Led by researchers at the Christina Lee Brown Envirome Institute at the University of Louisville, this five-year project seeks to identify and reduce loneliness among seniors aged 65 and older by combining neighborhood-level data, community engagement and targeted, place-based interventions.

“We are deeply grateful to the Humana Foundation for supporting this effort to find new ways to help seniors live healthier lives in Louisville and across Kentucky” said Ted Smith, Ph.D, co-director of the Humana Center for Community Health Research at UofL.

This initiative builds on the work of the Universal Basic Neighborhood (UBN) project, a framework developed to discover and promote the core resources neighborhoods offer that have been shown to support good health. Through the , researchers identified social connection as a key ingredient in healthy communities, and loneliness, especially among seniors, as a critical risk factor for poor health outcomes. The new project applies UBN’s data-driven approach to address this challenge, using demographic, clinical and environmental data.

“This project represents a direct application of this place-based framework to a real and growing need in our community,” said Lauren Anderson, a UofL researcher who developed that place-based data model for this work as part of her dissertation research.

The project continues a collaboration with Nancy Seay, Ph.D., with The Reverend Jesse Louis Jackson Sr. Center for Racial Justice and the Department of Sociology at Simmons College of Kentucky, who will lead the asset mapping and community-based research components of the study. Their work will focus on identifying both social needs and existing assets within the neighborhoods selected for intervention, helping to ground the study in the lived experience and local context of older adults.

Over the course of the study, researchers will work with community partners to test a variety of neighborhood-based strategies aimed at fostering social connection. The project will also gather new insights on how local infrastructure and community design influence emotional well-being in aging populations. While target neighborhoods are still being identified, the project team is also actively seeking organizations that serve seniors to join as collaborators and subject matter experts. Interested partners are encouraged to visit the project to learn more about how to get involved.

Funding for this work is provided by the Humana Foundation, whose commitment to community health and equitable aging has made this study possible.

How to participate:

• For seniors: Enroll in the study by taking the Baseline Loneliness Survey *Coming in July 2025*
• For partners: If you serve the senior population, contact Cayley.Crum@louisville.edu
• For volunteers: To help with outreach, survey collection or event support, contact Cayley.Crum@louisville.edu

The Ohio River Basin covers a region of 204,000 square miles, consisting of the ancestral and historical homelands of more than 40 federally recognized Tribal Nations, as well as those of the Tribal Nations currently within the basin, the Eastern Band of Cherokee Indians and the Seneca Nation of Indians. The Basin encompasses portions of 14 states including Alabama, Georgia, Kentucky, Illinois, Indiana, Maryland, Mississippi, New York, North Carolina, Ohio, Pennsylvania, Tennessee, Virginia and West Virginia.

The draft report, seeks to address several threats to local waters including inadequate water infrastructure, toxic pollution, nonpoint source pollution, mining issues, hydrologic modification, loss of habitat, invasive species and extreme weather and flooding.

“Everyone deserves access to clean, safe and affordable water, yet too many communities continue to have to worry about their children’s and seniors’ health due to point and non-point source impacts of their ground water and recreational waterways,” said Ted Smith, director of the Center for Healthy Air, Water and Soil, a part of UofL’s Christina Lee Brown Envirome Institute. “We see this as an important and needed step to make communities healthier, safer and more prosperous. Combined with other efforts, restoration investments can ultimately contribute to better health outcomes for people in the region.”

The Envirome Institute, in particular the Center for Healthy Air, Water and Soil, contributed substantial content to the report, with a focus on the importance of restoration of the Ohio River Basin as part of supporting community health. UofL faculty led the environmental human health risk analysis in the plan, building off their previously published work on environmental vulnerability analysis and the place-based health framework in place at UofL.��

Among concerns raised by Envirome are the 327 Superfund sites within the basin that have yet to be fully remediated. With historic flooding in Kentucky in recent years, these sites put our water system at risk for increased pollution. Additional issues include agricultural system runoff and heavy metals contamination related to power generation.

“One recent development is the great pressure being placed on fresh water sources in the basin to cool large-scale data centers. Clean water has never been more important to the health and security of this basin,” Smith said.

