Nursing professor to study link between heat waves and kidney disease hospitalizations

BUFFALO, N.Y. – Daniel Jackson Smith, an assistant professor in the University at Buffalo School of Nursing, has an opening statement that cuts to the heart of any discussion on climate change.

“We all recognize the world is getting hotter, right?” says Smith, PhD, an expert on extreme heat and its effects on human health. “Politically, the idea of climate change is if it’s manmade or not. But when we say it’s getting hotter, that’s not up for debate. And that’s impacting human health.”

Wherever you go, he says, people notice their surroundings are warmer than they remember as kids. It’s almost automatic.

So his research – including a three-year, $487,230 grant awarded by the National Institute of Nursing Research in August – carries that self-assurance that climate change and its effect on public health is not a problem that breaks down along political lines. This, he says, is a problem for everyone.

Smith and his team will use the award to explore the link between heat waves and kidney disease hospitalizations. They will examine environmental factors such as impervious land use, reduced green space and historical redlining, and find associations among these factors with kidney disease.

“We‘re looking for whatever associations we can find,” he says. “Patients admitted to hospitals, numbers of diagnoses, co-morbidities. The novel piece is we will be looking at people’s addresses and their neighborhood. Are they living in neighborhoods that were historically redlined, which we know are hotter than neighborhoods that weren’t.”

“We’re going to look at neighborhood characteristics, like more concrete, fewer trees. There is some evidence that historically neighborhoods were redlined because they were less desirable places to be, and one of those desirable factors was being cool,” says Smith, who in September attended the White House Extreme Heat Summit.

He aims to translate the research, which will involve data from about 80,000 individuals from the Philadelphia metropolitan area and the Atlanta metropolitan area, into community-based interventions.

“This grant is trying to take a look at how it’s really not only outdoor workers impacted by climate change, even though they are. But more so, anyone with kidney disease is impacted,” says Smith.

In other words, it’s not just about farm workers or those exposed to high heat outdoors, but also people working in overheated restaurants and other indoor environments.

As part of the grant, Smith will travel to Guatemala in January to train with his mentor, Emory University nursing researcher Lisa Thompson on implementation science, bringing research back to the community to directly help patients.

“That’s an important part of the study,” says Smith, who on Nov. 2. was inducted as a fellow of the America Academy of Nursing, among the highest honors in nursing.

He continues: "It takes 17 years for research findings to be translated into practice. We have to take the research back to the stakeholders – doctors, nurses, nurse practitioners, people running our public health departments. And especially patients. How do we start developing interventions that can potentially protect people’s health during periods of heart waves?”