In a study in the journal Environmental Research, researchers compared blood samples of people participating in the . The researchers found that people living in greener neighborhoods showed immune patterns consistent with lower chronic inflammation, including lower levels of several circulating immune cells linked to inflammatory activity, such as monocytes, natural killer cells, B cells and some white blood cell types.

“The study also found evidence of a shift toward a more regulated immune profile, suggesting that nearby trees and vegetation may do more than improve quality of life – they may also influence the body’s immune system in ways that support cardiovascular health,” said Daniel Riggs, assistant professor in UofL’s and first author of the study. “While the study cannot prove cause and effect, the findings add to growing evidence that greener residential environments may be an important public health resource for reducing inflammation and promoting long-term health.”

The findings provide additional support for preliminary findings from the Green Heart Louisville Project showing that people living in neighborhoods where the number of trees and shrubs was more than doubled had lower levels of a blood biomarker of inflammation than those living outside the planted areas. Those living in the greened area had 13-20% lower levels of high-sensitivity C-reactive protein (hsCRP) than those living in the areas that did not receive additional trees and shrubs. Higher levels of hsCRP are strongly associated with a risk of cardiovascular disease. Higher CRP levels also indicate a higher risk of diabetes and certain cancers.

The recent study evaluated the immune function of Green Heart Louisville Project participants based on the greenness of their residential environment prior to the addition of trees for the project.

“These studies show that greener neighborhoods don’t just look better; they appear to educate our immune system in ways that may reduce chronic inflammation and disease risk,” said Aruni Bhatnagar, director of the Envirome Institute. “They align with the Envirome Institute’s mission of identifying environmental conditions that shape human health and translating those insights into strategies for improving the health of our communities.”

UofL in partnership with The Nature Conservancy, Washington University in St. Louis, Hyphae Design Laboratory and others to study whether and how living among more densely greened surroundings contributes to better heart health.

The space features eight cooking stations where health care professionals and students will learn culinary medicine, a growing field that integrates nutrition science with practical culinary skills that can lead to improved health, including better management and prevention of chronic illnesses such as diabetes and heart disease.

The kitchen supports the mission of the Trager Institute/Republic Bank Foundation Optimal Aging Clinic, which is dedicated to enhancing the lives of older adults in Kentucky through innovative, age-friendly health care practices. The Culinary Medicine Kitchen, located in the institute’s East Market St. facility, will host physicians, trainees, medical students and other health care providers for hands-on demonstrations that will help them guide patients to better health through healthy eating. The kitchen also will host nutrition-focused cooking demonstrations for the community.

“This wonderful educational venue is an outstanding example of our dedication to advancing medical education and community health, reinforcing our role as a leader in integrating innovative practices into health care training,” said UofL President Gerry Bradley. “It also highlights the Trager Institute’s distinctive approach and dedication to ensuring that older adults across Kentucky receive the care and support they deserve with dignity and compassion.”

The UofL School of Medicine joins 60 other medical schools in using the American College of Culinary Medicine curriculum to train health care professionals to understand and communicate the impact of good nutrition on their patients’ health. At UofL, the kitchen will serve as a vital resource for the Schools of Medicine, Public Health and Information Sciences, Nursing, Social Work and others, supporting their mission to train future and current health care providers and advisors in the role of nutrition in patient health.

“Research shows that good nutrition not only promotes overall health and well-being but also plays a crucial role in preventing and managing chronic diseases,” said Joe D’Ambrosio, director of behavioral health at the Trager Institute. “The Culinary Medicine Kitchen will help bridge the gap between what we know about nutrition and the practice of medicine.”

The Culinary Medicine Kitchen was created with support from GE Appliances, a Haier company, which donated state-of-the-art appliances for the buildout. Features such as an overhead camera and large-screen TVs in the kitchen give learners a bird’s-eye view of techniques for engaging, informative demonstrations. Integrated technology also enables live remote classes as well video recording to create enduring resources for sharing with patients and health professionals online.

Improving health for older adults

Beyond the kitchen, new and renewed funding for workforce training and support services has allowed the Trager Institute to expand its mission to improve the quality of life for older adults across the state. The institute has increased its age and dementia-friendly care and support services, particularly in underserved and rural areas to improve care for the Kentucky’s rapidly aging population.

