The opportunity cost of conservation

Colombia becomes first case study on how to balance biodiversity goals with limited economic resources

Peer-Reviewed Publication

ARIZONA STATE UNIVERSITY

 

IMAGE: THE DEFORESTATION RISK FOR COLOMBIA, FROM LOW TO HIGH RISK. THE PRESENCE OF FARC WAS THE MOST INFLUENTIAL VARIABLE DETERMINING THE FATE OF THE DEFORESTED AREA, AS THE ODDS OF FOREST CONVERSION TO COCA CROPS OVER CONVERSION TO CATTLE OR OTHER CROPS IN AREAS WITH PRESENCE OF FARC IS 308.04% HIGHER THAN THE ODDS IN AREAS WITHOUT FARC. view more 

CREDIT: CAMILA GUERRERO-PINEDA, ARIZONA STATE UNIVERSITY

In 2019, a landmark report gave the world its first report card on biodiversity loss. There was one crystal clear conclusion: human actions threaten more species with global extinction than ever before.

 

According to the IPBES (Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services) report, currently 25 percent, or 1 million species, are threatened with extinction. The drivers of change have only accelerated in the past 50 years. The human population has doubled to 8 billion, contributing to climate change, land and sea-use change, overexploitation of resources and pollution. Two-thirds of the oceans are impacted. 85 percent of wetlands have been lost.

 

As a result of these stark data findings, the IPBES agreement fingered human land-use changes as the primary culprit.

 

Now, an ASU research team has developed the first-of-its-kind study that combines conservation with practical economic tools for a case study of Colombia, South America, a high priority but underfunded country for biodiversity conservation.  

 

“We focused on the case study of the country of Colombia to demonstrate an approach to maximize the biodiversity benefits from limited conservation funding while ensuring that landowners maintain economic returns equivalent to agriculture,” said Leah Gerber, who was lead author of the IPBES report, and is a professor of conservation science in the School of Life Sciences and founding director of the Center for Biodiversity Outcomes (CBO) at Arizona State University.

 

While they found that Colombia would need to substantially increase its conservation spending,

the study developed a prioritization map that permits policymakers to target conservation actions toward regions where conservation benefits are the highest and economic impacts are low---giving the biggest ecological bang for the buck. 

 

To do so, Gerber teamed up with Colombia native Camila Guerrero-Pineda, who, just three years ago, left her home country to join ASU and be mentored as a graduate student by Gerber and Gwenllian D. Iacona, assistant research professor at the School of Life Sciences, to ultimately make a difference back home.

 

“It’s fair to categorize that Colombia is a megadiverse country” said Guerrero-Pineda. “It arguably has some of the greatest biodiversity in the world, given its size, and a lot of scientists and academics in Colombia fear the ecological consequences of human actions.”

 

Now, she is the first author and a first-year ASU School of Life Sciences and Conservation Innovation Lab graduate student who contributed their results in the prestigious journal Nature Sustainability.

 

Cattle, coca and biodiversity

Colombia ranks among one of just 17 megadiverse countries in the world.

 

Colombia possesses a unique geography and natural beauty as the only South American country with combined coastlines of the Pacific Ocean and Caribbean Seas, along with the Sierra Nevada de Santa Marta, which at 13,000m, is the world’s highest coastal mountain range.

 

Human actions now threaten the only freshwater species of its kind, the pink river dolphin. The cotton-top tamarin. The Orinoco crocodile. The 100-pound, giant capybara rodent. The spectacled bear. Plants (flor de mayo orchid), amphibians (golden poison frog) and butterflies (Colombian eighty-eight) too.

 

All unique species to Colombia. And all could vanish.

 

In the South American continent, Colombia stands out as a region that has retained its biodiversity, one of the few silver linings due to a long history of violent, human conflicts. Prior to a 2016 peace agreement, Colombia had government instability and a decades long guerrilla war led by the Revolutionary Armed Forces of Colombia, or FARC, and other minor groups.

 

“FARC had a lot of control over the forests, and it prevented a lot of economic development” said Guerrero-Pineda. Since the FARC controlled the forest for coca leaf (the plant used to produce cocaine) production and the drug trade to finance five decades of asymmetrical warfare, one effect was to prevent unbridled development ---and inadvertently preserve biodiversity. 

