Download A Physician*s Guide to Climate Change, Health and Equity

Climate Change, Health
and Health Equity
Subtitle or training audience/location
Date
Acknowledgments
Kaiser Permanente
The Kresge Foundation
California Medical Association Foundation
National Ethnic Physicians Organization
National Medical Association & Golden State Medical
Association
page 2 |© 2016 Public Health Institute/Center for Climate Change and Health
A Physician’s Guide to Climate Change, Health and Equity
Climate change 101
Climate change and health equity
Physician surveys on climate change
Specific climate change impact on
health
Heat
Drought
Wildfires
Rainfall and Storms
Sea Level Rise
Allergens
Air Quality
Infectious Disease
Food Security
Mental Health
page 3 |© 2016 Public Health Institute/Center for Climate Change and Health
Special focus areas
Children
Workers
Pregnant women
Co-benefits of climate action
Transportation Solutions
Energy solutions
Food system solutions
Urban greening solutions
Climate Change 101
Climate vs. weather
Warming of earth’s surface and
oceans
Emissions
Carbon dioxide
Methane
Nitrous oxide
Black carbon
Potent climate pollutants
page 4 |© 2016 Public Health Institute/Center for Climate Change and Health
Why 1.5oC?
In order to avoid catastrophic
impacts of climate change,
including the ability of human
life to adapt and continue on
the planet, the earth’s average
global temperature cannot rise
more than 1.5oC above preIndustrial levels. Currently, the
planet is on track for a 4oC rise,
making the earth uninhabitable.
To stay below 1.5oC, we must
remain within our carbon
budget, or the total amount of
carbon-equivalent emissions
that would raise temperatures
past 1.5oC. At current
emissions rates we will blow
through the budget in about 5
years.
Climate Change and health: what physicians think
• Climate change relevant to direct patient care:
86%
• My patients are already being affected by climate change: 79%
• Extreme weather events and wildfires
88%
• Chronic disease due to air pollution
88%
• Increase in allergy symptoms
80%
• Heat related illness
75%
• Vector borne illness
58%
• Food and waterborne illness
56%
Safarty, M., Mitchell, M., Bloodhart, B., Berg, C., & Maibach, E. (2014). Key findings National Medical Association Physician
Survey. George Mason University Center for Climate Change Communication
page 5 |© 2016 Public Health Institute/Center for Climate Change and Health
“My patient
experienced atrocities
during Hurricane
Katrina. As a result,
she had PTSD and
severe depression
that prevented her
from holding a stable
job.”
“…the area in
which I work has
been affected by
increased flooding
and increased
snowfall which has
increased episodes
of back injury from
snow and water
removal.”
Climate Change 101
Photo credit: US Global Change Research Project Climate and Health Assessment
page 6 |© 2016 Public Health Institute/Center for Climate Change and Health
Climate Change and Health Equity: The Climate Gap
"Social injustice is killing people on a grand
scale.”
WHO Commission on the Social Determinants of Health, 2008
“…climate change is a ‘threat multiplier’…
[that] will intensify the challenges of global
instability, hunger, poverty and conflict.”
U.S. Secretary of Defense Chuck Hagel
page 7 |© 2016 Public Health Institute/Center for Climate Change and Health
Extreme Heat
Leading cause of weather related
deaths
Exacerbates cardiovascular,
respiratory and renal disease
Drug interactions and efficacy
Crop and livestock loss
Stronger longer pollen seasons
Urban heat islands
page 8 |© 2016 Public Health Institute/Center for Climate Change and Health
By 2025, rising
average
temperatures will
result in 2,1004,300 excess
deaths in
California.
African Americans
in Los Angeles
are more than
twice as likely to
die in a heat wave
than other
residents.
Drought
Community showers, East Porterville, CA
The total
economic impact
of the 2015
drought to
California’s
agriculture is