Last year, the institute received $5 million from the Health Resources and Services Administration through the Geriatrics Workforce Enhancement Program (GWEP), the third consecutive GWEP grant awarded to the institute, following grants in 2015 and 2019.

The new funding allowed the institute to establish FlourishCare Centers of Excellence in the , Cumberland Valley and Barren River regions of Kentucky, bringing together experts from universities, health care providers, community organizations and local governments to improve how care is provided to older adults. Their goal is to ensure health care professionals have the specialized knowledge needed to care for aging adults and to help them stay independent, maintain their dignity and improve their overall well-being.

“By connecting different systems — hospitals, nursing homes, senior care programs and government services — the centers foster a coordinated approach to health care, ensuring that older adults, including those with Alzheimer’s and other memory-related conditions receive continuous and well-organized support, whether they are at home, in a hospital or in a care facility,” said Anna Faul, executive director of the Trager Institute.

In addition, the institute’s Republic Bank Foundation Optimal Aging Clinic was selected as a UofL Health demonstration site for the (GUIDE) model by the Centers for Medicaid and Medicare Services. This national initiative is focused on improving communication between primary care providers and specialists, provides educational resources and emotional support for caregivers, offers respite care and ensures health equity for dementia patients and their families. It is provided at no cost to eligible participants.

The Trager Institute also is expanding its FlourishCare initiative that supports vulnerable older adults with diabetes, depression and dementia, as well as their caregivers thanks to a $600,000 grant over four years from the Administration for Community Living. FlourishCare services aim to improve health outcomes and access to care for those in underserved areas of Kentucky, including:

• BRI Care Consultation:��Supports people with dementia and their caregivers by addressing unmet needs, reducing stress and alleviating depression
• Diabetes Self-Management Program:��Empowers participants to manage their diabetes effectively
• Program to Encourage Active Rewarding Lives for Seniors:��Helps older adults manage and reduce symptoms of depression

To see more images from the ribbon cutting, visit the .

Matt Willinger contributed to this story.

Arsenic is highly poisonous and occurs naturally in some rocks and soil. As a result, of exposure is drinking contaminated water, particularly ground water from private wells. More than get their water from private wells, including many in areas of Kentucky that may be contaminated from previous coal mining.��

“What people don’t realize is that private wells and even public water supplies serving smaller numbers of people are not regulated,” said , a UofL researcher who’s been studying arsenic’s role in cancer for more than 25 years. “People using private wells for their water are on their own to test for toxic chemicals.”��

Chronic exposure to low doses of arsenic, as from drinking water, can cause a host of serious health concerns, including cardiovascular disease, diabetes and several cancers, including skin, lung and bladder cancer. In high doses, arsenic can also be fatal.��

States and collaborator, , backed by two new grants from the National Institutes of Health and American Cancer Society totaling $3.6 million, are working to discover what specifically about arsenic exposure can cause and accelerate the development of those conditions. Understanding this cause and effect could help researchers and public health officials find ways to keep people safe and healthy.

States and Banerjee believe it may all come down to how arsenic binds with proteins that help the body regulate the expression of genes. When gene expression isn’t properly regulated, your cells can begin to behave abnormally, mutating and multiplying out of control and not dying when they should. In other words, they become cancer cells.��

Many proteins need zinc to do their jobs properly. When arsenic binds with these proteins instead, it takes the place zinc would normally fill. This disables these regulatory proteins and accelerates dysregulation.

Even worse, Banerjee said, is that there’s significant overlap between the communities who drink potentially contaminated well water and those who are more likely to have a zinc deficiency. If the body doesn’t have enough zinc to bind with the regulatory proteins in the first place, it can increase your risk of some of the same health concerns as arsenic exposure — including heart disease and cancer. An of the global population is zinc deficient.��

“It’s a double whammy,” said Banerjee, an assistant professor of pharmacology. “The populations we’re talking about are largely impoverished and rural, who are already more likely to be zinc deficient because they don’t have access to healthy, nutritious foods. So, you have a lack of zinc in the diet exacerbated by arsenic preventing what zinc they have from doing its job in the body.”��

There isn’t currently any medication that treats chronic arsenic exposure. However, Banerjee said, there may be a simple, over-the-counter solution — if the problem is a lack of zinc, it may be treatable with a zinc supplement. His research has shown zinc supplementation can mitigate or even regress some of the worse effects of arsenic exposure.��

“Zinc is over-the-counter, which makes it cheaper and readily accessible,” Banerjee said. “But I don’t think a lot of people are even aware of the potential danger of well water or what it can cause. We really hope this work can help those people.”

