What Toronto's health experts can learn from Brazil: Howard Hu

When it comes to health care, Toronto has much to learn from international partners – particularly in Brazil – says Professor Howard Hu, dean of the University of Toronto’s Dalla Lana School of Public Health.

Hu recently returned from São Paulo, Brazil where he presented a new research perspective on big data for population health and cultivated partnerships with public health and clinical leaders at the University of São Paulo and medical centres.

“Brazil’s rapid expansion in public health infrastructure and innovations in the teaching and delivery of public health and primary care is of great interest to our School’s mission of advancing population health, health systems and policy, both nationally and internationally,” Hu said.

“Toronto can learn a lot about building integrated public health and healthcare systems from our international partners, particularly those in Brazil.” 

This is Hu’s second trip to São Paulo since arriving at U of T in 2012.  In 2013, Hu traveled to Sao Paulo with colleagues to develop collaborations on air pollution and cardiovascular health. In October 2014, 13 U of T scholars – including Dalla Lana School of Public Health professors David Henry, Patricia O’Campo and Greg Evans – attended the Global Cities joint conference with President Meric Gertler to explore research partnerships in urban issues and health promotion.  

An environmental health professor with expertise in epidemiology and global health, Hu returned to São Paulo to speak at the Conference of the International Society for Environmental Epidemiology (ISEE) about what's missing from big data for health initiatives around the world and how U of T and the city of Toronto can lead the way.

“Big data from large populations has the potential to revolutionize the way we measure the presence or absence of disease and set new intervention targets, but we need to establish ethical, socially conscious parameters to guide its use,” said Hu, noting that the ISEE conference theme, Addressing Environmental Health Inequalities, fits nicely within the School’s core value system.

The importance of population health values, particularly equity and social justice, Hu says, is underlined by the recent anti-austerity protests that took place throughout Brazil and around the world this summer.

“To truly improve the health of entire communities, societies and countries, we must acknowledge and repair health inequities and partner with marginalized populations,” said Hu, who accepted ISEE’s 2015 John Goldsmith Award – the highest honor bestowed by the Society – based on his outstanding contributions to environmental epidemiology. 

Since 1990, Hu has led international teams of scientists devoted to studying how metal and nutrient exposure impacts child development and age-related diseases in population-based studies in the U.S., Mexico, India, China, and elsewhere around the world.  

He has examined the effects of toxic exposures to civilian populations in conflict situations and Indigenous populations exposed to industrial and mining wastes.

“Howard is a rare scientist.  Not only has he done pioneering work on getting environmental exposures for lead right, but he also understands the complex relationships between humans and environment,” said Prabhat Jha, professor of global health and epidemiology at the Dalla Lana School of Public Health. 
 
“Despite commonly held beliefs that we have bad stuff in our environment that makes us sick, actually health in most places is improving and exposure to the really nasty stuff, like lead, is less now than in the past.  This improvement is due in many ways to Howard’s rigorous science, and his ability to communicate the results of his fabulous research widely,” said Jha, also director of the Centre for Global Health Research located at St. Michael’s Hospital.

Hu said the response from conference attendees “confirms that by approaching big data research with an equity lens, we are on to something unique, and senior scientists from around the world are interested in collaborating with us.”