Working With and For Communities – A Grounded Approach to Public Health
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When the COVID-19 pandemic reached its fever pitch in the spring of 2020, Professor Jonathan Levy found himself in an interesting position. As a researcher and Chair of Environmental Health at BU’s School of Public Health, Dr. Levy had spent his career studying the health risks of indoor and outdoor air pollution, specifically in low-income and marginalized communities. With the rapid spread of an airborne virus, his life’s work was central to a growing global phenomenon. Like many, however, Levy was spending his time isolated at home following public health guidelines. With a rise in confusion over the unprecedented outbreak, he began searching for ways to disseminate accurate information to the public. In turning to Twitter (now known as X), Levy and his peers made new and direct connections to the public and conventional media outlets, allowing them to share their expertise and support. This group of researchers was also able to connect with government officials to assemble data on disease patterns before such information was widely available, and later on, they were able to amplify information from publicly available dashboards. With social media, it is easier than ever for researchers to share their expertise with people impacted by what they study. However, how they do so is important, too.
Effectively communicating accurate public health information is vital in protecting communities. For Dr. Levy, the pandemic highlighted a need to return to what he called “first principles” of public health, such as explaining risks of indoor air transmission in terms that are understandable and accessible to all. Levy believes in trying to get information into the hands of the public: “Those of us doing work that is intended to inform public policy have an obligation to explain not just the work to people, but the overall context and content to people in a public setting, not just in the literature.” As a published scholar, he understands the importance of rigorous peer review and the scientific process, but he also sees a dual responsibility to have genuine conversations with communities. He acknowledges that this part of the work is not easy, however, as it takes time and is made more difficult by changing audiences or shifting venues for conversation. Nonetheless, Levy says that researchers must consider the implications of their work and how they’ll make their case, then get out there and explain it.
In 2023, Dr. Levy’s work was once again at the center of a heated political debate. This time, the conversation was about using gas stoves in homes, as a new study had estimated substantial health risks and ignited discussion about whether the government might ban their use. However, the topic wasn’t new to Levy, who’d studied the health risks of gas appliances for around 25 years. He said that the science has been consistent across five decades of research: indoor nitrogen dioxide poses measurable health risks. Gas stoves are the primary source of exposure in homes, even in places with high outdoor pollution. With this rise in discourse, he contributed his expertise and authored op-eds and articles reiterating what the science indicates. However, he also wanted to communicate how the gas industry operated to understand why five decades of research had no real influence on policy or perceptions. What he found can best be summarized in the title of his LA Times op-ed: Gas stoves are bad for your health. So is the industry’s Big Tobacco-style coverup. Levy hadn’t realized how nefarious and covert the gas industry had impacted government policy. Much like the tobacco or pharmaceutical industry, companies were funding studies that produced results to confuse regulators. These studies produced findings of uncertainty in appliances’ link to poor health outcomes, all without disclosing their funding sources. In successfully gaining favorable regulations and promoting their product in the market, gas stoves have become a fixture in American households despite their well-documented hazards. Change, then, becomes more difficult, even with the data.
Dr. Levy understands why people were angered by the idea (even if not entirely based in reality) that there could be limitations in their ability to use gas stoves. There is a natural gut reaction to being told how to live, particularly in your home. He believes in respecting this sentiment and letting it inform the work in public health. He said, “Research that is not cognizant of how people live and think – especially about their home environment – is just going to be wildly out of touch.” In this way, public health research is “intrinsically applied,” with any proposed intervention being “intrinsically political” in nature. Levy feels he is doing his due diligence in evaluating health outcomes and understanding the broader context of his findings. The public needs to be brought into the conversation about health risks and alternatives. Regarding gas stoves, for example, Levy said reiterating the facts must be done in partnership with initiatives to increase excitement about new or different technology and reduce financial barriers to alternatives. Levy sees the goal as helping people do what they love to do more safely.
If there is one thing to take away from Dr. Levy’s life work, it’s that the pursuit of helping others guides his research. One of his current projects is focused on interventions related to gas stoves in low-income multi-family housing in Dorchester. This pilot program will investigate what needs to be done to effectively roll out induction stoves in Boston Housing Authority and Codman Square Neighborhood Development Corporation units concerning logistics, resident exposures, health, and well-being. For Levy, the most exciting part of his current project isn’t the science; it’s their partnership with the City of Boston. In having City Hall request a study, Levy and his team can design it around the needs of Boston and its residents. As he sees it, he’ll always return to community-centered research to get people access to the information they need to stay healthy and safe.