Their award-winning , named Paper of the Year by the American Journal of Physiology, sheds light on the heightened risk of kidney complications in cancer patients undergoing treatment. The study revealed that cancer itself may harm the kidneys, but that damage and scarring is intensified when patients take cisplatin, a commonly used chemotherapy drug.��

“Everything in your body is connected, from your internal systems to the medications we take,” said Andrew Orwick, lead author and recent doctoral graduate in pharmacology and toxicology.

Orwick’s doctoral research in the laboratory of researchers Leah Siskind and in collaboration with Levi Beverly, both from the and , examined the interplay of cisplatin and lung cancer, which is highly prevalent in Kentucky.

“By better understanding what those interactions are and how they happen,” he said, “we can take them into consideration and improve outcomes for the patient.”

Ultimately, that could lead to new diagnostics, more effective drugs and treatment plans that better consider the patient’s overall health and avoid or limit kidney damage.

Chronic damage to the kidneys can nausea, vomiting, fatigue, high blood pressure and even death, without transplant or dialysis. Because symptoms progress slowly, patients may not notice the condition until its advanced stages. Even so, current testing methods are difficult and invasive.

The UofL researchers think their work could help clinicians better predict not only which patients will react negatively to cisplatin and other chemotherapy drugs, but also identify potential kidney problems early. The goal is to better understand the underlying mechanisms and biomarkers, so clinicians can make more informed decisions.

“Obviously, addressing the cancer is first and foremost, but if we can do that while also preserving the patient’s overall health and feeling of health, that’s optimal,” said Siskind, a professor and senior author on the study. “The great news is that the fact that we’re even having this conversation means we’re making progress in solving cancer — we’re considering not only life, but the quality of that life.”

Siskind said the paper represents a paradigm shift in how researchers think about and treat both cancer and kidney disease. As it stands, no treatment for this form of kidney disease has made it past a phase 2 clinical trial or been approved for use in patients. This research could also help inform better drugs and experiments to fill that need.��

That innovative thinking and broad impact is likely part of why this work was selected as Paper of the Year, said Jon Klein, interim executive vice president for .

“Being selected for this honor is a massive accomplishment and underpins the immense value of the research being done by this team and across UofL,” Klein said. “This is work that truly can save and improve lives.”��

The UofL study is believed to be the first to connect biomarkers for chronic disease risk to factors such as stress, employee capacity for work assigned, workplace physical and social environment and whether we see our work as meaningful. The findings are published in the��.

These factors are part of a new concept the UofL researchers have coined which they hope will become a model for both employers and employees to better understand the health impacts of workplace culture.

“For a long time, we’ve assumed that workplace culture can impact our health,” said Brad Shuck, an author on the study and organizational culture researcher in UofL’s . “This study shows, in biological terms, that assumption is true and improving our understanding of these links could help both employees and employers make better, more informed decisions that keep everyone healthy and happy in their work����Ա������DzԳ���Գٲ�.”

In the study, Shuck and�� researchers Kandi Walker, Joy Hart and Rachel Keith asked participants to complete questionnaires on their well-being and work determinants of health factors, such as how engaged and positive or negative they felt about their work environment. Walker and Hart hold faculty appointments in the College of Arts & Sciences and Keith is a faculty member in the School of Medicine.

The Hub was launched earlier this year as a collaboration between UofL, The Humana Foundation, and Humana Inc. aimed at closing health equity gaps facing vulnerable populations. The 10 projects awarded in this initial round of funding furthers this goal by tackling inequities in areas such as access to mental and physical health care and healthy food. Projects were eligible for up to $100,000 per year for up to three years.

