This post originally appeared on the Robert Wood Johnson Foundation’s Culture of Health blog.
Louisville, Kentucky ranks among the poorest in air quality and highest in asthma rates among U.S. cities. A new art installation from Propeller Health shows residents real-time changes in the city's air quality, equipping them with the data to reach their goal of becoming one of the healthiest cities by 2020.
I stand in front of an intriguing art installation on a busy street corner in downtown Louisville, KY, and visualize the invisible. It’s a bright orange steel kiosk outfitted with an interactive touch screen that allows passersby to “see” how air pollution levels change around the city in real time while also learning how these pollutants impact the severity of asthma symptoms. Called AirBare, the installation project was funded by RWJF and represents a unique collaboration between visual artists, big data analysts and local health advocates. By “popping” virtual bubbles on the screen, users find out what causes air pollution and what it will take to reverse it. This is relevant information for residents of Louisville, a city that consistently ranks among the lowest in air quality in the nation and has one of the highest rates of asthma and other respiratory conditions.
My visit to the AirBare installation coincided with a conference held in Louisville in March that brought together economists, health policy folks, food experts and, remarkably, Charles, the Prince of Wales, to examine the issue of air quality and the larger concept of sustainability in this Ohio River Valley city. The Prince, a longtime advocate for environmental issues with connections in Louisville, added star power to the Harmony & Health conference, sponsored by the non-profit Institute of Health Air Water & Soil. But there is plenty else to be excited about in Louisville. Under the leadership of Mayor Greg Fischer, city agencies have collected reams of data on air quality, health outcomes, life expectancy, income inequality, and unemployment, among many other measures. What has emerged is a far better picture of the tough environmental and socioeconomic issues impacting the health and wellbeing of Louisville’s 600,000 residents, and a serious and concerted commitment to build a culture of health.
The numbers, contained in the Louisville Metro Health Equity Report, paint a clear picture of the city’s challenges. More than 63 percent of Louisville residents live in neighborhoods with a life expectancy below the national average, and people can experience an 18-year gap from one neighborhood to the next. Almost 32 percent of African-American residents are in fair or poor health, and one in five residents lives in poverty; unemployment is high. And then there is the air quality problem. Louisville sits in a valley where toxic pollutants generated by nearby coal and oil-burning power plants and other industrial facilities collect in the stagnant air. As a result, asthma is the third leading cause of hospitalization in Jefferson County—which includes Louisville.
Still, this is a community that is fully committed to taking the steps necessary to bring about sustainable change. Air Louisville, the city’s multi-stakeholder clean air initiative, is a great example of what it takes for a community to really move toward building a healthier culture. It all begins with documenting the problem. The city had air quality sensors placed around various Louisville neighborhoods to collect and record real time data on levels of particulates and other toxic chemicals. At the same time, some 350 asthma sufferers were given high-tech inhalers that used GPS to relay the time and geographic location of asthma symptoms. The tracking device—which can sit on top of any inhaler, was developed by a former RWJF Health and Society Scholar, who also started Propeller Health. The devices are being made available at no cost to members of the community who participate in the research. Interestingly, the AirBare installation utilizes data from both the neighborhood sensors and the high-tech inhalers to raise awareness about the connection between air quality and asthma in community members.
This month the Air Louisville initiative is expanding. In a collaboration between the Institute for Healthy Air, Water and Soil, Propeller Health, local health plans, and other groups, 1,000 more Louisville citizens are being equipped with sensors for their asthma inhalers to track when, where, and how often they use their devices. This data-driven initiative uniting public, private and philanthropic organizations is designed to use digital health technology to help patients better manage their asthma symptoms, and aid city leaders in making smarter policy decisions about how to keep the air clean.
Louisville has as its goal to be one of the country’s healthiest cities by 2020. That’s an ambitious aim, but my recent visit convinced me that this city is up for the challenge. The key factor is collaboration: Louisville has enlisted a broad range of partners working in community development, health care, transportation and business—to name just a few—in executing its strategic plan. Along with the Air Louisville program, there are initiatives under way to improve health care delivery, reduce obesity and increase residents’ access to fresh, healthy foods. It’s exciting to see a community resonating so closely with RWJF’s framework for building a Culture of Health.
Alonzo Plough, PhD, MPH, is vice president, Research-Evaluation-Learning and chief science officer for the Robert Wood Johnson Foundation. Read more from his blog series.