For more than fifteen years as an activist and community organizer, Bloomberg Fellow Julian Drix has promoted environmental justice for frontline communities impacted by fossil fuels and climate change. That’s how he became involved with one of the most serious environmental health issues: asthma. 

In 2014, Drix took the helm of the Rhode Island Department of Health’s Asthma Control Program, where he manages the state’s comprehensive asthma surveillance system and promotes effective interventions. Rhode Island’s child and adult asthma rates have long been above the national average.

At the Johns Hopkins Bloomberg School of Public Health, Drix is a part-time student pursuing an MPH with a focus on environmental challenges. He talked to us about how Rhode Island is addressing asthma and where he sees environmental health going as a field.

Bloomberg Fellow Julian Drix

What are some of your current projects at work?

We’ve been building a business case for why asthma home visits, as an evidence-based intervention, should be a covered health insurance benefit. Home visits combine asthma education with helping people reduce environmental triggers. Right now, health care plans that cover asthma home visits are pretty spotty, so most of the funding for this intervention comes from the Centers for Disease Control and Prevention, the Environmental Protection Agency and other grant makers. But they’re not sustainable funding sources. 

So, in collaboration with Medicaid and national partners, we’ve been evaluating the effectiveness of home visits using claims data from insurance companies. We have also demonstrated that this intervention will improve health outcomes and reduce costs, and therefore insurance companies would save money by covering them upfront.

What do you think is missing from how we currently handle environmental issues? 

We need to be able to go up against class inequality, gender inequality, racism and all the ways people in power maintain the status quo. A lot of the time, I think we are too timid to engage those topics and powerful forces. 

If we truly want to uphold the mission of public health and reduce health disparities, we need to be able to address the root causes of health problems. And that’s everything from why polluting facilities are concentrated in low-income communities of color to why those same communities experience higher than normal rates of diseases like asthma, lead poisoning and diabetes.

What do you hope for the future of public health as it relates to environmental challenges? 

I want to see stronger partnerships between frontline communities, social movements and public health. With tobacco, we’ve seen health advocacy take on a powerful corporate interest, and a lot of policy change has come out of it. To rise to the challenge posed by climate change, we need public health to engage with and actively support transformative climate-justice social movements.

I would also love to see more people like myself who’ve come from social movement backgrounds having access to the fellowship program. Before joining, I had no expertise in biostatistics or epidemiology. Now, I’m learning how to show connections between environmental exposure and health outcomes and use that information to effect policy change.