Monica Wendel, who leads the Hub, said finding solutions for these challenges will create more choices for people in making decisions that affect their health.��

“These factors play a huge role in our health outcomes,” said Wendel,��a professor��in the UofL School of Public Health��and��Information Sciences.��“We all want to be healthy and whole. But��the choices people make are the choices people have. For communities that have been marginalized, their choices are greatly limited by structural and social barriers. Our goal with the Hub and with this research is to dismantle these barriers, create more choices and thus empower people and communities.”

The funded projects include:��

• • The Pharmacy Accessibility Index (PAI) Project (Lihui Bai, J.B. Speed School of Engineering);
  • Healing-Centered Capacity Building: Social Justice Youth Development Certificate (Aishia Brown, School of Public Health and Information Sciences);
  • An Examination of the Feasibility and Acceptability of a Racial Trauma Processing for Family Health Intervention (Emma Sterrett‐Hong, Kent School of Social Work);
  • Exploring Workforce Development, Well‐Being, and Organizational Readiness to Recruit, Retain Black American Adults Living in Low Resource Communities (Meera Alagaraja, College of ����ֱ�� and Human Development);
  • A Community-Engaged Feasibility Study of hrHPV Self‐Sampling for Primary Cervical Cancer Screening in Sexual and Gender Minorities (Mollie Aleshire, School of Nursing);
  • A Community‐based, Knowledge Translation Approach to Address Neighborhood Factors that Impact HIV Care Continuum Participation (Jelani Kerr, School of Public Health and Information Sciences);
  • Assessing risk factors associated with childhood lead poisoning in Jefferson County: Structural racism and a legacy of lead (Brian Guinn, School of Public Health and Information Sciences);
  • “Getting the Listening” in Louisville: Environmental Health Literacy and Justice in and around Rubbertown (Megan Poole, College of Arts and Sciences);
  • Empowered by the Sun: Exploring the Intersections of Housing Justice and Green Technologies in Louisville (David Johnson, School of Public Health and Information Sciences); and
  • Equity‐Centered, Trauma‐informed Teacher Preparation: Development and Study of a Teacher Residency Curriculum (Shelley Thomas, College of ����ֱ�� and Human Development).

Wendel said the Hub will work closely with researchers and their community partners throughout the projects and plans to open a new round of research funding in 2023. Many projects will be conducted in collaboration with Louisville-based Humana Inc., which will share anonymized data for research purposes.��

“We’re proud to back both research and underrepresented minority researchers to help communities achieve greater health equity and improved outcomes,” said Keni Winchester, director, strategy & community engagement at The Humana Foundation.��“Through the collective efforts of researchers, community partners and the University of Louisville’s Health Equity Innovation Hub, people in Louisville and beyond will thrive.”��

The Hub launched with a potential total investment of $25 million from the Humana Foundation, Humana Inc., and UofL, representing one of the largest single donations in the history of the university. Humana also recently announced it would donate a fully furnished eight-story building, located at 515 W. Market St., to house the Hub’s administrative team and programming.��

“This research is an important facet of the great collaboration we have with The Humana Foundation and Humana Inc.,” Wendel said. “These projects are designed to lead to scalable solutions to health equity issues here in Louisville and beyond.”��

Six projects were selected this funding cycle, two of which are from UofL:

• Pediatric NeuroRecovery Posture Control System (researcher Andrea Behrman)
• Vertify Probe: Intraoperative Device for Measurement of Bone Quality (researchers Stuart Williams, Maxwell Boakye and Michael Voor)

KYNETIC is a statewide program supported by $6.6 million in funding, including a $4 million��Research Evaluation and Commercialization Hub (REACH) grant from the National Institutes of Health and matching funds. The goal is to advance the most promising biomedical research innovations — including pharmaceuticals, devices and apps — from the state’s eight public universities and the Kentucky Community & Technical College System (KCTCS).

KYNETIC grants support six-month, milestone-driven projects focused on��quickly determining whether or not each technology is viable as a commercial product.��Awardees will receive funding for product-focused research and development, attend trainings, and get advice from program staff, industry, investors and other experts on identifying needs, navigating regulations and protecting their intellectual property.��

Paula Bates, professor of medicine at UofL, who co-leads KYNETIC, said the idea is to spur innovation and economic development through collaboration.