estimated to be
$2.7 billion—
including losses in
crop revenue,
livestock and
jobs.
page 9 |© 2016 Public Health Institute/Center for Climate Change and Health
Water quality and quantity
Crop loss and food insecurity
Wildfire risk
Migration and conflict
Infectious disease risk
Valley Fever
Dengue and West Nile
Virus
Air Quality
Higher temperature ground level ozone  smog
Drought more dry, dusty conditions
Wildfires more PM pollution
Storms and flooding indoor mold
Limits indoor and outdoor physical activity
Asthma, COPD and other respiratory disease
Complications for cardiovascular disease
California has 7 of the top 10 most polluted cities in the country for
year-round particle pollution.
Los Angeles has been ranked the No. 1 most ozone-polluted city
for at least the past 16 years.
page 10 |© 2016 Public Health Institute/Center for Climate Change and Health
Allergens
Longer and stronger pollen seasons
Increased pollen production and potency
More potent poison ivy, poison oak
Higher temperatures more ozone increased
sensitivity of respiratory tract
page 11 |© 2016 Public Health Institute/Center for Climate Change and Health
Wildfires
Smoke from
wildfires in
Quebec traveled
more than 1,000
miles downwind,
causing a 30fold increase in
Baltimore’s air
pollution in
2002.
Risk of injury, burns or death
Homes and businesses destroyed
LA Times
Emergency response and public safety occupations at
risk
Trauma, stress, displacement
Risks to water supply
Air pollution: soot and fire fighting chemicals
Exacerbates asthma, COPD and cardiovascular
disease
Premature death and acute illness
page 12 |© 2016 Public Health Institute/Center for Climate Change and Health
Rainfall, Storms and Floods
Risk of injury and death from floods and severe storms
Worsening indoor air quality: mold
LA Times
Increased waterborne pathogen exposure from sever
runoff and overflow
Increased winter precipitation increased pollen
production in spring
Recreational water risks
Getty Images
page 13 |© 2016 Public Health Institute/Center for Climate Change and Health
NOAA
Sea Level Rise
Flooding and erosion: injury, death, property loss
Freshwater contamination (salinization): threatens
drinking water and irrigation stores, fish and wildlife
Soil contamination (saltwater intrusion): threatens plants
and wildlife
page 14 |© 2016 Public Health Institute/Center for Climate Change and Health
The U.S.
government has
allocated $48 million
to relocate the entire
community of Isle de
Jean Charles, LA,
where homes and
property are being
flooded by sea level
rise. The island’s
inhabitants,
members of the
Biloxi-ChitmachaChoctaw tribe, are
the first American
climate refugees.
Infectious Disease
Flooding & storm surge waterborne and foodborne illness,
diarrheal disease
Drought Valley Fever (Coccidiodes immitis spores) and West
Nile Virus
Expanded mosquito and tick habitat
Dengue fever, West Nile Virus, Zika Virus
Lyme Disease
National Climate Assessment
page 15 |© 2016 Public Health Institute/Center for Climate Change and Health
Food Security and Nutrition
Declining crop yields and nutrient content
Increased herbicide and pesticide use
Rising food prices and water shortages
Algal blooms increased shellfish toxins
Livestock death, decreased fish yields
page 16 |© 2016 Public Health Institute/Center for Climate Change and Health
The typical
American meal
includes
ingredients from
at least five
foreign countries,
contributing to
transportation
GHGE, especially
if food is shipped
by air.
Climate Change and Mental Health
Economic stress, anxiety
Nutrition and physical activity
Chronic disease management and co-morbid
depression
The Weather Channel
Displacement, trauma and PTSD
At risk groups
First responders
Pre-existing mental illness
CDC
Pregnant women and children
page 17 |© 2016 Public Health Institute/Center for Climate Change and Health
Co-benefit solutions: healthy people, healthy places, healthy planet
Active transportation and transit

