By: Christina Hernandez Sherwood
Eugenia (Gina) South, MD, MS, and Atheendar Venkataramani, MD, PhD, first met over two decades ago as students at Washington University School of Medicine in St. Louis. Years later, they ran into each other in Blockley Hall at Penn and realized they had become colleagues. More than that, they shared a commitment as researchers and advocates for public policy that looked at the underlying reasons why people were healthy, or not, due to social determinants of health.
And, soon, they would combine their strengths in an ambitious research study together.
South and Venkataramani had separately followed each other’s research careers with admiration. South, an emergency medicine physician who is now associate vice president and executive director of the Center for Health Justice at Penn Medicine, led research that examined environmental and place-based factors related to health—often along the lines of historical racial segregation. She and her colleagues made key findings about the impacts of greening vacant lots on reducing crime, improving mental health, and more. Health economist Venkataramani, meanwhile, led influential research linking proximity to automotive plant closures with the risk of opioid overdose deaths, for example, Venkataramani has also studied associations between economic opportunity, health behaviors, and mortality across different counties in the U.S.
“Gina’s research has been successful in tackling what we tend to think of as big, intractable problems—systemic discrimination, crime—because of her incredible imagination,” said Venkataramani, an associate professor in the Department of Medical Ethics and Health Policy at the Perelman School of Medicine. “She had that in medical school.”
When the NIH Common Fund sought “transformative” research projects to address health disparities and advance health equity, South and Venkataramani teamed up to secure a nearly $10 million grant to study whether certain environmental and financial interventions in specific Philadelphia neighborhoods could move the needle on Black health disparities. Their trial, which began in late 2021 and is known as IGNITE, involves a suite of environmental initiatives paired with economic assistance for half of the 571 enrolled households.
“We had to do something with the environment and economics,” South said, “with this idea of getting concentrated investment in small geographic areas to disrupt the links between structural racism and poor health.”
A trial designed to address environmental and economic health in Philadelphia neighborhoods
The IGNITE study’s environmental interventions that involve greening vacant lots are a nod to South’s past research.
The trial’s research-backed environmental interventions are greening more than 60 vacant lots, a nod to South’s research on how these spaces impact crime, mental health, acute stress, and prenatal health; remediating more than a dozen abandoned homes, which South and other colleagues had found reduces gun violence; planting hundreds of trees, which could be protective against gun violence; and instituting weekly cleanups for all the trash that accumulates in neighborhoods outside of the cans picked up by the sanitation department.
Venkataramani, who directs the Opportunity for Health Lab at the Perelman School of Medicine, focuses his research on how people’s economic opportunities, such as tax policies and work loss, shape their own perception of their health, the choices they make for their health, and, ultimately, their health outcomes. “If people have [economic] opportunities, something like quitting smoking becomes more attractive because you want to be healthy to take advantage of your opportunities,” he said.
Venkataramani and George Dalembert, MD, MSHP, an assistant professor of Clinical Pediatrics at the Perelman School of Medicine and an attending physician in the Division of General Pediatrics at Children’s Hospital of Philadelphia, worked together to devise the trial’s economic interventions. Based on a Federal Reserve study that found about one-third of Americans lack the cash to cover a $400 emergency expense, each household enrolled in the trial received a one-time cash grant in that amount. To support long-term economic security, each household was also offered free financial counseling services.
And, to reduce barriers to public benefits, such as tax credits and food assistance, each household was connected with organizations that could help. “Take-up [of these benefits] is incomplete because you have to jump through a lot of hoops,” Venkataramani said. “For folks who are doing a lot in life, working really hard, taking care of children or older adults, and generally just dealing with a variety of stressors, it’s hard to do all that.”
Evan Spencer, a project manager on IGNITE, said the effort is reaching people where they are, instead of putting the onus on them to access the resources they need to thrive. “I felt it was monumental,” she said. “I really wanted to be a part of that.”
A West Philadelphia native, Spencer said the research-backed interventions are locally meaningful. “Some people can’t afford to even get their taxes done because most places charge a fee,” she said. “And I remember myself having a few [abandoned homes] in my neighborhood growing up, and my parents always telling me to stay away from them.”
The rare research study with federal funding to dismantle impacts of racism
Throughout the 18-month intervention period, the IGNITE team is collecting data on participants’ health and well-being, as well as local crime. Qualitative interviews with participants began in June 2024, with more follow-up data collection getting underway in September. The team hopes to find that the environmental and economic interventions improve health on individual, household, and community levels.
Large-scale federal funding for studies of this type that specifically aim to dismantle the impacts of racism are rare, so South and Venkataramani are eager to learn as much as possible through this rigorous trial and move the needle on strategies proven to work.
“This is the way forward if we’re going to innovate,” Venkataramani said.
But while the results of rigorous research from studies like IGNITE can—and, the researchers hope, will—make a difference in influencing government policy, Penn Medicine is already investing in institutional-level action based on South’s prior research. The initiative partners with local communities on greening, grantmaking, and capacity building to grow healthier neighborhoods.
Often, South noted, when academic researchers do community-based studies, there isn’t a strong foundation of trust or a lasting relationship. “It’s more extractive,” she said, and researchers leave when the study is over. “Although we don’t always get it right, we are trying intentionally to do things differently.”
Explore related stories about health justice at Penn Medicine
Health, greenery, and justice for all: Reversing racial inequities is a full-force effort rooted in research that includes gardens and parks, financial support, and lifting up local community members to lead the way.
‘We are all Deeply Rooted’: Bringing health justice to action, Deeply Rooted is a community partnership that plants trees, greens vacant lots, and funds grassroots programs.
From the neighborhood: For the Center for Health Justice, hiring people with deep roots of their own in West Philadelphia is key to partnering effectively to support healthier communities.