Philly as lab, classroom, and collaborator

In the pre-dawn darkness, graduate student Michael O’Shea searches the sides of Philadelphia streets for research material, crouching down to vacuum it up and bag it for analysis. The material? Sediment from the neighborhood.

A third-year doctoral candidate in the lab of Penn earth scientist Reto Gieré, O’Shea is collecting samples of road dust to inventory the compositional makeup of sediment found in different parts of the city. So far, he has amassed about 50, and has analyzed a little more than half.

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“Almost everything that happens in Philadelphia is going to be represented in the road dust—the local organics in the soil, whatever you’re building with, industrial legacy products,” O’Shea explains. “I’m using it as a tool to build context for what the urban environment is like in Philadelphia.”

Road dust may not seem like a good barometer of the chemicals in a particular area, but Gieré believes otherwise. “Philadelphia is one of the big industry towns, and there are a lot of leftovers, if you will,” he says. “We hope to find correlations between traffic and industrial activity, and natural components, too. After all, we live in an area that has a lot of exposed bedrock.”

Gieré is describing, in part, the stone formations of the Wissahickon Valley, rocks hundreds of millions of years old with interesting names like pelitic schist, and gneiss, and quartzite. They ended up where they are via natural movement like tectonic drift, and their remnants provide a historical timeline for a city that has, itself, undergone seismic shifts dating back to its earliest roots as a manufacturing town.

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“There are many important questions that the city needs to have answered,” says Eugenie Birch, a PennDesign professor who co-directs the Penn Institute for Urban Research (Penn IUR). “Philadelphia is a city of size, yet it’s not too big that we lose access to the major players like the mayor and neighborhood leaders. These folks welcome us to do our research, and we can work closely with them.”

And a wealth of the University’s researchers do as well, studying everything from disease interventions to the psychological ramifications of vacant lots, in an effort to better understand human health, mental health, and the natural world.

On the health care front

During the past three decades, diabetes numbers across the globe have skyrocketed. Today, about 8.5 percent of the adult population worldwide—422 million people—lives with the disease, prompting the World Health Organization to call it “one of the biggest global health crises of the 21st century.” At the Dr. Bernett L. Johnson, Jr. Sayre Health Center at 58th and Walnut streets, Penn’s Kent Bream has noticed similar spikes of this disease in the patient population.

It’s a trend that’s occurring in the highlands of Guatemala, too, where Penn medical anthropologist Frances Barg has conducted work. Adriana Petryna, also a medical anthropologist and director of the M.D./Ph.D. program in the Department of Anthropology in the School of Arts and Sciences (SAS), works with Bream and Barg to assess the health costs of unhealthy environments and policies.

“Diabetes is this silent disease that sits in our communities,” says Bream, a family medicine physician at the Perelman School of Medicine and medical director at the Sayre Health Center. “It’s significantly under-diagnosed and is not visible until it’s complicated, when someone gets an amputation, or an ulcer that won’t heal, or has a heart attack.”

About two years ago, the trio realized the extent of the similarities between the populations in West Philadelphia and Guatemala, and began collaborating. Funded by an SAS “Making a Difference in Diverse Communities” grant, the project aims to change the diabetes narrative for minority groups that have experienced discrimination and health care disparities. It also teaches this year’s 10 participating Penn undergraduates how to do a unique type of research in varied settings using an anthropological framework.

“I like to look at how different micro-environments and context like politics and economics affect health,” says Barg, who has joint appointments in Penn Medicine and in the Department of Anthropology. “In both settings, we’re listening to local people, hearing from their perspective what the issues are, what their priorities are for addressing health problems.”

Rather than didactic directions and authority-based interventions, the objective is to partner with the patients. “It doesn’t only require biochemistry or health economics,” Bream says. “It requires understanding people, their communities, their traditions, and beliefs.”

Penn sociologists Emilio Parrado and Chenoa Flippen took a comparable approach in a study of Latino immigrants in South Philadelphia. Through a partnership with a local organization called Casa Monarca, they conducted 300 interviews about the health needs and risks of this population—conversations likely impossible without the inside connection.

The researchers learned a great deal. For example, 43 percent of the men and 80 percent of the women said they had been tested for HIV. A third had been the victim of a crime. Half reported that at some point they had needed to see a doctor but didn’t go, primarily because of real or imagined costs.

It’s valuable information that can both inform broad conversations about immigrant groups and help those groups at the same time. “We want to contribute to the knowledge about these communities in places that are receiving growing immigrant populations, to answer questions about how they’re doing, what’s going on with their children, what socioeconomic progress they’re making,” Parrado says. “But we also want to participate in the discussion of the policies, programs, and needs that the community faces.”

Quality-of-life factors

It’s a familiar sentiment—those complementary goals of making scientific headway and making progress for the individuals involved—for Penn collaborations happening across Philadelphia, like the work economist Susan Wachter, criminologist John MacDonald, and emergency medicine physician Eugenia South are doing on overgrown, abandoned spaces.

Starting in the early 2000s, Wachter, co-director of Penn IUR and a real estate and finance professor at Wharton, partnered with the Philadelphia Horticultural Society on a program that revitalizes rundown and vacant lots.

“The resulting study was the first to show that remediating this land and even simply planting trees could increase nearby property value,” Wachter says. “This was not surprising—except for the size of the effect—but it had not been quantitatively shown before, simply because the data had not been gathered. The study sparked a ‘blight to green’ movement in disinvested urban neighborhoods across the country.”

Talk about whether this type of intervention could also reduce crime reached MacDonald, and he was intrigued.

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“There are theories in criminology about the importance of the physical conditions of places and how it impacts crime and violence,” says MacDonald, a professor of criminology and sociology in SAS. The most popular, the “broken windows theory,” posits that shattered windows or other visible signs of outward disorder can trigger crime.