Comments on the report can be submitted through July 18. A public engagement session will be held in Louisville June 25, 6-7:30 p.m. at St. Matthew’s Episcopal Church, 330 North Hubbards Ln.��Additional opportunities can be found on the , including in-person events across the region and a public webinar on June 12.

“We all have a role to play in the restoration and protection of the natural resources that make this region such a special place,” said Harry Stone, past chair of the Ohio River Basin Alliance. “Through collaboration and trust we are putting together a roadmap to improve our environment, our health and our local economies. By continuing to work together, we can secure a healthier environment and a better future for all of the people who call this region home.”

Once finalized, the report will be provided to members of Congress.

Background

Despite progress over the past 50 years to restore the region’s waters by local, state, Tribal and federal partners, serious threats remain: 69 percent of assessed stream miles and 64 percent of lakes in the region do not meet water quality standards due to a variety of pollutants. The report provides a case statement for increased collaboration with, and engagement by, the federal government to accelerate progress in addressing water quality concerns. The report recommends:

• Increasing federal investment in proven restoration actions
• Increasing monitoring and research to guide future actions
• Increasing coordination across the region to manage ecosystems holistically
• Increasing technical assistance to ensure local communities benefit from restoration actions

The plan supports solutions for cleaning up pollution, reducing runoff, restoring wildlife habitat, modernizing water infrastructure, mitigating the impacts of floods and the prevention of non-native, invasive species.

The fishing event was organized by Kentucky Waterways Alliance (KWA) and UofL’s to help monitor the health of the Ohio River and its fish populations. Additional support was provided by Backcountry Hunters and Anglers��(Kentucky chapter), two centers affiliated with Envirome – the Center for Healthy Air, Water and Soil and the Center for Integrative Environmental Health Sciences – along with the Falls of the Ohio Foundation and Humana Foundation.

UofL researchers and KWA arranged for laboratory testing of the channel catfish and freshwater drum caught from the Ohio River at the Clarksville, Ind. park by volunteer anglers for an array of contaminants:�� heavy metals, polychlorinated biphenyls (PCBs) and per- and polyfluoroalkyl substances – known as forever chemicals. Researchers then compared these laboratory results with screening values and action levels from the EPA and the FDA.

Levels of the contaminants found in the fish were generally low, with most samples falling within safe consumption thresholds. One metal that exceeded EPA recommended screening levels was selenium, a naturally occurring heavy metal that can be affected by a fish’s age and diet. PCB levels for all fish samples were well below the FDA’s consumption action level threshold of 2.0 mg/kg of fish. However, PFOS, a forever chemical, was slightly above the EPA screening level in the freshwater drum. All forever chemicals were below recommended levels in catfish samples.

“These results highlight the need for continued monitoring of contaminants and will be used to inform ongoing waterway restoration efforts and updated consumption guidelines for fish caught in the Ohio River,” said Ted Smith, director of the Center for Healthy Air, Water and Soil. “This project is a powerful example of participatory science, allowing local residents to engage directly in environmental health research and contribute to the assessment of waterway health.”

The data gained from this event will support ongoing research and advocacy for cleaner water policies, helping to ensure the long-term health and sustainability of the Ohio River, the source of drinking water for millions of people, and its ecosystems.

The idea of a fishing day to enlist local volunteers in monitoring contaminant levels in the Ohio River first arose at the Association for the Advancement of Participatory Sciences regional conference hosted by the Envirome Institute’s Center for Healthy Air, Water and Soil in the spring of 2024.

“The Humana Foundation’s generous grant enables us to not only enhance our research capacity but also continue our commitment to breaking down barriers and achieving equal health outcomes,” said University of Louisville President Kim Schatzel. “This partnership will generate a lasting impact for all and allows us to further amplify our efforts to reduce health disparities and fulfill our mission of improving lives through education, research and service.”

This six-year initiative positions the university as a leader in addressing systemic health disparities through innovative solutions that can serve as national models. Led by Dean Katie Cardarelli and Ted Smith, professor of environmental medicine representing the Christina Lee Brown Envirome Institute, the center will advance interdisciplinary research and foster collaboration across multiple fields and deepen understanding of social determinants of health. By tackling systemic barriers to health equity, the center aims to foster best-in-class community engagement and solution-oriented research that aligns with national health equity standards.��

“The Humana Foundation is proud to continue its partnership with the University of Louisville in its mission to foster health equity and drive impactful research and community engagement,” said Tiffany Benjamin, chief executive officer of the Humana Foundation. “Together, we aim to generate lasting, meaningful change by addressing the root causes of health disparities and ensuring that innovative solutions are accessible to all.”

