Hot off the presses: our new article “Research Opportunities to Advance Cardiovascular Health through a Planetary Health Lens” has been published in the American Journal of Preventive Cardiology. This paper arose from our NHLBI workshop on planetary health, and is available open-access from AJPC.

I’m grateful for getting to bring an urban planner’s perspective to this group. Cardiovascular health is often framed in terms of individual risk: diet, exercise, smoking, blood pressure, access to care - but these are of course only part of the story. In this paper we consider human health broadly through a planetary health perspective, asking how climate change, air pollution, water quality, food systems, housing, transportation, and urban design shape cardiovascular risk across the life course.

The central argument is that these systems do not operate separately. Food production depends on water and energy; energy production affects air quality and climate; urban planning shapes heat exposure, physical activity, displacement, and access to care; and so on. These connections matter because well-intentioned interventions can have uneven or unintended effects across disciplines that need better integration.

Our paper outlines some research opportunities for studying these links more carefully - bridging spatial analysis, remote sensing, causal inference, exposome science, health informatics, AI, and community-engaged research. Cardiovascular researchers, urban planners, environmental scientists, public health practitioners, and our communities themselves need to work together if we want evidence that can actually guide policy and improve health in a changing world.

From the abstract:

Cardiovascular health (CVH) across the life course requires stable, nurturing environments and a healthy planet. Increasing human demands on the earth’s resources destabilize our world’s ecosystems, compromising CVH. Unique research opportunities for cardiovascular researchers exist at the intersection of planetary and CVH. Using systems thinking can reveal cardiovascular and planetary health connections and mechanisms of action. For example, meeting global demands for water, food and energy threatens food, water and air quality at the local level, and with it, cardiovascular health. A refined understanding of planetary-CVH interconnections is urgently needed to guide decision making. Emerging, cutting-edge research methodologies include the use of spatial indicators and urban analytics to reveal relationships between physical environments and health outcomes; advanced causal inference methods and modeling simulations; studying human exposure patterns and the exposome - the totality of environmental exposures across the life span - in a population; advances in health informatics made possible by evolving computation methods and AI; and new ways of engaging community in research. The study of planetary health is advanced by engaging a diversity of disciplines from the fields of behavioral, medical, and social sciences to earth sciences, climate change, anthropology, Indigenous studies, and engineering. By employing a planetary health lens, systems thinking and research methodology innovations, expanded opportunities exist for CV researchers and others across a diversity of disciplines. The field will benefit from the development of a holistic research agenda, increased cross- and trans-disciplinary engagement, policy evaluation, and implementation science to support dissemination of evidence-based findings.

For more, check out our free open-access article at AJPC.