Graduation Year

2024

Document Type

Dissertation

Degree

Ph.D.

Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

Civil and Environmental Engineering

Major Professor

James Mihelcic, Ph.D.

Co-Major Professor

Qiong Zhang, Ph.D.

Committee Member

Amy Stuart, Ph.D.

Committee Member

Margrit von Braun, Ph.D.

Committee Member

Rebecca Zarger, Ph.D.

Keywords

Equity, Heavy Metals, Household Air Pollution, WASH, System Dynamics

Abstract

Environmental health inequities such as household air pollution, inadequate water, sanitation, and hygiene, and chemical pollution persist globally and have myriad consequences on individual and societal well-being. Unfortunately, while billions of dollars and countless hours of research have been applied towards addressing these issues in development, humanitarian, and environmental justice contexts, attempts to reduce the environmental burden of disease can seem successful at first, but then backslide to pre-intervention conditions (or worse). This is indicative of policy resistance, a tendency of complex systems that makes it very difficult to enact change if the “rules” of the system are misunderstood. There is a need and an opportunity to critique the dominant paradigms in global environmental health praxis, including how they affect decision-making and collective learning. Even as institutions increasingly recognize the theoretical potential of systems thinking in global environmental health, there are limited examples of transformative applications. This dissertation includes three case studies, each focusing on a different environmental health risk and geographic location. The case studies helped to answer the following overarching research questions: (1) How can systems thinking approaches be applied in different contexts to advance global environmental health? and (2) How do such approaches differ from dominant approaches in global environmental health praxis? System dynamics, a modeling methodology rooted in the systems thinking paradigm, was applied in each study at a different intervention stage. The first case study (Chapter 3) looked back at an intervention in Ghana which aimed to help rural households transition from solid cooking fuels to liquefied petroleum gas but failed to achieve sustained adoption and use. The second case study (Chapter 4) explored potential interventions for improving rural sanitation in Uganda, especially strategies that can sustain improvements without continuous external support. In the final case study (Chapter 5), a complexity-aware monitoring procedure was developed to support adaptive management of an intervention targeting heavy metal pollution in the Kyrgyz Republic. These applications support evidence that systems thinking can be applied to diverse environmental health challenges in different settings. The research also demonstrates that systems thinking encourages an endogenous focus. This means that problems are seen to arise from interrelationships of important variables, rather than the endpoint effect of some array or chain of causes. An endogenous focus also highlights another important systems thinking principle – systems tend to be resilient. This means that shocks or perturbations (i.e., interventions) may disrupt a system momentarily, but if its endogenous structure remains the same, the system will recover and return to its original state. While creating computer simulation models, it was found that model development supports learning by formalizing and iteratively updating mental models. Furthermore, virtual simulation experiments lead to safe and cost-effective learning. The dissertation concludes with the following recommendation for global environmental health researchers and practitioners: systems thinking and system dynamics modeling can be used as a constant companion to intervention design, implementation, and evaluation, especially as a tool for engaging and learning with affected communities.

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