Why this research matters

Health disparities, shaped by social determinants such as housing, education and access to health care, contribute to unequal health outcomes across communities. By addressing these systemic barriers, the Humana Health Equity Research Center will play a pivotal role in reshaping public health policy and practice at a national scale. The center’s efforts will generate data-driven insights, develop best practices for community engagement and create innovative, evidence-based interventions to advance health equity.

Building on research leadership

This grant builds upon UofL’s strong foundation of health equity research, UofL’s and the Humana Foundation’s earlier health equity work and the university’s reputation as a leader in community engagement. The funding will enhance the university’s ability to attract top-tier faculty, expand resources and retain the prestigious Carnegie Foundation’s Classification for Community Engagement. These enhancements further UofL’s capacity to tackle pressing public health issues with a national and global reach.

National and regional impact

The Humana Health Equity Research Center will develop accessible frameworks for addressing health disparities, benefiting communities throughout Kentucky and serving as a replicable model for other regions. By integrating research with actionable solutions, the center is poised to influence policy and practice across the nation, solidifying UofL’s status as a trailblazer in health equity innovation.

The commitment to the Humana Health Equity Research Center is expected to enhance faculty resources within the School of Public Health and Information Sciences and the Christina Lee Brown Envirome Institute, allowing faculty to undertake advanced research on the social determinants of health and other health equity issues. It will also build upon previous work with Humana and the Humana Foundation to address health equity challenges in Louisville and Kentucky more broadly.

Through this grant, UofL strengthens its commitment to building healthier communities and ensuring equitable access to health resources for all, setting a benchmark for impactful research and meaningful engagement.

The awards honor “those who have made an impact on health care in our community through their concern for patients, research, innovation, management skills and being on the frontlines fighting the Covid-19 pandemic,” according to the publication.��

The UofL honorees are:

• Front-Line Hero: Andrew Odom, emergency room charge nurse with UofL Hospital.
• Health Entrepreneur: Mahendra Sunkara, director of UofL’s and professor of chemical engineering, who worked to develop, commercialize and produce reusable N95-style masks during the height of the COVID-19 pandemic.��
• Health Equity Champions: Suzanne Kingery, director of the UofL Pediatric Endocrinology Fellowship Program; and Keith Miller, a trauma surgeon with UofL Health.
• Health Innovator: Mark Slaughter and Siddharth Pahwa (dual award), cardiovascular and thoracic surgeons with UofL Health; and Ted Smith, director of the Center for Healthy Air, Water and Soil in the , who collaborated with other researchers at UofL, including those in the����and��UofL Genomics and Bioinformatics Core facilities, to rollout innovative wastewater testing for pandemic tracking.
• Health Provider: Dawn Balcom, a nurse practitioner with the UofL School of Medicine and advanced practice specialist with the UofL International Travel Clinic.��

This year’s Health Care Heroes will be profiled in the Feb. 25��edition of Louisville Business First, and will be honored at an in-person event the day before at The Olmsted. You can register to attend .

UofL researchers already are testing wastewater to determine whether coronavirus infection exists in different neighborhoods around Jefferson County. This new work goes one step further, with the goal of estimating how many people within those neighborhoods are infected. If virus levels are high in the wastewater, it may be a signal of widespread infection in the community.

“This could revolutionize the way we track and contain pandemics, and not just COVID-19,” said Aruni Bhatnagar, professor of medicine. “It gives us an invaluable tool that could offer a clearer view of where and how the virus spreads.”

Researchers at UofL’s , where Bhatnagar is director, began testing wastewater last year as part of the Co-Immunity Project, a groundbreaking partnership with the to track COVID-19 in Metro Louisville.

As part of that effort, the from 12 sites representing multiple neighborhoods and five water quality treatment centers that aggregate the entire county to the UofL Center for Predictive Medicine for virus analysis.