 

In the ASU-led study, they found that the probability of transformation to cattle and other crops decreases with distance to roads, while the probability of transformation to coca increases. These results suggest that coca crops are grown in more isolated areas, away from roads, compared with cattle.

 

The presence of FARC was the most influential variable determining the fate of the deforested area, as the odds of forest conversion to coca crops over conversion to cattle or other crops in areas with presence of FARC is 308.04% higher than the odds in areas without FARC.

 

“It also prevented a lot of scientific monitoring because scientists were afraid of going into the forests,” said Guerrero-Pineda.   

 

But Colombia now stands at a biodiversity crossroads. The 2016 peace agreement has now brought unprecedented development. During the past 5 years alone, GDP growth has been 5-6% every year.

 

During that time, the deforestation rate rose by 44% after the peace agreement. Palm oil production, logging, mining, and gas oil extraction are some of the leading culprits besides agriculture development.

 

Do nothing, and Gerber’s team estimates the current biodiversity loss rate could increase by 50% by 2033.

 

Paradise lost or opportunity cost?

But how does Colombia preserve its biodiversity while balancing the need for economic development? Gerber’s team thinks they found a new blueprint to not only aid Colombia, but also extend to other policymakers in other countries to help make a difference. 

 

For the first time, they applied a unique quantitative model that relates conservation investment to national biodiversity outcomes.

 

“The methods developed here offer an approach to identifying areas of greatest conservation returns on investment by balancing cost of conservation action, measured as opportunity cost for agriculture, and biodiversity impacts,” said study lead author Camila Guerrero-Pineda.

 

When it comes to development, everything economically comes down to opportunity costs.

 

An extreme example of the choices nations must make is often referred to as the “Guns versus butter” model of economics. It refers to whether a country is more interested in spending money on war or feeding their people---but it can’t do both, and there are always going to be tradeoffs.

 

In Colombia’s case, it’s economic development versus biodiversity outcomes. Or more colloquially, parks versus parking lots. Preservation versus development.

 

Their team modeled the opportunity cost of conservation (OCC) to agriculture as an approximation of the expected cost of compensating a landowner for avoiding conversion of their property.

 

“Opportunity cost is what you're missing out on or what you're not doing because of a decision to do something else,” said Guerrero-Pineda. “What that means is that someone is not going to be able to use the land that is going to be used for conservation.”

 

They assumed in the modeling of a protection cost that deforestation can be counteracted by compensating the land owner, either by purchase, such as the setting the sale value of a parcel equal to its expected future cash flow, or as continued payments for ecosystem services.

 

To avoid this additional biodiversity loss, Gerber’s groups estimated that Colombia would have to invest $37-39 million USD annually in the best and worst-case scenarios of deforestation. According to them, this means an increase in its conservation spending of 7.69-10.16 million USD per year. Avoiding this decline (preventing further loss) would require $61-63 million USD annually, which is more than twice the conservation spending before the peace agreement.

 

“Our strategy for targeting conservation funding involves first identifying regions with a high

risk of forest conversion to agriculture [such as cattle ranching or other crops],” said Gerber.

“More broadly, the research agenda is around incorporating cost into decision-making to achieve the most outcomes, given limited resources.”

 

They found that the Andean region contains the highest mean OCC, reflecting a very strong probability of agricultural conversion of the remaining forests. Following closely behind were the Pacific, the Caribbean and the Orinoquía regions. The Amazon region, the one with the lowest mean probability of agricultural conversion, had the greatest forest cover percentage and the greatest forest area, had a much lower OCC.

 

“One of the things we're excited about with this work is that it's a demonstration of the potential of this idea of using return on investment for thinking about allocated conservation resources,” said co-author Gwenllian D. Iacona.  “And so, we took these two high profile approaches that are out there, called the Waldron Model and the Species Threat Abatement and Restoration (STAR) metric, and we put them together so country-level decision makers can make the best-informed decisions at that type of scale.”

 

Their results can also assist in the planning of land preservation and national parks. In Colombia, the National Natural Park System is working to declare five new protected areas, and to expand three more. This builds on evidence showing that more effective and lasting conservation outcomes are achieved when governance empowers local communities and support their environmental stewardship, including indigenous communities, reserves and Afro-Colombian lands.  

CAPTION

Their team modeled the opportunity cost of conservation (OCC) to agriculture as an approximation of the expected cost of compensating a landowner for avoiding conversion of property. To avoid this additional biodiversity loss, Gerber’s groups estimated that Colombia would have to invest $37-39 million USD annually in the best and worst-case scenarios of deforestation.

CREDIT

Camila Guerrero-Pineda

 VIDEO  Nova explosion [VIDEO] | EurekAlert! Science News Releases

More to come

“I think Camila’s work really sets us up to assist entities, whether they be countries or companies, in quantitatively measuring the impact of conservation interventions on different metrics, whether they need biodiversity or climate mitigation, or other types of conservation strategies,” said Gerber. “I'm optimistic that we'll be able to build and scale this to improve conservation outcomes more generally.”

 

“Camila, for example, in the summer, will be working on a collaborative USAID project with Conservation International in Peru and we're going to be applying a similar approach to identify green economic growth pathways.”

 

Their approach is another prime example of ASU’s commitment to advance research to finding practical solutions of social, economic and today’s urgent environmental challenges.

 

“So, in that sense, Camila’s foundational work is not only novel, but also represents a practical foundation for broad applications globally”, said Gerber.  “We're exploring applications in several other countries and for additional sustainable development goals.  By coupling this work with market-based incentives, this work offers to rapidly accelerate our ability to achieve sustainable development goals.”

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JOURNAL

Nature

DOI

10.1038/s41893-022-00871-2 

METHOD OF RESEARCH

Case study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

An investment strategy to address biodiversity loss from agricultural expansion

ARTICLE PUBLICATION DATE

14-Apr-2022

UNH research finds pandemic adversely impacts already stressed national forests

Peer-Reviewed Publication

UNIVERSITY OF NEW HAMPSHIRE

 

IMAGE: LONG TRAFFIC LINES WERE JUST ONE OF THE IMPACTS AND ISSUES UNH RESEARCH FOUND DURING THE PANDEMIC WHEN THERE WAS A SIGNIFICANT INCREASE IN THE NUMBER OF VISITORS TO NEW ENGLAND NATIONAL FORESTS. view more 

CREDIT: USFS

DURHAM, N.H.—Many human experiences were uniquely altered during the COVID-19 pandemic including a significant rise in the number of people seeking outdoor recreation options during quarantine. In a series of studies looking at this trend, researchers at the University of New Hampshire found a dramatic increase during the pandemic of visitors to the parks and protected areas of New England that resulted in significant social, situational and ecological impacts on people’s behavior, decision making and experience quality.

“At the height of the pandemic, in the summer of 2020, outdoor recreation visitation within New England national forests increased by more than 60%, or approximately two million visitors, a majority of which came from out of state,” said Michael Ferguson, assistant professor of recreation management and policy. “While it was great to see so many people rediscovering the outdoors and taking advantage of recreation opportunities, it also raised questions and concerns about these already overwhelmed natural resources.”

The extensive suite of research, which includes a study recently published in the journal Society and Natural Resources, assesses the status of the so-called outdoor renaissance at the peak of the pandemic by examining visitation increases and shifts in behavior and decision making at the White Mountain National Forest and the Green Mountain National Forest. While the pandemic fueled visitation issues, these national forests were already seeing significant problems as early as 2017, including social (crowding and conflict), situational (site access and litter) and ecological (snowpack and ticks). During the summer of 2020, resource managers at the White Mountain National Forest commissioned the researchers to take a closer look at these concerns. The results of this study, published in the Journal of Outdoor Recreation and Tourism, found never-before-seen visitation numbers resulting in even more pervasive recreation challenges including long traffic lines, lack of parking, trail congestion and unprecedented instances of overcrowding and discord.

However, researchers found for the most part, visitors were largely able to cope and deal with most of the situations they encountered, but the one factor that was consistently difficult for them to tolerate was visitor conflict. This included arguments or disagreements, mostly between in-state and out-of-state visitors, largely based on perceived violations of pandemic safety protocols like not wearing masks or honoring physical distancing.

