Jeannette Ickovics, PhD

Climate and Urban Health: I direct the Program on Climate Change and Urban Health within the Yale Center on Climate Change and Health. Our flagship project is the Urban Pulse initiative, dedicated to putting health and equity at the heart of climate action. Urban Pulse is a transdisciplinary collaboration between Yale University and the Resilient Cities Network: a network of 100 cities in low-, middle-, and high-income countries. Our partnership generates actionable knowledge to build urban climate and health resilience, foster civic and institutional engagement, and support evidence-based policies and programs – increasing the capacity of city systems and urban dwellers to thrive. We are a transdisciplinary team working to identify urban health and climate priorities, discerning solutions specific to city-level resources and solutions for global scale-up. In 2024, we conducted a global survey and stakeholder interviews with nearly 200 city leaders from 118 cities across 52 countries, providing a comprehensive overview of the current landscape, successful interventions, and actionable recommendations for cities, stakeholders, and funders regarding climate change and health. The survey utilized the framework established by the 2023 Lancet Countdown report, emphasizing the critical need for a health-centered response to climate change, including health hazards, adaptation and planning, mitigation actions, economics and finance, and public/political engagement. In this report, we underscore the urgency for action and highlight innovative solutions, providing a roadmap for cities to enhance resilience, safeguard public health, and promote social equity. A new collaboration is underway with the Resilient Cities Network, Mode Economics, and the Sustainable Markets Initiative’s Health Systems Task Force, providing an economic analysis of climate and health prevention interventions to support urban evidence-based policymaking.

Innovations in Prenatal Care: More than 3.5 million women give birth annually in the US. Rates of preterm birth and low birth weight have been intransigent for more than three decades. These are leading causes of infant morbidity and mortality, cost >$30 billion annually, and represent extreme racial/ethnic health disparities. We developed and tested an innovative model of group prenatal care to standard individual care, and found women randomized to group prenatal care had a 33% lower rate of preterm delivery overall, and a 41% lower rate of preterm delivery for African American women. Moreover, we found that all perinatal and postpartum outcomes were as good or better for women randomized to group care compared to those randomized to traditional individual care (e.g., delivery complications, breastfeeding, psychosocial outcomes, repeat pregnancy, incident postpartum STDs). A second cluster RCT (14 New York City community hospitals and health centers) found that group prenatal care reduced risk for small for gestational age infants and depressive symptoms (which in turn were associated with preterm birth). I was the principal investigator on these two multi-site NIH-funded randomized controlled trials (R01MH/HD61175, R01MH074399). Based on successful outcomes, United Health Foundation funded a dissemination study of group prenatal care in Detroit MI and Nashville TN with an eye toward national scale-up. Group prenatal care is currently being utilized in more than 500 clinical sites in the US and globally. This work has been recognized as “innovative” as part of the Harvard Health Acceleration Challenge. It was featured in a special section of the New England Journal of Medicine (2024) on evidence-based approaches to reduce health disparities.

Other research in maternal and child health: Prior to these randomized interventions, I was PI and co-PI on numerous longitudinal studies of teens and young women to identify factors that influence behavioral and biological outcomes associated with HIV and STD risk. These studies were among the very first focused on women at risk for HIV, impact of testing, and then subsequently on pregnant women and preventing maternal to child transmission. Additional research demonstrated psychosocial factors impacted HIV progression (i.e., viral load, CD4 count). This research has expanded to address social determinants of maternal and child health outcomes, including maternity care deserts.

Community Health Needs Assessments: Driven by unprecedented growth in obesity, chronic diseases such as diabetes, heart disease, stroke and cancer account for 7 of 10 deaths in the US annually. I have made significant contributions to public health’s understanding of the influence of the social and environmental factors that contribute to poor health outcomes. My team received numerous foundation grants related to this topic, leading community-based interventions that change environments and more fully involve community members to ensure sustainable reductions in obesity (e.g., Kresge, Aetna, Donaghue Foundations). We worked directly with New Haven neighborhoods to form local partnerships, empower residents, identify challenges, and provide resources to promote wellness through action. Triennially (beginning in 2009) we conducted community-stratified, population-level health surveys across Connecticut. In addition, we conducted collaborative interventions to improve community/population health.

School-based Obesity Prevention: I was Principal Investigator (MPI with Dr. Marlene Schwartz) on an NIH-funded cluster randomized controlled obesity prevention trial at 12 middle schools in collaboration with the Rudd Center and the New Haven Public Schools (1R01 HD070740). Health for Achievement was a 5-year study that examined the impact of school-based policies on risk factors and outcomes related to obesity, chronic disease and academic achievement. With data from students at 12 participating schools, we developed and/or implemented interventions to enhance student health. We conducted research with >1,800 middle school students regarding their physical health, health behaviors, school and neighborhood environments. Results of this research have been disseminated locally and nationally, aiming to educate our communities and encourage better health for all students.