Bhargav Krishna, DrPH ’21, hopes to build public support for improving the country’s ‘really terrible’ air, which puts millions—including his wife—at risk for health problems
May 6, 2021 – For Bhargav Krishna, the fact that Delhi has some of the worst air quality of anywhere on the planet is reason enough to fight air pollution.
But there’s more. About six years ago, his wife Sagri was diagnosed with asthma at age 28. Her doctor speculated at the time that air pollution exposure from early childhood onwards may have been a potential cause.
Krishna, who will earn his doctor of public health (DrPH) degree from Harvard T.H. Chan School of Public Health in May, has tackled air pollution issues in India since 2014 through his work at the Public Health Foundation of India (PHFI), which aims to strengthen public health training, research, and policy development in India. He said the DrPH program has provided him with skills in conducting research and in how best to translate that research for groups such as policymakers, the media, and the general public.
Convincing these various stakeholders of the importance of curbing air pollution is no easy feat in India, a developing nation that is heavily reliant on industrial expansion and on power sources like coal that contribute significantly to fine particulate pollution. Over the past several years, in spite of mounting evidence of the health dangers of air pollution, there’s been considerable pushback on the veracity of the data, and attempts to shift blame, from politicians, Krishna noted. “Air pollution is a really inconvenient problem when you’re trying to bring hundreds of millions out of poverty rapidly,” he said wryly.
The facts about pollution in India are alarming. Many more people died prematurely from air pollution in India than from COVID-19 over the past year, Krishna noted. Average annual exposure to fine particulate air pollution (PM2.5)—tiny particles that work their way into the lungs and bloodstream and can worsen asthma, decrease lung function, and be particularly harmful to people with heart or lung diseases, children, and older adults—is 15 times higher in India than limits recommended by the World Health Organization, and seasonal exposure can sometimes surge 50 times higher.
And yet, in Delhi, people tend to notice air pollution only in the winter, Krishna said, “when it gets so bad that you can barely see 100 feet in front of you.” The pollution is pernicious, he said, because “most of the time, you can’t see it. But during most days when you think that the air quality is quite good it’s still really terrible in most parts of Delhi.”
Watching his wife struggle to breathe has been a strong motivating factor in Krishna’s career. He said that when the air is really bad in Delhi—which is almost all of winter, and a big chunk of the spring and summer—Sagri wears an N95 mask when she goes outside, needs to use an inhaler, and at home the couple uses air purifiers.
Krishna knows that he and Sagri are, in a sense, lucky. Most people in India don’t have access to expensive air purifiers and high-grade masks, and socioeconomic disparities mean that certain groups bear a disproportionate burden from pollution, he said. Krishna co-authored a December 2020 article in The Wire Science, a publication in India, that described how policies, especially those relating to housing or urban planning, often leave marginalized communities living near pollution hotspots, where they’re exposed to more air pollution and suffer more pollution-related illnesses.
Path to public health
Krishna wound up in public health somewhat by accident. After earning degrees in biotechnology and environmental sciences, he found work at a management consulting firm. His first client was a large coal mining company. The work was interesting, he said, but he began to ask himself, “How am I really helping anybody’s life improve as a result of doing this work? It’s like I’m actively making the world a worse place by contributing to these people making more money.’”
He left that job to take a six-month unpaid internship in New York with UN-Habitat, the United Nations’ cities program, where he wrote briefing notes and position papers outlining the vision for sustainable cities, as part of the UN’s Sustainable Development Goals. Back in India after the internship ended, he wandered into a bookshop one day and struck up a conversation with a man there. They spoke about Krishna’s work. The man turned out to be K. Srinath Reddy, adjunct professor of epidemiology at Harvard Chan School and president of PHFI. After that conversation and a brief interview, Reddy hired him.
Reddy knew that Krishna hadn’t previously worked in public health, but recognized his interest in sustainable development and air pollution, both areas of focus for PHFI. He told Krishna that public health is a discipline where everybody is welcome. “So that’s how I ended up in the field,” Krishna recalled.
The chance meeting in the bookstore also led to Krishna meeting his wife—she was a colleague at PHFI.
In his more than seven years at PHFI, Krishna has had a hand in research, strategic planning, policy, and advocacy on projects on air pollution, chemical exposures, and sustainable development. Krishna also serves as a director and board member of a nonprofit he co-founded called Care for Air, which focuses on raising awareness of air pollution and its impacts on health in India.
In 2015, Krishna helped win a National Institutes of Health grant that established a partnership between PHFI and Harvard Chan School’s Department of Environmental Health to help build research and training capacity among public health professionals focused on air pollution in India. In 2017, thanks to the funding from the grant, Krishna came to Harvard Chan School as a visiting scientist, working on other grant proposals on air pollution in India and taking courses in research and policy. While at the School, he learned about the DrPH program and decided that it would help him build his skills even further and hopefully provide him with tools to better facilitate policy change regarding air pollution in India, with its myriad stakeholders and competing needs.
During his time at Harvard Chan School, Krishna—who was both a Julio Frenk Fellow and a Prajna Leadership Fellow—has conducted research on the links between air pollution and health issues in India. An August 2020 paper co-authored by Krishna and colleagues, including Reddy and Joel Schwartz, professor of environmental epidemiology and , found an association between high levels of ambient air pollution and high blood pressure in Delhi. Krishna and colleagues are also that looks at the link between short-term exposure to PM2.5 pollution and early death in Delhi. Such evidence is sorely needed to help build public support for rapid and substantial decreases in air pollution, he said.
In spite of the uphill battle he faces to improve air quality in India, Krishna has no plans to back off. “We’ve barely scratched the surface of such work,” he said. “And given the wide disparities among socioeconomic, caste, and other strata when it comes to exposures to environmental pollutants and their associated health outcomes, it’s vital that as many of us as possible continue to work in this space in the coming years.”
Photo courtesy Bhargav Krishna