Modernization and Emerging Infectious Diseases: The Case of Avian Influenza in Vietnam: Archived Project


East-West Center researchers investigated poultry markets in Vietnam as part of a study on how disease risks and perceptions of risk change in a modernizing society.


The East-West Center recently completed a project that explored whether risks and perceptions of risk associated with highly pathogenic avian influenza (HPAI)—caused by the H5N1 virus—are associated with transitions that occur as societies evolve from one state of development to another. The project explored this question in Vietnam, based on a "lived-place-based" unit of analysis. This is a novel way of looking at HPAI and similar health risks, suggesting that these risks are not an accident of time and place, but rather are linked to processes of modernization.

This research was designed to help develop basic principles and methods for understanding the mechanisms that underlie the emergence of new and reemerging infectious diseases, involving complex interactions within and among natural and human systems. The goal was to add to the fundamental knowledge base of several interdisciplinary fields—including geography, ecology, systems theory, environmental science, and risk perception—and to enhance the capabilities of researchers, practitioners, and policymakers at local, national, and regional levels.

The project brought together a multidisciplinary team of specialists from the East-West Center, the University of Hawaii at Manoa, and the Hanoi University of Agriculture in Vietnam. It also included graduate students in ecology, conservation, and pathogen biology working under an Integrative Graduate Education and Research Traineeship (IGERT) funded by the National Science Foundation (NSF).

This work provided an important first step toward building local capacity to study a critical health problem in a developing-world context. Since the project was conducted in conjunction with the end users of the information produced (researchers, policymakers, and poultry owners), the communication of research findings needed to be rapid and meaningful. Information-dissemination resources of the East-West Center were used extensively to inform larger audiences of the outcomes.

In January 2017, the East-West Center published an AsiaPacific Issues paper summarizing results from this project.

The questionnaire used for the survey is available in English and in Vietnamese.

Collaborating scholars

The project was conducted by a multidisciplinary team of scholars with strong records in research, application, and management in urban planning, land-use and land-cover change, biosecurity and waste management, perceptions of risk and environmental change, ecology, remote sensing and geographical data analysis, statistical analysis, and modeling. The team included:

  • Jefferson Fox (Principal Investigator), Senior Fellow, East-West Center
  • Melissa Finucane (Co-Principal Investigator), Senior Fellow, East-West Center
  • Sumeet Saksena (Co-Principal Investogator), Senior Fellow, East-West Center
  • Jim Spencer (Co-Principal Investigator), Associate Professor, Urban and Regional Planning, and Director, Globalization Research Center, University of Hawaii Manoa
  • Tran Duc Vien (Co-Principal Investigator), Rector Hanoi University of Agriculture
  • Bruce Wilcox (Co-Principal Investigator), Professor, Department of Tropical Medicine, Medical Microbiology, and Pharmacology, University of Hawaii Manoa
  • Dr. Michael Epprecht (Senior Personnel), Research Scientist, Swiss National Center of Competence in Research
  • Nguyen Thi Lan, Lecturer, Hanoi University of Agriculture
  • Ian Pagano, Biostatistician, Cancer Research Center, University of Hawaii Manoa
  • Nancy Davis Lewis, Director, Research Program, East-West Center

Scientists and students from the East-West Center, the University of Hawaii, and Hanoi University of Agriculture participated in the project. More than 10 staff members, including research scientists and graduate students, were trained in data collection and analysis methods.

Related publications


Spencer, James H., Melissa L. Finucane, Jefferson M. Fox, Sumeet Saksena, Nargis Sultana (2020). Emerging infectious disease, the household built environment characteristics, and urban planning: Evidence on avian influenza in Vietnam. Landscape and Urban Planning. 193 (January 2020).


Finucane, Melissa L., Nghiem Tuyen, Sumeet Saksena, James H. Spencer, Jefferson M. Fox, Nguyen Lam, Trinh Dinh Thau, Tran Duc Vien, and Nancy Davis Lewis (2017). Perceived risk of avian Influenza and urbanization in northern Vietnam: Results from a household survey. EcoHealth. 14(1): 144-54.

Saksena, Sumeet, Nong Huu Duong, Melissa Finucane, James H. Spencer, Chinh C. Tran, and Jefferson Fox (2017). Does unplanned urbanization pose a disease risk in Asia? The case of avian influenza in Vietnam. AsiaPacific Issues No. 128. Honolulu: East-West Center.


Tran, Chinh C., John F. Yanagida, Sumeet Saksena, and Jefferson Fox (2016). An alternate vaccination approach for the prevention of highly pathogenic avian influenza subtype H5N1 in the Red River delta, Vietnam—a geospatial-based cost-effectiveness analysis. Veterinary Sciences. 3(1): 6–20.