In this new work, MSD and other community partners will continue collecting wastewater samples over the next six months. After analysis, UofL will also send the results to the CDC’s National Wastewater Surveillance System, which will help inform efforts across the U.S.

As with previous rounds of COVID-19 testing conducted through the Co-Immunity Project, researchers will recruit participants by sending letters to selected households across Jefferson County. They hope to continue to enroll a few thousand people every month and will compare their COVID-19 infection and antibody results with wastewater samples from the same area, with the goal of finding how they correlate.

“The aim of the project is to figure out whether we can estimate how many people in a given area are infected by simply testing the community wastewater,” said Ted Smith, associate professor of medicine and a lead on the wastewater epidemiology project. “Additionally, this is a passive and comparatively low-cost way to monitor community infection and has the additional benefit of being inclusive of all communities in our city and is a promising step to ensuring public health equity.”

Since the beginning of the pandemic, the Co-Immunity Project has conducted ongoing testing and surveys to better understand the spread of the coronavirus and COVID-19. In the past year, UofL researchers have tested more than 12,000 people for COVID-19 infection and antibodies, beginning with frontline health care workers. They also have worked to gauge how local citizens feel about COVID-19 vaccines, with in a recent poll saying they would like to be vaccinated.

“This is critically important work in our fight against COVID-19,” said Kevin Gardner, UofL’s executive vice president for research and innovation. “Our hope is that by working with the CDC, we can develop these new, more efficient tools for tracking pandemics and take a big step in advancing health for all of our community.”

Last year, U.S. Senator Mitch McConnell (R-KY), then-Senate majority leader, negotiated and championed five historic and completely bipartisan COVID-19 rescue packages. In addition to supporting workers and propping up the economy, these relief bills also allocated for COVID-19 testing. McConnell personally called then-U.S. Secretary of Health and Human Services Alex Azar to request that the CDC direct a portion of that funding to UofL’s Co-Immunity Project.

“Our country has responded to this terrible pandemic with innovation and discovery and Kentucky continues to play a major role in beating this virus. I’d like to congratulate Dr. Bhatnagar and UofL’s entire Co-Immunity Project on their groundbreaking study,” McConnell said in a statement. “After hearing about their work, I took this project to the highest levels of the federal government to help accelerate their research with additional federal funding.��As UPS and other Louisville employers are sending safe and effective vaccinations around the country, I’m proud top researchers right here at UofL are pushing the boundaries of knowledge in detection and prevention.”

Among the authors for this work were researchers from the , Louisville Metro Department of Public Health and Wellness, Louisville Metro Office of Civic Innovation and Technology, Family Allergy & Asthma, Columbia University Mailman School of Public Health, Propeller Health, University of California Berkeley, Harvard TH Chan School of Public Health, University of Texas at Austin and Colorado State University.

Coal-fired power plants are known to emit pollutants associated with adverse health effects, including increased asthma attacks, asthma-related ED visits and hospitalizations. In 2014, coal-fired power plants accounted for 63 percent of economy-wide emissions of sulfur dioxide (SO₂) in the United States. Historically, Kentucky has ranked among the top five states in the U.S. for emissions from power generation.

Starting with a pilot in 2012, the city of Louisville embarked on a project called , which aimed to use data from digital inhaler sensors to gain insights into the impact of local air quality on the burden of respiratory disease in the community. More than 1,200 Louisville residents with asthma and COPD were equipped with sensors produced by , which attach to patients’ existing inhalers and deliver insights on medication use, symptoms and environmental factors to an app on their smartphone.

Between 2013 and 2016, one coal-fired power plant in the Louisville area retired coal as an energy source and three others installed stricter emission controls to comply with regulations from the U.S. Environmental Protection Agency. Researchers took advantage of these circumstances to analyze the impact of the coal-fired power plant energy transitions on residents’ respiratory health, using data from Propeller and local hospitals to assess how asthma-related symptoms, ED visits and hospitalizations changed over time.

The study looked at the frequency of the total number of asthma-related ED visits and hospitalizations per ZIP code in Jefferson County, where Louisville is located, as well as the frequency of asthma rescue medication use among 207 people. Data on rescue medication use for asthma was used as a proxy for patients’ symptoms, as patients use their rescue medication for acute relief from symptoms such as coughing and shortness of breath.

