New Postdoctoral Fellowship Tackles U.S. Health Inequity

Many communities have experienced challenges getting the people who need help to use the centers. To date little research has been done to determine what the stumbling blocks are, so Sprague is planning to study cooling networks in at least eight cities across the country, including Boston.

The goal is to figure out how to make cooling centers the kind of places people want to be, Sprague said. Instead of a sterile, air-conditioned room with folding chairs, could cooling centers be welcoming community spaces? Is there a way to harness the cooling and wellness benefits of green spaces to make more welcoming cooling spaces?

Studies like Sprague’s are important for effectively responding to the impacts of climate change on the health of all populations.

“Climate change isn’t a potential problem, it’s a crisis that’s already happening,” Sprague said. “The evidence is already clear. The urgent task now is translating existing evidence into action that empowers communities to protect our health, our well-being, and our planet.”

Since crises like climate change tend to act as threat multipliers that make health disparities worse, Sprague said, it’s crucial to focus on solutions that protect the most vulnerable.

“The rapidly changing world we live in is full of problems no one has ever faced,” Sprague said. “We have a lot to learn, but we also know a lot of things that can make life better for all of us — like educating children, cherishing our time in community, and getting off our screens to spend time in the beautiful green spaces that are all around us.”

The importance of education and nature

Growing up in Chicago, Sprague had learning disabilities, anxiety, and other mental health issues. He says he knows that he was lucky to come from a family that had the resources to help him secure the academic accommodations that he needed to thrive. Summer canoe camping trips in Canada’s wild Algonquin Provincial Park allowed him to discover that spending time in nature had profound benefits for his learning and his mental and physical health.

But he noticed that many children growing up in Chicago did not have similar opportunities.

That can profoundly threaten people’s health. In fact, Chicago’s neighborhoods have some of the starkest differences in health of any county in the nation. People in some neighborhoods can expect to live 30 years more than their neighbors across town.

Much of that early mortality can be attributed to differences in wealth and access to medical care, but geographic factors like access to green space also play a key role.

When Sprague moved to St. Louis for college, he saw the same pattern of disparities. He was determined to do something to help.

Building a collaborative research community

In 2016, Sprague launched a small pilot project in one under-resourced school that grew into Gateway to the Great Outdoors (GGO), a nature-based enrichment program for science, technology, engineering, and math (STEM). GGO uses hands-on science experiments, school gardens, and nature field trips to spark a love of learning and to heighten well-being for youth in low-income schools in both St. Louis and Chicago.

In the beginning, GGO conducted research to evaluate its programs and generate evidence about the importance of nature-based science education. Sprague and colleagues have found abundant evidence that students’ interest in school, skills in STEM, behavior, and well-being blossom when they enroll in the program.

As he pursued a master’s degree in public health at Washington University in St. Louis and a PhD in epidemiology at Columbia University, Sprague deepened his appreciation of the complex interplay between health and educational outcomes, not just in childhood but across the course of life. He also began to incorporate innovative techniques at GGO based on his research and training that would inspire students to take charge of their educational and environmental futures and help evolve the program based on their perceptions and experiences.

Sprague began working to establish a collaborative relationship between the researchers, GGO, the schools, the students, and the whole community.

Instead of simply testing to see if their science skills were improving over the course of a year and then trying to tweak the curriculum to get better results, Sprague began to use more inclusive methodologies.

Giving the community a voice

Using people’s own stories about their experiences helps researchers better understand the most important problems a community wants to solve and offers important hints to possible solutions, Sprague said. Based on what he is learning from the students, he is developing a framework for thinking, teaching, and researching environmental help that considers the thoughts and experiences of youth.

As a bonus, participatory research methods can also be effective teaching tools. Sprague and colleagues showed that the students’ scientific skills improved compared to GGO peers who weren’t involved in the planning.

Sprague is looking forward to using these techniques to build deep research collaborations and community engagement as he explores how climate change, social inequities, and urban systems intersect to shape health and well-being.

He is currently working with a group of GGO students on a project to express through artwork how they experience climate change. The pieces they produce will be exhibited at the St. Louis Museum of Contemporary Art. The project is supported by a Community Action Funds Award from the Harvard Chan National Institute of Environmental Health Sciences (NIEHS) Center for Environmental Health.

“If we want our work to make a difference for health equity, we need to do a better job of making our research accessible to people outside the academic community,” Sprague said. “People who would never read a scientific paper will be able to come to this show and see for themselves what science, the environment, and climate change mean to these young people.”