Nong, Duong H., Jefferson Fox, Tomoaki Miura, and Sumeet Saksena (2015). Built-up area change analysis in Hanoi using support vector machine classification of Landsat multi-temporal image stacks and population data. Land. 4(4): 1213–31.

Saksena, Sumeet, Jefferson Fox, Michael Epprecht, Chinh C. Tran, Duong H. Nong, James H. Spencer, Lam Nguyen, Melissa L. Finucane, Vien D. Tran, and Bruce A. Wilcox (2015). Evidence for the convergence model: The emergence of highly pathogenic avian influenza (H5N1) in Viet Nam. PLoS ONE. 10(9): e0138138. doi:10.1371/journal.pone.0138138.

Tran, Chinh C., and John F. Yanagida (2015). Computational economic analysis of duck production at the farm household level in the context of highly pathogenic avian influenza subtype H5N1 in the Red River Delta, Vietnam. Asian Journal of Agricultural Extension, Economics, and Sociology. 6(4): 172–84.


Castrence, Miguel, Duong H. Nong, Chinnh C. Tran, Luisa Young, and Jefferson Fox (2014). Mapping urban transitions using multi-temporal Landsat and DMSP-OLS night-time lights imagery of the Red River Delta in Vietnam. Land 3(1): 148-66.

Finucane, Melissa L., Tuyen Nghiem, Sumeet Saksena, Lam Nguyen, Sumeet Saksena, James H. Spencer, and Trinh Dinh Thau (2014). An exploration of how perceptions of the risk of avian influenza in poultry relate to urbanization in Vietnam. EcoHealth. 11(1); 73-82.

Finucane, Melissa L., Nghiem Tuyen, Sumeet Saksena, James H. Spencer, Jefferson Fox, Nguyen Lam, Trinh Dinh Thau, Tran Duc Vien, and Nancy D. Lewis (2014). Perceived risk of avian influenza in poultry varies with urbanization in Vietnam. East-West Center Working Papers: Environment, Population, and Health Series No. 5. Honolulu: East-West Center.

Finucane, Melissa L., Jefferson Fox, Sumeet Saksena, and James H. Spencer (2014). A conceptual framework for analzing social-ecological models of emerging infectious disease. In M.J. Manfredo, J.J. Vaske, A. Rechkemmer, and E.A. Duke, eds. Understanding society and natural resources: Forging new strands of integration across the social sciences. New York: Springer.

Nong, Duong, Christopher Lepczyk, Tomoaki Miura, Jefferson Fox, James Spencer, and Qi Chen (2014). Quantify spatiotemporal patterns of urban growth in Hanoi using time series spatial metrics and urbanization gradient approach. East-West Center Working Papers: Environment, Population, and Health Series No. 2. Honolulu: East-West Center.

Saksena, Sumeet, Jefferson Fox, James H. Spencer, Miguel Castrence, M. DiGregorio, M. Epprecht, N. Sultana, Melissa Finucane, L. Nguyen, and T.D. Vien (2014). Classifying and mapping the urban transition in Vietnam. Applied Geography 50: 80-89.

Saksena, Sumeet , Jefferson Fox, Michael Epprecht, Chinh Tran, Miguel Castrence, Duong Nong, James Spencer, Nguyen Lam, Melissa Finucane, Tran Duc Vien, and Bruce Wilcox (2014). Role of urbanization, land-use diversity, and livestock intensification in zoonotic emerging infectious diseases. East-West Center Working Papers: Environment, Population, and Health Series No. 6. Honolulu: East-West Center.


Spencer, James Herbert (2013). Urban health transition hypothesis: Empirical evidence of an avian influenza Kuznets curve in Viet Nam? Journal of Urban Health 90(2): 343-57.

Tran, Chinh C., Russell S. Yost, John F. Yanagida, Sumeet Saksena, Jefferson Fox, and Nargis Sultana (2013). Spatio-temporal occurrence modeling of highly pathogenic avian influenza subtype H5N1: A case study in the Red River Delta, Vietnam. ISPRS International Journal of Geo-Information 2(4): 1106–21.


Fox, Jefferson, James H. Spencer, and Sumeet Saksena (2011). Periurbanization and planning: Identifying, mapping, and managing periurban communities in Viet Nam. Paper prepared for the workshop on Changing Cities: Linking Global Knowledge to Local Action, 26–28 September. East West Center and Penn Institute for Urban Research.


Kapan, Durrell D., Shannon N. Bennett, Brett N. Ellis, Jefferson Fox, Nancy D. Lewis, James H. Spencer, Sumeet Saksena, and Bruce A. Wilcox (2006). Avian influenza (H5N1) and the evolutionary and social ecology of infectious disease emergence. EcoHealth 3(3): 187–94.


Wilcox, Bruce A., and Rita R. Colwel (2005). Emerging and reemerging infectious diseases: Biocomplexity as an interdisciplinary paradigm. EcoHealth 2(4):244–57.

See all current East-West Center Research Projects.