“Our data and modeling suggest that approximately 10% of annual visitation, which represents nearly 400,000 visitors, noted they would likely never return for outdoor recreation because of the issues they experienced,” said Ferguson.

To validate these initial findings, the researchers took a deeper dive into the impact of the pandemic on outdoor recreation visitors, with a specific focus on historically marginalized populations. This paper, published in the Journal of Outdoor Recreation and Tourism, confirmed the huge surge in national forest visitation during the pandemic and explored the significant increase in adverse interactions. The researchers also found that historically marginalized populations stated unique hurdles. For instance, low income visitors reported significantly less substitution options as opposed to high income visitors and female visitors reported significantly higher instances of conflict during the pandemic.

“COVID-19 unleashed a phenomenon that we didn’t anticipate,” said Ferguson. “It really changed the outdoor recreation experience and the manner in which these resources and experiences must be managed.”

Researchers say more studies are needed to determine next steps but hope this extensive research will help pinpoint continued issues and improve the decision-making process for resource managers, elected officials and visitors. The study team also noted that many parks and protected areas across the country experienced similar issues and moved to managed access systems to combat increasing visitation. Researchers are hopeful that future studies will help determine the best solutions for the New England national forest system.

Funding for this research was provided by the USDA Forest Service.

The University of New Hampshire inspires innovation and transforms lives in our state, nation and world. More than 16,000 students from all 50 states and 71 countries engage with an award-winning faculty in top-ranked programs in business, engineering, law, health and human services, liberal arts and the sciences across more than 200 programs of study. A Carnegie Classification R1 institution, UNH partners with NASA, NOAA, NSF and NIH, and received $260 million in competitive external funding in FY21 to further explore and define the frontiers of land, sea and space.

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The link between transit use and early Covid cases

New study looks at the association of America’s mass transportation usage and case counts in opening months of the pandemic

Peer-Reviewed Publication

GEORGIA INSTITUTE OF TECHNOLOGY

 

IMAGE: GEORGIA TECH CO-AUTHORS MICHAEL THOMAS, JOHN TAYLOR, AND NEDA MOHAMMADI view more 

CREDIT: GEORGIA TECH

Researchers from Georgia Tech’s Colleges of Engineering and Computing have completed the first published study on the link between America’s mass transit use and Covid-19 cases at the beginning of the pandemic.

Using data from the Federal Highway Administration’s National Household Travel Survey, the team looked at the nation’s 52 largest metropolitan areas and each community’s likelihood of riding buses and trains. They then compared the numbers with the 838,000 confirmed Covid cases on the Johns Hopkins Center for Systems Science and Engineering's dashboard from Jan. 22 – May 1, 2020.

The timeframe covers the initial days, weeks, and months of the pandemic, before mask mandates were in place and prior to widespread social distancing. Ventilation on public transit had yet to be addressed, along with other public health measures that have since become the norm.

The study found that cities with high-usage public transportation systems displayed higher per capita Covid incidence. This was true when other factors, such as education, poverty levels, and household crowding, were accounted for. The association continued to be statistically significant even when the model was run without data from transit-friendly New York City.

The paper, “Investigating the association between mass transit adoption and COVID-19 infections in US metropolitan areas,” is published in the journal Science of the Total Environment. While the researchers don’t suggest that transit is the sole cause of the high incidence rates, they say it could have been an important factor early in the pandemic.

“This is what we expected, but we wanted to run the models to know for sure. Policymakers shouldn’t make decisions based on what they assume to be true,” said Michael Thomas, one of the study’s co-authors and a Ph.D. student in Georgia Tech’s School of Computational Science and Engineering. “This study is similar to dusting off a dinosaur dig site and finding a leg bone. This isn’t the entire dinosaur. There are many ways of making the argument about Covid spread, and transit is just part of it.”

The team got the idea of tracking transit and Covid cases after watching early reports from Wuhan, China, and reflecting on how differences in public transportation systems may factor into pandemic spread patterns. As assumptions were being made about how American cities should react based on ridership patterns on the other side of the globe, Professor John Taylor thought the pandemic shouldn’t be treated as a “one size fits all” situation.

