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Flooding • A big issue in the West Midlands 3 of the 10 most serious UK natural disasters between 1900-2009 were floods and affected the West Midlands Physical Health Injury/Drowning Respiratory diseases Skin complaints Water borne diseases... Mental Health Post-traumatic disorder Anxiety Psychological conditions... • Case Study: Selly Park South Flood 06.09.08 • Some elderly residents suffered physically Photos: © by John Clayton • Most problems were psychological •Trauma due to loss of property • