Along with Dr. Alison Lee from Mount Sinai School of Medicine and Drs. Kwaku Poku Asante and Sulemana Abubakari from Kintampo Health Research Centre, I co-lead work that aims to harness existing cohort data to better characterize the sensitivity of key health outcomes to climate exposures. The use of existing cohort data is critical in Ghana, which lacks registries that capture national-level data. Our current efforts are focused on two sets of analyses:

Heat exposure and mortality

Existing Health and Demographic Surveillance Systems (HDSS) in Kintampo, Dodowa, and Navrongo have been following >450,000 individuals in Ghana for >20 years. These HDSS areas span Ghana’s three main agro-ecological zones. Core data -- captured at least annually for all individuals at the district level -- include births and deaths (including date of death, age at death, and verbal autopsy to ascertain cause of death), morbidity, in- and out-migration, and household assets. The Kintampo HDSS in the central region launched in 2003 with approximately ~160,000 individuals and has grown to encompass ~540,000 individuals. Dodowa HDSS (coastal region) launched in 2005 and has maintained surveillance over ~160,000 individuals, and Navrongo HDSS (northern region) launched in 1992 and has maintained surveillance over ~165,000 individuals. Currently-underway analyses assign each household temperature and humidity exposure estimates based on gridded reanalysis data and use a bidirectional, time-stratified case-crossover design to characterize the association between humid heat exposures and mortality.

Heat exposure and birth outcomes

Pregnant women are especially vulnerable to extreme climate events, including temperature. Temperature exposures over pregnancy, similar to other environmental exposures, may not only impact birth outcomes, but also program future child health. To provide critically needed data on the sensitivities of birth outcomes and child health to temperature, we are working to integrate existing birth cohorts including GRAPHS (n=1414 pregnancies) and PRiSMA (n=3000 pregnancies) with daily temperature and humidity exposures (again drawn from gridded reanalysis data). To evaluate time-varying association between daily heat metrics and birth outcomes, we apply nonlinear distributed lag models.

Engagement with policy stakeholders, communities, and researchers

1. Communicate the climate sensitivities estimated in as described above to key climate policy actors in the Government of Ghana and engage to ensure that they are appropriately reflected in climate adaptation policy.
2. Engage with communities in the three HDSS catchment areas to understand subjective experiences of climate change and to give voice to these experiences.
3. Help strengthen a community of practice of researchers engaged in climate impacts research in Ghana and West Africa.
4. Position the three HDSS as prospective Climate and Health Cohorts by augmenting current data collection with new information addressing morbidity, agricultural productivity, nutrition, and household wealth.

Funding

Wellcome Trust Climate Impact Award