“In the initial months of the pandemic, models were being developed here at home based on incidence rates in Wuhan. But, in terms of mass transit ridership behavior, China’s may be far different than what we see in American cities,” said Taylor, Frederick Law Olmsted Professor and associate chair for graduate programs and research innovation in the School of Civil and Environmental Engineering. “For instance, people in Chinese urban areas often stand in long, single file lines as they wait for trains and buses. We don’t. Different spread patterns can develop because of differences in mass transit behaviors.”

Taylor’s primary research focuses on the dynamics that can occur at the intersection of human and engineered networks, such as how people change electricity consumption behaviors and changing mobility patterns in natural disasters. Pandemics were on his research radar before Covid became a household name, as Taylor wanted to create better models to forecast the spread of illnesses. His first research effort in this direction was tracking the Ebola virus that reached Texas in 2014.

In the fall of 2019, Thomas was working as a biostatistician at the Georgia Department of Public Health when he spoke with Taylor about pursuing his Ph.D. Thomas submitted his application to Georgia Tech that November — just four months before Covid shut down America.

The two, along with study co-author and senior research engineer Neda Mohammadi, are now creating models to predict the spread of future illnesses among populations. They’re also looking to demonstrate how researchers can modify those models for better accuracy.

“If engineers and scientists can better understand the factors of community spread, policymakers can make faster, more accurate decisions to protect public health,” said Thomas. “In transportation, for example, it could lead to quicker decisions to restrict the number of people on buses. Or policies to stagger vehicle departure times more consistently. Studies like ours provide a basis for those decisions.”

Having more accurate models also takes varying human behavior into account, according to the researchers. Just as people in Wuhan wait for public transportation differently than those here in America, cities can differ from each other.

“Your pandemic is different than your neighbor’s,” said Mohammadi. “Pandemic spread isn’t the same from city to city, nor is ridership. Decision makers often look to other communities to see how they’re responding to shape their actions. That’s not always accurate. Models need to be customizable because populations don’t react uniformly. It’s our goal to improve decision making to be easier, faster, and more accurate for the next pandemic.”

CITATION: Thomas, M., Mohammadi, N., Taylor, J. Investigating the association between mass transit adoption and COVID-19 infections in US metropolitan areas. Science of the Total Environment Vol 811, 152284 (2022). https://doi.org/10.1016/j.scitotenv.2021.152284

This material is based upon work supported by the National Science Foundation (NSF) under Grant No. 1837021. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the NSF.

 

About Georgia Institute of Technology

The Georgia Institute of Technology, or Georgia Tech, is a top 10 public research university developing leaders who advance technology and improve the human condition. The Institute offers business, computing, design, engineering, liberal arts, and sciences degrees. Its nearly 40,000 students representing 50 states and 149 countries, study at the main campus in Atlanta, at campuses in France and China, and through distance and online learning. As a leading technological university, Georgia Tech is an engine of economic development for Georgia, the Southeast, and the nation, conducting more than $1 billion in research annually for government, industry, and society.

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JOURNAL

Science of The Total Environment

DOI

10.1016/j.scitotenv.2021.152284 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Investigating the association between mass transit adoption and COVID-19 infections in US metropolitan areas

Laser trailblazer: US Navy conducts historic test of new laser weapon system

Business Announcement

OFFICE OF NAVAL RESEARCH

 

IMAGE: THE LAYERED LASER DEFENSE WEAPON SHOOTS DOWN A DRONE DURING A FEBRUARY DEMONSTRATION AT THE U.S. ARMY’S HIGH ENERGY LASER SYSTEMS TEST FACILITY AT WHITE SANDS MISSILE RANGE IN NEW MEXICO. THE ONR-SPONSORED DEMONSTRATION MARKED THE FIRST TIME THE U.S. NAVY USED AN ALL-ELECTRIC, HIGH-ENERGY LASER WEAPON TO DEFEAT A TARGET REPRESENTING A SUBSONIC CRUISE MISSILE IN FLIGHT. view more 

CREDIT: (PHOTO COURTESY OF LOCKHEED MARTIN)

ARLINGTON, Va.—The ground-based laser system homed in on the red drone flying by, shooting a high-energy beam invisible to the naked eye. Suddenly, a fiery orange glow flared on the drone, smoke poured from its engine and a parachute opened as the craft tumbled downward, disabled by the laser beam.