Heart disease, diabetes, obesity and cancers
Clean energy

Respiratory disease, cardiovascular disease, adverse
birth outcomes
Sustainable agriculture

Food security, heart disease, antibiotic resistance,
pesticide exposure
Urban greening

Heat illness, flood risk, air pollution, physical activity,
carbon capture
page 18 | © 2016 Public Health Institute/Center for Climate Change and Health
Health provider voice is critical
Health frame elicits support for climate action
Health co-benefits and community empowerment
Health and equity opportunities are real and current
Health workers are trusted, credible messengers in
communities
Health works in and with vulnerable communities
Health voice has been critical – in partnership with
community advocates
page 19 |© 2016 Public Health Institute/Center for Climate Change and Health
Health Provider Role in Climate Change, Health and Equity
Eat less meat, especially red meat
Walk, bike, use transit
Clean energy, energy efficiency
Green your clinic or hospital
Grand rounds presentation
Policy statement or resolution
Patient education
Care plans and protocols
Home assessments
Write an Op-ed or Letter to the Editor
Tv and radio interviews
Community presentations
Local zoning and development
Legislative visits
Policy testimony
page 20 |© 2016 Public Health Institute/Center for Climate Change and Health
Climate and Health Champions Take Action
Fresno Madera Medical
Society Climate and Health
Resolution
Legislative Testimony for California
Senate Bill 1383: Climate Super
Pollutants
page 21 |© 2016 Public Health Institute/Center for Climate Change and Health
References
1.
United States Environmental Protection Agency (2016). Inventory of US greenhouse gas emissions and sinks: 1990-2014 (DRAFT). Retrieved from:
https://www3.epa.gov/climatechange/ghgemissions/gases.html
2.
Morello-Frosh, R., Pastor, M., Sadd, J., Shonkoff, S. (n.d.) The climate gap: Inequalities in how climate change hurts Americans & how to close the gap. Available at: University of California Program for
Environmental and Regional Equity website: https://dornsife.usc.edu/pere/climategap/
Wendland, T. (2016, May 14). Native Americans’ relocation from Louisiana home: ‘first climate change refugees.’ National Public Radio. Available at http://www.npr.org/2016/05/14/478040492/nativeamericans-relocation-from-louisiana-home-first-climate-change-refugees
Associated Press. (2015, October 3). Alaska seeks federal money to move a village threatened by climate change. The New York Times. Available at http://www.nytimes.com/2015/10/04/us/alaska-seeksfederal-money-to-move-a-village-threatened-by-climate-change.html?_r=0
Howitt, R., MacEwan, D., Medellín-Azuara, J., Lund, J., Sumner, D. (2015). Economic analysis of the 2015 drought for California agriculture. UC Davis Center for Watershed Sciences.
http://www.pbs.org/wgbh/americanexperience/features/general-article/dustbowl-mass-exodus-plains/
California Department of Public Health. (March 2016). Community assessment for public health emergency response (CASPER) addressing the California drought-Tulare County, California, October 2015.
Available at http://hhsawebdocs.tchhsa.org/Questys.CMx.HHSAWebdocs/File.ashx?id=3813&v=1&x=pdf&r=HHSA_Webdocs
Zelezny, L., Fu, X., Harootunian, G., Drexler, D., Avalos, A., Chowdhury, N., …Edmonson, C. (2015). Impact of the Drought in the San Joaquin Valley of California. Available at:
http://www.fresnostate.edu/academics/drought/
California Department of Public Health. (March 2016). Community assessment for public health emergency response (CASPER) addressing the California drought-Tulare County, California, October 2015.
Available at http://hhsawebdocs.tchhsa.org/Questys.CMx.HHSAWebdocs/File.ashx?id=3813&v=1&x=pdf&r=HHSA_Webdocs
American Lung Association. (2016). State of the Air 2016. Available at http://www.lung.org/our-initiatives/healthy-air/sota/
Rowangould, G.M. (2013). A census of the US near-roadway population: Public health and environmental justice considerations. Transportation Research Part D: Transport and Environment, 25, 59-67.
Beitler, J. (October 2006). Tracking Nature’s Contribution to Pollution. NASA Earth Observatory. Available at http://earthobservatory.nasa.gov/Features/ContributionPollution/
Center for Disease Control and Prevention. (May 23, 2013). Deaths associated with Hurricane Sandy October-November 2012. MMWR, 62(20). 393-397. Available at
https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6220a1.htm
Gilbert N. 2012. One-third of our greenhouse gas emissions come from agriculture. Available at http://www.nature.com/news/one-third-of-our-greenhouse-gas-emissions-come-from-agriculture-1.11708.
Natural Resources Defense Fund. 2007. Food miles: How far your food travels has serious consequences for your health and the climate. Available at https://food-hub.org/files/resources/Food%20Miles.pdf.
Uejio, C.K., Tamerius, J.D., Wertz, K. & Konchar, K.M. (2015). Primer on climate science. In G Luber & J Lemery (Eds.), Global Climate Change and Human Health (p. 5), San Francisco, CA: Jossey-Bass.
Wendland, T. (2016, May 14). Native Americans’ relocation from Louisiana home: ‘first climate change refugees.’ National Public Radio. Available at http://www.npr.org/2016/05/14/478040492/nativeamericans-relocation-from-louisiana-home-first-climate-change-refugees
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