Research
Environmental epidemiologists have long documented that air pollution worsens asthma, and that climate change compounds those harms. But a subtler question has emerged: does living in a polluted or socially disadvantaged environment also affect whether asthma treatments work?
My research interests sit at the intersection of environmental science, pharmacoepidemiology, and health equity — asking not just who gets sick, but who gets better, and why that differs.
Climate × Medication × Vulnerable Populations
Climate-Drug Interactions in Medicaid Populations
At Rutgers, I examine how climate exposures — extreme heat, wildfire smoke, PM 2.5 — interact synergistically with medication use to produce adverse outcomes in vulnerable populations. Using national Medicaid data linked to gridded climate exposures at the ZIP code level, this work generates real-world evidence to inform clinical and policy decisions for populations disproportionately burdened by climate change.
Environmental Epidemiology × Clinical Effectiveness
Environmental Modification of Treatment Response
The standard assumption in clinical trials is that treatment effects are uniform across the enrolled population. My work challenges this by testing whether ambient air pollution — PM₂₅, NO₂, and ozone — modifies the efficacy of pharmacological therapies for asthma, including corticosteroids and biologic agents.
I apply effect modification methods to data from landmark asthma clinical trials (STICS, BARD). The question is not only whether a drug works on average, but for whom — and whether the environment a patient lives in is part of that answer.
Social Determinants × Pharmacological Efficacy
Comparative Effectiveness × Real-World Evidence
Comparative Effectiveness Using Electronic Health Records
Using EHR data from large health systems and target trial emulation methods, I evaluate real-world treatment effectiveness for asthma — including monoclonal antibody therapies. This work examines who benefits, who is missing from the evidence base, and how structural factors like healthcare access shape treatment outcomes in practice.
For a complete publication record, see the Publications page.
Social Stress and Treatment Response
Social stressors — neighborhood disadvantage, residential instability, community violence — shape immune function and the inflammatory pathways that asthma therapies target. My research examines whether these exposures act as treatment effect modifiers, altering patient responses to both inhaled corticosteroids and biologic agents.
This extends the traditional environmental health focus on “who gets exposed” to ask “who benefits from treatment” — a question with direct implications for health equity in clinical practice.