The February demonstration marked the first time the U.S. Navy used an all-electric, high-energy laser weapon to defeat a target representing a subsonic cruise missile in flight.

Known as the Layered Laser Defense (LLD), the weapon was designed and built by Lockheed Martin to serve as a multi-domain, multi-platform demonstration system. It can counter unmanned aerial systems and fast-attack boats with a high-power laser—and also use its high-resolution telescope to track in-bound air threats, support combat identification and conduct battle damage assessment of engaged targets.

The drone shoot-down by the LLD was part of a recent test sponsored by the Office of Naval Research (ONR) at the U.S. Army’s High Energy Laser Systems Test Facility at White Sands Missile Range in New Mexico. The demonstration was a partnership between ONR, the Office of the Under Secretary of Defense (Research and Engineering) and Lockheed Martin.  

“Innovative laser systems like the LLD have the potential to redefine the future of naval combat operations,” said Chief of Naval Research Rear Adm. Lorin C. Selby. “They present transformational capabilities to the fleet, address diverse threats, and provide precision engagements with a deep magazine to complement existing defensive systems and enhance sustained lethality in high-intensity conflict.”

The LLD testing supports a broader effort by the naval research and development community, partnered closely with the fleet, to mature technologies and field a family of laser weapons that can address multiple threats using a range of escalating options. These capabilities range from non-lethal measures, such as optical “dazzling” and disabling of sensors, to destruction of a target.

Laser weapons provide new precision and speed of engagement for naval warfighters. They also offer simplified logistics that are safer for ships and their crews, as lasers are not dependent on the traditional propellants or gunpowder-based ordnance found on ships.  

Instead, modern high-power lasers run on electricity, making them inherently safer and able to provide weapon capability as long as a ship has power. This also means the cost per engagement for a laser weapon can be very low, since the only consumable item expended is fuel to run the system.

For years, the Department of Defense (DoD) and all the Services have recognized the promise of directed-energy weapons such as lasers, and continue to prioritize research. Recently, the Under Secretary of Defense for Research and Engineering, the Hon. Heidi Shyu, re-affirmed that directed energy is one of the DoD’s critical technology areas.

ONR plays an important role in developing technologies for laser weapons and has fielded demonstration systems for operational experimentation. Notably, in 2014 ONR saw the Laser Weapon System tested successfully aboard the USS Ponce in the Persian Gulf. More recently, ONR fielded the Laser Weapon System Demonstrator aboard the USS Portland in 2021.

Although there’s no plan to field the LLD, it offers a glimpse into the future of laser weapons. It is compact and powerful, yet more efficient than previous systems. It has specialized optics to observe a target and focus laser beams to maximum effect, while also incorporating artificial intelligence to improve tracking and targeting.

“LLD is an example of what a very advanced laser system can do to defeat significant threats to naval forces,” said David Kiel, a former Navy captain who is a program officer in ONR’s Aviation, Force Projection and Integrated Defense Department, which managed the testing. “And we have ongoing efforts, both at ONR and in other Navy programs, to keep building on these results in the near future.”

During the recent test at White Sands, the LLD tracked or shot down an array of targets—including unmanned fixed-wing aerial vehicles, quadcopters and high-speed drones representative of subsonic cruise missiles.

“We’re proud to say that the Layered Laser Defense system defeated a surrogate cruise missile threat in partnership with the Navy, White Sands Missile Range and Army High Energy Laser Systems Test Facility teams. Lockheed Martin drew best-in-class laser weapon subsystems from across the corporation, including key industry partner Rolls-Royce, to support the entire threat engagement timeline from target detection to defeat,” said Rick Cordaro, vice president, Lockheed Martin Advanced Product Solutions. “We leveraged more than 40 years of directed energy experience to create new capabilities that support the 21st century warfighter.”

Dr. Frank Peterkin, ONR’s directed energy portfolio manager, said, “The Navy performed similar tests during the 1980s but with chemical-based laser technologies that presented significant logistics barriers for fielding in an operational environment. And, ultimately, those types of lasers did not transition to the fleet or any other Service.