“But that’s not the only one,” he says. “There’s a strong theoretical foundation in this work.”

South, an assistant professor of emergency medicine at the Hospital of the University of Pennsylvania, studies the effect of chronic stress and neighborhood environment on health outcomes. During her training, she conducted a study that monitored heart rates, a marker of acute stress, of people as they passed by both abandoned and kempt lots.

“When you walk by a vacant lot, full of trash, that might raise your heart rate. I wanted to know what would happen if it was greened,” she says. “Heart rates did go down.”

She joined a team led by MacDonald and Charles Branas (now at Columbia University), which had continued its partnership with the Horticultural Society. The researchers conducted a clustered randomized trial of 541 lots in a handful of Philadelphia neighborhoods. Some lots received a complete makeover, scraping the ground, planting new grass and trees, putting in a fence. Some were partially cleaned up, and those in the control condition remained vacant and overgrown. The researchers then looked at subsequent crime data for surrounding neighborhoods. The results were powerful.

“We consistently saw a reduction in serious crime—particularly gun-related crime—by making this fairly simple remediation to abandoned, vacant land,” MacDonald says. “For something like gun violence, which seems really difficult to change, it turns out you can at least get a measurable effect by making better use of the space.”

Though this single solution won’t completely reverse the worst crime happening in the most violence places, MacDonald stresses it could be part of an overall strategy, one that has the potential for replication in other cities, and that might benefit both the physical and mental health of affected individuals.

That’s what sociologist Kristen Harknett is hoping for, too, but in an unrelated field. Since 2016, she and Daniel Schneider of the University of California, Berkeley, have been collecting survey data nationally from retail and food-service workers to learn about how work schedules affect health, well-being, and family life.  

They’ve asked questions like, do you work on call? How much notice do you receive? Do your hours change day to day and week to week? From that dataset, she and Schneider are publishing city-specific reports, beginning with Philadelphia this past February.

“Workers contend with a lot of volatility,” says Harknett, an adjunct associate professor and research associate in Penn’s Population Studies Center. (She’s also an associate professor at the University of California, San Francisco, where she is currently based.) “We’ve systematically documented that this is happening at a very broad level.”

They found that most people in this sector get fewer than two weeks’ notice about when they’ll work, and many experience last-minute changes. This can lead to sleep problems and psychological distress, and even potentially spill over onto their children.

“These workers are economically vulnerable because they have low wages,” Harknett says, “but they have this extra challenge of having unpredictable timing, too.”

Environmental health

The challenges vulnerable populations face drive much of the work Penn environmental scientist Reto Gieré does around Philadelphia. “Environmental components have an impact on our health,” he says. “Very often, unfortunately, the largest impacts are in communities less able to defend themselves.”

One danger particularly pertinent to Philly is lead hiding in the paint of old buildings and pipes.

In the past five decades, what’s considered a safe level of lead in the blood has dropped markedly. In 2018, according to the Centers for Disease Control and Prevention, this amount should not exceed 5 micrograms per deciliter. Before 2012, that number was 10, and in the 1960s, it was 60.

As scientists’ understanding of the toxicity of lead has crystallized, there’s also been a greater emphasis on keeping it at arm’s length, particularly for children.

“Lead is specifically an issue for kids,” Gieré says, “because lead is a neurotoxin.”

Gieré is conducting several studies related to the substance. One, with Vincent Reina of PennDesign, Eugenia South (the researcher working with John MacDonald on the vacant lots), and Richard Pepino, a colleague from the Department of Earth and Environmental Science and the Center of Excellence in Environmental Toxicology, focuses on lead in and around homes in two neighborhoods in North Philadelphia.

From 30 samples collected from Fishtown, the researchers have found contamination levels that run the gamut, from barely anything to dangerous. They still plan to collect soil and dust from the Kensington neighborhood. They’ll also interview residents and test soil and samples from inside and around 20 homes in each place. If the pilot study succeeds, South says they’d like to create a larger intervention that could be replicated in other Philadelphia spots, and potentially beyond the city limits.

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“We’re just starting out,” she says. “Both towns had lead smelters and there’s the potential for a lot of lead in the soil. The housing stock is old and there’s a high risk of lead paint.” Plus, with the continuous demolition of old buildings, the lead contained within those structures turns to dust and floats freely, polluting waterways and the air, and eventually landing in our lungs or on the ground—where Michael O’Shea may one day vacuum it up.

“As you vacuum your house, I vacuum the street,” O’Shea says. “From curb to curb, I go back and forth collecting the dust.”

Both the methodology and the findings could have applicability in a broad range of urban settings, Gieré adds. “There will be many more cities that have these issues, especially the old ones. In the past, we took the technology that was available, and that’s why there are so many lead lines today.”  

The extent of the problem and how to actually remedy it remain big unknowns, two questions in a long list that highlight just how much there is left to learn in and about Philadelphia. In addition to lead and other environmental factors, potential research can cover urban revitalization and economic development, health care, education, poverty, and the needs of an aging population and diverse communities.

This “city as lab” vision has become a nationwide movement, one Wharton’s Wachter says Penn helped launch. This coming fall, under the aegis of the University’s 2018-2019 academic theme “Year of Why,” Penn IUR hopes to convene researchers working on projects in the city to share their work, to make connections, and deepen their findings.

“The whole range of urban concerns are on exhibit in Philadelphia,” says PennDesign’s Birch, “open to research and investigation and exploration.”

Homepage photo: Undergraduate Lynn Hur, Penn medical anthropologist Frances Barg, and Kent Bream, a Penn Medicine physician and medical director of the Sayre Health Center.