Ted Smith, PhD, director of the Center for Healthy Air, Water and Soil in the UofL Envirome Institute and co-author of the study, said the work confirms important connections between environment and health.

“At the Envirome Institute and the , we are pioneering an approach that puts a focus on place in medicine – the places where people live and how their location affects clinical outcomes,” Smith said. “This research is a great example of the impact of environmental factors on people’s health. Air pollution first affects the lungs, but we know that when people breathe pollutants, it also affects other organs, including the heart.”

The study spanned 2012 to 2017, when four coal-fired power plants in Jefferson County either retired coal or installed stricter SO₂ controls. The researchers found that energy transitions in the spring of 2015 resulted in three fewer hospitalizations and ED visits per ZIP code per quarter in the following year, when comparing areas that had high coal-fired power plant emission exposure prior to the transition to those with lower levels. This translates into nearly 400 avoided hospitalizations and ED visits each year across Jefferson County.

At the individual level, the Mill Creek SO₂ scrubber installed in June 2016 was associated with a 17-percent immediate reduction in rescue medication use, which was maintained thereafter. The study also found the odds of having high rescue use throughout a month (on average more than four puffs per day) was reduced by 32 percent following the June 2016 energy transition.

“AIR Louisville brought together local government, public and private partners and residents for a common mission: To leverage local data to help push for safer and healthier air,” said Louisville Mayor Greg Fischer. “This study demonstrates the public health impact of retiring coal as an energy source or further controlling coal-fired emissions.”

“This study was unique in its ability to measure asthma morbidity based on both hospitalizations and daily symptoms, and to leverage an abrupt change in environmental exposure to more directly attribute changes in asthma exacerbation to changes in coal-fired power plant emissions,” said Joan Casey, PhD, lead author of the paper and assistant professor of environmental health sciences at Columbia University Mailman School of Public Health.

The main funding for the project was provided by the Robert Wood Johnson Foundation. Support also was provided by the Foundation for a Healthy Kentucky, Norton Healthcare Foundation, Owsley Brown Charitable Foundation, the American Lung Association, the National Institute of Environmental Health Sciences and the U.S. Environmental Protection Agency. The contents of the research and related materials are solely the responsibility of the grantee and do not necessarily represent the official views of the USEPA or the Robert Wood Johnson Foundation.

As part of its Strategic Plan, the University of Louisville will throw its research and scholarship weight behind solving these Grand Challenges — some of the biggest, global problems of our time.��

President Neeli Bendapudi appointed a in late 2019 to identify these areas, ones where UofL could become a national leader while making a dramatic impact on problems facing society.

The committee from the campus community through an online form, direct outreach and meetings with various faculty, staff and students. From hundreds of submitted ideas, they whittled it down to three broad Grand Challenges themes:

• Empowering our communities;
• Advancing our health; and
• Engineering our future economy.

A video explaining these challenges and form to provide additional feedback are available .��

“Our researchers and faculty can help the world make headway in these areas,” said Kevyn Merten associate vice president for research and innovation and subcommittee co-chair. “We can play a big role in solving these problems and shaping our world for years to come.”

These challenges were chosen because they are broad enough to offer countless lines of inquiry; build on UofL’s strong existing expertise and infrastructure; differentiate the UofL as a leader in global innovation and change; and can be positively influenced through multidisciplinary solutions.

For example, subcommittee co-chair Ted Smith “empowering our communities” might look like the research project from the J.B. Speed School of Engineering that uses to help kids with autism learn social skills they need to succeed in the classroom, or the School of Public Health and Information Sciences’ ��

“Advancing our health” might look like the Christina Lee Brown Envirome Institute’s , which is planting trees around Louisville to understand how greenness impacts heart disease.��

And “engineering our future economy” might look like yet another project through the College of ����ֱ�� and Human Development, that uses�� to help companies keep employees engaged.

“There’s really something here for everyone,” said Smith, an associate professor of pharmacology and toxicology. “Each and every discipline plays a key role in exploring and advancing these challenges.”

But, he added, the Grand Challenges subcommittee needs the help of campus to strengthen these challenges. They are asking faculty, staff and students to submit feedback on these three challenges, including ideas for lines of inquiry and how to move them forward. To submit your feedback, see the subcommittee’s .