problems. The baby’s tiny body is not as strong as a baby of normal birth weight. He or she may have a harder time eating, gaining weight, and fighting infection. Low-birth-weight babies often have a hard time staying warm because they don’t have much fat on their bodies ” https://www.stanfordchildrens.org/en/topic/default?id=low-birthweight-90-P02382
-micro-pollutants: “natural and synthetic contaminants that make their way into ground and surface waters largely due to human activities” https://cals.cornell.edu/water-resources-institute/research-themes/micropollutants-emerging-contaminants
-surface water: “surface water is any body of water found on the Earth’s surface, including both the saltwater in the ocean and the freshwater in rivers, streams, and lakes. A body of surface water can persist all year long or for only part of the year” https://education.nationalgeographic.org/resource/surface-water
-underdiagnosis: “failure to recognize or correctly diagnose a disease or condition especially in a significant proportion of patients” https://www.merriam-webster.com/medical/underdiagnosis
Sources Cited
Adel Krim “City Buildings on a Hill and Elevated Road in Mist” https://www.pexels.com/photo/city-buildings-on-a-hill-and-elevated-road-in-mist-12012612/. Accessed 12 December 2022.
Bell, Michelle L., et. al, “The avoidable health effects of air pollution in three Latin American cities: Santiago, Sao Paulo, and Mexico City” Environmental Research, vol. 100, issue 3, 2006, https://www.sciencedirect.com/science/article/abs/pii/S001393510500109X. Accessed December 12th, 2022.
Bilal, Usama, et. al. “Inequalities in life expectancy in six large Latin American cities from the SALURBAL study: an ecological analysis” The Lancet Planetary Health, vol. 3, issue 12, 2019, https://www.sciencedirect.com/science/article/pii/S2542519619302359. Accessed December 12th, 2022.
Carrington, Damian. “Air pollution linked to almost a million stillbirths a year” The Guardian,
https://www.theguardian.com/environment/2022/nov/29/air-pollution-million-stillbirths-study. Accessed 13 December 2022.
El-Sheikh, Sharm. “Highlights of some key health events at COP27.” WHO, https://www.who.int/news/item/03-11-2022-highlights-of-some-health-key-health-events-at-cop27. Accessed 12 December 2022.
Fort Wainwright Water Quality Program. “The Water Cycle” US ARMY, 8 January 2022 https://www.army.mil/article/242281/the_water_cycle_and_you. Accessed 12 December 2022.
Gouveia, Nelson and Junger, Washington L. “Effects of air pollution on infant and children respiratory mortality in four large Latin-American cities” Environmental Pollution, volume 232, 2018, https://www.sciencedirect.com/science/article/abs/pii/S0269749117313568
Jiwani, Safia S., et. al., “The shift of obesity burden by socioeconomic status between 1998 and 2017 in Latin America and the Caribbean: a cross-sectional series study” Global Health, vol. 7, issue 12, 2019, https://www.sciencedirect.com/science/article/pii/S2214109X19304218. Accessed December 12th, 2022.
Paul, Maria Luisa. “They dyed a waterfall for a gender reveal. An investigation followed.” The Washington Post,
https://www.washingtonpost.com/nation/2022/09/30/gender-reveal-waterfall-brazil-dyed. Accessed 13 December 2022.
Pena-Guzman, Carlos et. al, “Emerging pollutants in the urban water cycle in Latin America: A review of the current literature” Journal of Environmental Management, vol. 237, 2019, https://www.sciencedirect.com/science/article/pii/S0301479719302579. Accessed December 12, 2022.
Perez-Padilla, Rogelio and Menezes, Ana Maria B. “Chronic Obstructive Pulmonary Disease in Latin America” Annals of Global Health, vol. 85, issue 7, 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7052319/ Accessed December 12th, 2022.
Wang, X. et. al, “Commute patterns and depression: Evidence from eleven Latin American cities” Journal of Transport & Health, vol. 14, 2019, https://www.sciencedirect.com/science/article/pii/S2214140518306169#bib38. Accessed December 12th, 2022.
World Health Organization. “Chronic obstructive pulmonary disease (COPD).” WHO, https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd). Accessed 12 December 2022.
Young, John Q. “Lessons from Ecuador on responding to the mental health crisis in the U.S and around the world”, STAT news, https://www.statnews.com/2022/12/13/ecuador-lessons-increasing-access-mental-health-care/, Accessed 13 December 2022.
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