“Today, ONR coordinates closely with the Navy’s resourcing and acquisition communities to make sure we develop laser weapon technologies that make sense for the Navy’s requirements to defend the fleet and for operations in the rough maritime environment at sea,” Peterkin continued. “It’s a challenging problem, but Navy leadership at all levels see potential for laser weapons to really make a difference. The next few years are going to be very exciting as we work with the Navy and joint partners to make the capability we just saw demonstrated by the LLD a reality for the naval warfighter.”

 FOR PROFIT HEALTHCARE

Food insecurity doubled likelihood of foregoing or delaying medical care during first year of COVID-19 pandemic in U.S.

Survey conducted in December 2020 also found minorities and low-income individuals were at elevated risk of food insecurity

Peer-Reviewed Publication

JOHNS HOPKINS UNIVERSITY BLOOMBERG SCHOOL OF PUBLIC HEALTH

Individuals experiencing food insecurity—a household’s lack of consistent access to adequate food resources—in the U.S. during the first year of the pandemic were more than twice as likely to forego or delay medical care due to cost concerns compared to food-secure households, according to a survey led by researchers at the Johns Hopkins Bloomberg School of Public Health.

Conducted in December 2020, the survey also found that racial and ethnic minority groups and lower-income individuals were significantly more likely to face food insecurity compared to whites and higher-income individuals.

The findings were published online April 13 in the American Journal of Public Health.

For their study, the researchers conducted a nationally representative online survey of 8,481 adults aged 18 and older between December 15 and December 21, 2020. The researchers found that nearly one in five adults—18.8 percent—reported experiencing food insecurity at some point during the previous 30 days. Of those experiencing food insecurity, nearly 3 in 10 (27.4 percent) reported delaying or foregoing medical care in the last month.

In addition to delaying any medical care during the prior month, individuals with food insecurity were also two to three times more likely to have delayed or foregone specific types of care during the first nine months of the pandemic, including skipping a treatment or test recommended by a doctor, not going to a recommended follow-up visit, and not filling a prescription.

The link between food insecurity and foregoing medical treatment is well documented. This study is thought to be the first to investigate this relationship during the pandemic.

“We already know that people who struggle with maintaining a healthy diet are at higher risk of many health problems, including those that can make them more vulnerable to COVID-19,” says Jaclyn Bertoldo, MPH, RDN, the lead author of the study and a Bloomberg American Health Fellow and DrPH student at the Bloomberg School. “Delaying or postponing care could compound the risk of COVID-19 complications and contribute to widening health disparities in the pandemic and well after it ends.”  

The researchers also found that food insecurity disproportionately affected racial and ethnic minority groups and low-income people. Non-Hispanic Blacks were nearly two times as likely as whites to face food insecurity, and Hispanics more than one and a half times as likely as whites. People who had lost a job or more than half of their income due to the pandemic were three and a half times more likely to experience food insecurity.  

“Individuals experiencing food insecurity often make difficult tradeoffs between food and other basic needs, including health care,” says Julia Wolfson, PhD, co-lead author of the study and an assistant professor in the Department of International Health at the Bloomberg School. “Policies to help offset the cost of food, such as Supplemental Nutrition Assistance Benefits, or food stamps, are critical to provide food insecure households with needed money.”

The authors note that tying SNAP benefits to inflation and more frequently adjusting benefit levels is important to help low-income families afford the true cost of food. They also add that continuing to expand access to Medicaid and working toward more affordable health insurance and prescription drug prices can also help low-income families avoid needing to choose between health care and food.   

This survey was part of the National Pandemic Pulse project, a series of comprehensive surveys led by researchers at the Johns Hopkins University. Begun in September 2020, the series’ surveys measure disparities and inequities in the experience and impact of the COVID-19 pandemic.

“Food insecurity and delayed or foregone medical care during the COVID-19 pandemic” was written by Jaclyn Bertoldo, Julia A. Wolfson, Samantha M. Sundermeir, Jeffrey Edwards, Dustin Gibson, Smisha Agarwal, and Alain Labrique.

The study was funded by the Johnson & Johnson Foundation through the National Pandemic Pulse project.

