‘We want to focus on building public health and planetary health’

Kaumudi Joshipura public health and planetary health

Kaumudi Joshipura, Dean of our recently announced School of Public Health, shares her vision for the School in this interaction, expanding on how she plans multiple creative initiatives integrating research, education, and health promotion.

Q. Leading a 21st-century educational institution in an area that's the world's concern - public health, what is your vision for the School of Public Health?

Public health includes all organised measures to prevent disease, promote health, prolong life among the population, and provide conditions where people can be healthy using large population-based perspectives and approaches.

Our mission is:

  • To develop leaders with the motivation and ability to develop data-driven, wholistic solutions to interdisciplinary problems
  • To implement innovative no-cost, low-cost, and cost-saving initiatives to prevent disease, maintain wellness, and improve health and health equity.
  • To study ways to understand and mitigate the impact of climate change on health.

Education, research, and health promotion are all central to the School of Public Health and will be more effective when integrated with each other around common goals. The long-term goals for education are to develop comprehensive and innovative interdisciplinary programmes. The initial focus of education programmes will be epidemiology, environmental health, and data science.

We believe that small steps taken consistently by many can greatly improve our health and planet.

Q. At the launch of the School, we discussed how planetary health was closely connected to public health. Could you share your thoughts on the interconnectedness?

Climate change impacts health in multiple ways. Damage to the Earth’s ecosystem from human activity is not just an environmental problem; it’s a threat to human health. Communities are already experiencing first-hand the health impacts of climate change, which come from flooding, food and water insecurity, climate-sensitive diseases, and more.

As the world’s second most populated country, climate change’s impact on agricultural productivity and quality poses significant risks to India. The adverse effects of weather variability on food security could have serious health implications. For example, child stunting is projected to increase by 35 per cent by 2050. Similarly, access to clean water for a large part of the population is threatened by the rapidly melting glaciers in the upper Himalayas. Vector borne diseases fuelled by sudden torrential rains and subsequent water logging are putting substantial pressure on the country's health infrastructure. Warmer weather leads to higher ozone levels in the air, causing respiratory and cardiovascular problems and some infectious diseases. Kidney disease increases during hot weather, especially among outdoor workers who don’t have access to adequate fresh water. By 2100, extreme heat could kill as many people per year as obesity and diet-related illnesses do now. 

In brief, we cannot achieve optimum human health without good planetary health.

Q. You have always emphasised public health institutions addressing real issues of the public and speaking to them directly. What drives this focus and the impact on public health?

I started out as a clinician, and after my public health training, engaged in teaching and research on identifying novel risk factors for cardiometabolic conditions. Through this work, I became acutely aware that even well-established preventive measures such as physical activity were not well adopted.

The major health problems, which consist mainly of cardiometabolic and other non-communicable diseases, are mostly preventable, and some are easily preventable with simple interventions (e.g. Vitamin D to improve bone health and prevent osteoporosis). Hence, translating research into action, not just dissemination, but also enabling and empowering people to make healthy changes, needs to be a major priority. Educational institutions can positively impact public health through education, research, and action (policy, community outreach, and health promotion).

Q. Could you describe some key research areas and projects the School aims to focus on in the coming years to address pressing public health challenges?

Our research goals are geared towards finding novel modifiable factors with an initial focus on cardiometabolic (e.g. diabetes) and other non-communicable disease that could be translated into innovative interventions, programmes, and policies at the individual, organisation, national, and global levels. For example, our earlier work showed that routine over-the-counter mouthwash use was associated with an increased risk of diabetes and hypertension; mouthwash use is a novel, easily modifiable risk factor.

Our goals not only include promoting healthy lifestyle factors but also tackling global environmental problems, especially climate change, which will otherwise become a formidable risk factor for morbidity and mortality. India has the highest deaths from air pollution globally, and access to safe water is a major challenge in many parts of the world. Water and agricultural policies impact air pollution, which, in turn, impacts water quality. Hence, maintaining a healthy state and healthy conditions is increasingly complex and largely beyond the control of individuals.

Adequate solutions to complex public health problems often need expertise from and engagement with several disciplines, such as Medicine, Environmental Science, Engineering, Agriculture, and Urban and Infrastructure Planning and Management. It also requires bold and creative action to motivate people, communities, and organisations to change norms to improve human and planetary health. 

Understanding complex risk/preventive factors that impact health will enable the development and implementation of data-driven, evidence-based interventions to reduce climate change and its impact.

Q. Collaboration is often key in addressing complex health problems. Can you elaborate on the School's strategy for fostering collaborations with other academic institutions, government agencies, and healthcare organisations?

We are already in discussions with several entities, including academic institutions, government agencies, and healthcare organisations. Our goal is to collaborate with institutions with similar interests, philosophies, and complementary expertise. The collaborations should have specific goals and be a win-win situation for all key stakeholders.

Q. How do you plan to leverage technology and data analytics to advance public health research and practice?

We plan to leverage newer technology and tools for novel approaches such as digital data collection, data analysis, and creating apps to improve health and fitness.

We aim to use novel approaches to gather and integrate information from various sources, such as electronic health records (EHRs), wearable technology, social media, and public databases. We plan to employ advanced analytical techniques, such as machine learning and artificial intelligence. We can use predictive modelling to identify disease outbreaks, assess risk factors, and forecast healthcare resource needs. We can also use interactive dashboards and visualisation tools, including Geographic Information Systems (GIS), to communicate findings to policymakers, healthcare professionals, and the public. We are also interested in implementing real-time monitoring systems and data driven alerts to track disease outbreaks, vaccination rates, and other critical health metrics and threats.

Last but not least, we will use various platforms including social media to disseminate health information, promote healthy behaviours, and increase health literacy.

Q. How do the Health Fair and Health Survey initiated by the School of Public Health contribute to the mission and goals?

Our Health Survey gathers data on health status, knowledge, attitudes, and practices related to health and environmental sustainability. This will help us design health promotion initiatives essential to the broader global mission of improving health and addressing environmental challenges through sustainable health practices. 

The Health Fair conducted in collaboration with the Office of the Dean of Students will help in the early detection of high blood pressure and diabetes. During the Health Fair, participants receive information about their health and different aspects of fitness (e.g. flexibility, strength, endurance) important for health and wellness. The information gained from various components of the Health Fair will help increase health awareness, and help our University community make healthier choices.

Additionally, both initiatives integrate research and education goals. These initiatives serve as pilot work for future research and community initiatives. This research will inform effective interventions and strategies to improve public health. We aim to translate such research findings into actionable information and improve public health. For students, the opportunity to experience a research project as a participant and subsequently to be able to evaluate and understand these data and results in various courses will constitute a unique real-world experiential learning.

In summary, the Health Survey and Health Fair integrate education, research, and health promotion and are highly related to our mission of improving health and environmental sustainability, locally, nationally and globally. So, we encourage everyone to complete the survey ( https://bit.ly/3Py5mkV), and also to participate in the Health Fair.