Training in Environmental Health to Reduce Chronic Disease in Latin America

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DESCRIPTION (provided by applicant): Environmental exposures early in life contribute significantly to some of the most common, chronic non-communicable diseases in children and can have an effect throughout the lifespan. Examples are: 1) asthma, the most common chronic disease in children is caused or aggravated by environmental factors including indoor allergens, air pollution and tobacco smoke; 2) obesity and diabetes are epidemic in developed countries and are increasing alarmingly in the developing world. Exposures in the built environment related to increasing urbanization contribute to both conditions. 3) exposure to lead and other heavy metals and neurotoxins such as pesticides continue in the developing world and contribute to neurobehavioral effects later in life. Despite the contribution of childhood environmental exposures to the burden of chronic disease, few pediatricians or other health care providers are trained to study, diagnose, treat or prevent disease of environmental origin. The goal of the Division of International Health of the Department of Community and Preventive Medicine at Mount Sinai School of Medicine is to train health professionals in Latin America to implement research and service programs that identify, treat and prevent chronic disease of environmental origin. Specific Aims are: 1) Train medical professionals to implement clinical and research practices that aim to ameliorate chronic disease by identifying environmental exposures in children. 2) To create an online reference tool and distance learning program to reach a large number of health professionals in Latin America. 3) To train and support key leaders in pediatric environmental health. By leveraging resources from existing international training programs at Mount Sinai, it will be possible to offer mentored research opportunities to Latin American researchers who are trained through the offerings described above. Recipients of the training will initially be selected through partnerships with institutions in Costa Rica, Mexico, Colombia and Uruguay, to be expanded in later years to other Latin American nations. It is expected that this program will result in the opening of at least three new PEHSUs in Latin America with the potential to implement research programs in those countries, thus ensuring continuity beyond the scope of this proposal. PUBLIC HEALTH RELEVANCE: A significant proportion of chronic non-communicable diseases have an origin in environmental exposures during childhood including asthma, some neurological disorders, obesity and diabetes. In the developing, these diseases are on the rise and are taking a significant toll on health of the growing populations. This program will provide training in the identification, prevention, research, and treatment pediatric environmental health for Latin American health care providers and scientists.