From Health to Water: The Power of Context

This opinion article was written by Human Environmental Analyst Dr. Penelope Mitchell

I’m a human-environmental analyst for GWSC with a background in human and health geography. At GWSC I specialize in unpacking complex water problems at a strategic level, mostly in the Middle East and South America, digging into issues like water supply, transboundary river sharing, licit and illicit agriculture, and energy problems.

Prior to joining GWSC, however, I worked in a completely different problem space that wasn’t much related to water at all. Recently, a Journal of Maps collection on mapping health that I contributed to was released, so I thought I’d take the opportunity to give a shout out to that collection—and to editors Marynia Kolak, Michael Desjardins, and Yanjia Cao for making it happen!

I also wanted to share how I made the jump from researching the opioid epidemic, a complex health problem, during my doctoral work to exploring strategic water security challenges as a career.  As it turns out, these two seemingly different fields actually rely on a surprisingly similar way of thinking.

Crunching Numbers, Finding Meaning

At GWSC, we explore how changing environmental conditions could lead to instability in key sectors through many different pathways. And this work always starts with numbers. But these numbers seldom mean the same thing across space. It’s the marriage of quantitative information with context that most often brings about key insights and surprising results.

Likewise, in my PhD research I started with numbers. I kept reading about shortages of opioid addiction treatment providers, and as opioid overdoses climbed it seemed logical that improving spatial accessibility to treatment could reduce overdose rates. On that notion, I focused on measuring spatial accessibility to treatment across the country, then I explored those accessibility results by race, ethnicity, and rurality, as highlighted in the Journal of Maps article linked above. I found something unexpected.

As you might expect, urban areas had much better access to treatment compared to the treatment deserts out in rural communities. But here’s what stood out to me: Even though most urban treatment facilities were located in minority neighborhoods, overdose rates among minority populations were still going up.

Synthesizing quantitative accessibility data alongside contextual literature helped me realize that access to providers wasn’t necessarily the main barrier in these urban areas. Instead, deeper issues—structural, political, physical, and social factors—seemed to play a bigger role in whether people were willing and able to seek, try and stick with treatment. Meanwhile, in rural areas, the challenge looks quite different—there, physical distance and the scarcity of nearby providers emerged as a substantial barrier to care.

Water in Context

In the water issues we explore at GWSC, adding context to the numbers sheds light on sometimes obscured leverage points. We like to say we do our fair share of myth busting.

A great example of this in the water world comes from a product we put together about the Panama Canal in 2024 following a severe El Niño drought that was constraining Canal crossings. News articles and Canal Authority statements framed the situation as an unprecedented drought driving record-low reservoir levels.

But after digging into the system context, we found something more nuanced. Conditions were certainly dry in Panama, but not outside of the historic record. Rather, the biggest factor behind the reservoir decline wasn’t the drought itself—it was management. And ship transits by far accounted for the largest withdrawal from the watershed.

Because the canal is a major economic contributor to Panama’s GDP, the Canal Authority is continually looking to increase its transits; in fact, 2023 marked the third-highest tonnage year on record. The takeaway from this situation wasn’t that Panama faced its worst drought ever, or that changing environmental conditions caused the traffic jam—it was that humans struggle to plan for and adapt to the natural variability of the water cycle.

For more details on this story—including why the Panama Canal uses so much freshwater—check out this New Security Beat article.

Lessons Across Problem Spaces

Whether it’s a health problem, a water problem, or something entirely different, the pattern is the same—numbers give us a starting point, but context provides meaning. It’s only by pairing data with an understanding of systems and people that we start to see the real leverage points for change. That’s the mindset I’ve carried from my doctoral research into every water problem I work on today.