“I’m very pleased with the strong projects awarded in this cycle of KYNETIC, each of which will have a positive impact on human health,” she said. “Collaboration and innovation go hand-in-hand, and that’s our goal with KYNETIC. It’s a really powerful way to use our collective expertise to help to turn great ideas from our state into products that improve people’s health and wellbeing.”

Applications for the next cycle of KYNETIC funding are ��and��require a two-page pre-proposal. Funding cycles are offered twice a year and are open to faculty, staff, trainees and students. Competitive renewal opportunities are available.

Launched in 2019, the KYNETIC program builds on UofL’s strong history of translational research support, which includes a prestigious for turning research into products.

“Through these programs, UofL supports commercialization of the work being done by our researchers here,” said Jessica Sharon, UofL’s director of innovation programs. “The goal is to translate research into products that can improve, or even save, lives.”

KYNETIC is led by UofL, the University of Kentucky, the Kentucky Cabinet for Economic Development, and Kentucky Commercialization Ventures, and works closely with Kentucky’s regional universities and KCTCS.

In the first study, UofL researchers Aruni Bhatnagar, professor of medicine and director of the Envirome Institute, Ray Yeager and Daniel Riggs, with Carver Coleman and Arden Pope of Brigham Young University and others, analyzed retrospective data from more than 5.5 million cancer patients and survivors from 2003 to 2016. They found that cancer patients in greener counties lived longer than those in counties with less greenness. The protective effects of greenness against cancer mortality were seen with both males and females and individuals of all ages, but were more pronounced at urban locations. Individuals with cancers that were highly survivable – such as breast, prostate and skin cancer – benefitted more from greenness than those with cancers with low survival rates such as brain, esophageal, liver, lung and pancreatic cancer. ����

The study, “,” published in the journal Environment International, evaluated associations between greenness and fine particulate matter in the air on causes of death in a large group of cancer patients and survivors in the United States.

“This is the largest study of the relationship between greenness and cancer mortality, and it provides clear evidence that living in green areas is beneficial to cancer patients,” said Bhatnagar “However, we do not yet understand why greenness protects against cancer mortality. Much more remains to be done to see whether greenness benefits cancer patients by lowering mental stress and anxiety or by reducing the levels of air pollutants or whether some other mechanisms are at play.”

The study also found that cardiopulmonary disease, but not cancer, was associated with higher levels of fine particulate air pollution. Mortality from cardiopulmonary causes – stroke, heart attack or COPD – was not affected by county greenness, except in rural locations.����

Greenness and depression

A second study, led by Kandi Walker and Joy Hart, professors in the UofL Department of Communication, Bhatnagar and other researchers in the Envirome Institute, found that people’s satisfaction with levels of greenness in their neighborhood was associated with lower levels of self-reported depressive symptoms. ��

The researchers surveyed participants about their perceptions of greenness in their neighborhoods and their mental health symptoms and found that those who were more satisfied with the greenness surrounding their homes also reported lower depression symptoms on a health survey, the Patient Health Questionnaire-9.

The 44.5% of survey participants who reported they were satisfied with the level of greenness in their neighborhood collectively scored better on the health questionnaire for depression.

“Given the pervasiveness of depression in the U.S. population, any changes that can reduce depression are essential, particularly those that can affect a large number of people,” Hart said. “The findings of this study suggest that greening interventions that focus on greenness satisfaction may be a strategy to reduce depression in urban populations.”

The study, “,” was published in July in the journal Population Medicine.

South Louisville study participants needed

Participants in the greening satisfaction study were part of the Health, Environment and Action in Louisville (HEAL) study of the Great Heart Project, which is an ongoing assessment of the effects of neighborhood greenness on individual health. Additional participants are needed for the HEAL Study by the end of September. More information is available on the website.

“Together, these studies add weight to the importance of trees, shrubs and other vegetation in urban areas in benefitting and nurturing human health. Accumulation of such evidence strengthens the case that increasing greenness in urban locations can decrease the high rates of non-communicable diseases in cities,” Bhatnagar said. “And since greenness improves health in general, it may also be effective against infectious disease.”