Healthography in the Americas

“There is no doubt that this is a disease of the poor,” explained Jennifer Crowe from the National University at Costa Rica. “This is drastically clear.”

Crowe, a panelist at a global health session on environmental health in the Americas, discussed chronic kidney disease of unknown origin in Central America. Unlike kidney disease related to common risk factors, such as diabetes, hypertension and obesity, very little is known about the cause of chronic kidney disease of unknown origin, which has occurred mostly on the Pacific coast of the region.

What is known is that it’s related to the social determinants of health, such as income, and it usually affects men, particularly sugar cane workers. In fact, farmworkers, workers who perform hard labor and those who live in regions where the condition is prevalent are particularly vulnerable to this type of kidney disease.

The leading hypothesis as to what causes chronic kidney disease of unknown origin is exposure to extreme heat and dehydration, Crowe told attendees at the Tuesday session. However, others researchers have put forth theories surrounding the role of nephrotoxins, such as pesticides. Crowe noted the desire of researchers to “latch on to one hypothesis” to explain this disease; but the reality is that the exact cause is largely unknown and the illness is most likely caused by several factors.

Chronic kidney disease is one of the many environmental health issues that are burdening populations in the Americas and overwhelming the region’s health care systems. Horacio Riojas Rodriguez, a presenter from the National Institute of Public Health of Mexico, discussed another environmental health problem of serious concern: air pollution.

Health issues caused by outdoor air pollution, which affects about 36 million people in Mexico alone, have increased alongside urbanization and population growth — and it’s a concerning trend considering the Americas is the most urbanized region in the world. Additionally, another 22 million Mexicans are exposed to indoor smoke associated with the burning of solid fuels inside the home. In an effort to reduce health issues caused by air problems, the country has worked to establish air quality monitoring stations and programs that promote the use of clean cookstoves, Rodriguez said.

The session’s presenters were brought together by the Pan American Health Organization, which is working to address the health issues and inequalities caused by global environmental changes. In an effort to tackle these problems in an organized manner, PAHO is working to support and strengthen a collaborative network in Latin America to positively impact environmental health policy and drive promising solutions.

Visit PAHO to learn more about the organization’s environmental health efforts.

— S.L.