# # #

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JOURNAL

American Journal of Public Health

ARTICLE TITLE

Food insecurity and delayed or foregone medical care during the COVID-19 pandemic

ARTICLE PUBLICATION DATE

13-Apr-2022

Investigating the connections between medicaid and cancer survival

University of Colorado Cancer Center Deputy Director Cathy Bradley, PhD, recently published two papers on Medicaid-related research

Peer-Reviewed Publication

UNIVERSITY OF COLORADO ANSCHUTZ MEDICAL CAMPUS

At first blush, the numbers aren’t great: Cancer patients who are covered by Medicaid tend to have later-stage disease and higher rates of mortality.

But when Cathy Bradley, PhD, deputy director of the University of Colorado (CU) Cancer Center, started digging into the data a little deeper, she found some of the reasons for the dire statistics. Many people with cancer enroll in Medicaid only after they are diagnosed, suggesting they may have been uninsured prior to diagnosis and had limited access to cancer screening and treatment.

“What some researchers have done in the past is looked at Medicaid and observed that people who are insured by Medicaid and diagnosed with cancer have late-stage disease and greater mortality rates,” she says. “What I was able to show is that Medicaid is actually picking up people who were otherwise uninsured or underinsured. They get diagnosed with cancer, and enroll in Medicaid afterward. By then, they have late-stage cancer because they most likely did not have health insurance that would have given them access to screening and treatment prior to cancer diagnosis.”

In recent research published in the journal Cancer Epidemiology, Biomarkers & Prevention, Bradley also shows that cancer patients who were insured by Medicaid prior to diagnosis do about as well as people with private insurance.

“Ultimately, the message is that having continuous coverage in order to be able to get access to screening and care prevents late-stage disease and high mortality,” she says.

Insurance trumps income

Using data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results Cancer Registry, linked with Medicaid enrollment data, Bradley looked at the association between Medicaid enrollment and distant stage for three screening-amenable cancers: breast, cervical, and colorectal. In addition to her general findings about the importance of continuous insurance coverage, she looked specifically at the National Breast and Cervical Cancer Early Detection Program, a Centers for Disease Control initiative that offers free breast and cervical cancer screening to uninsured or underinsured low-income women who were not low-income enough to qualify for Medicaid initially.

“If cancer is found, these women are enrolled in their state Medicaid program, but Medicaid may only cover their cancer-related treatment rather than full coverage,” Bradley says. “Providers may also be reimbursed at a lower rate than regular Medicaid. What I was able to show is the breast and cervical cancer screening program — which has saved thousands of lives — is inferior to having continuous insurance coverage. Because these women, even though they were slightly higher income, it wasn't the income that made a difference. It was the health insurance.”

Call for coverage

Not surprisingly, Bradley’s paper concludes with a call for more insurance options for those with lower incomes. The Affordable Care Act, which went into effect in 2014, expanded Medicaid eligibility, but many states opted not to expand, setting their income thresholds much lower than the federal guidelines allow.

“Medicaid has gotten an undeserved bad rap. I’m certain Medicaid would rather have patients prior to diagnosis or early stage and take care of them rather than spend a whole lot of money and have them die,” Bradley says. “Even though states that expanded Medicaid greatly reduced the number of uninsured people, there are still over 12 million uninsured people who do not qualify for Medicaid and still don’t have health insurance. And those are the ones most vulnerable to late-stage diagnosis.”

The HIV-cancer connection

An economist by training, Bradley has a longtime interest in insurance and Medicaid and how they affect those diagnosed with cancer. In “An ounce of prevention: Medicaid's role in reducing the burden of cancer in men with HIV,” a recent editorial in the journal Cancer, she explains how people living with HIV have a greater incident of some cancers. Thanks to new treatments, many of these people are expected to live long-term and will require treatment for cancer, she says, and because many of them are also insured by Medicaid, new approaches to public health practice and policy are needed.

“Cancer drugs can be super-expensive, and we've got to think about this complex care of providing for people with both conditions, when 20-30 years ago, you would have died from either of them,” she says. “Now both become chronic, and the cost of the drugs for both conditions is very expensive.”

To avoid these costs, she says, greater emphasis on prevention through HPV vaccination and screening is needed. Measures to control drug costs will also be needed as the population grows.

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JOURNAL

Cancer Epidemiology Biomarkers & Prevention

DOI

10.1158/1055-9965.EPI-21-1077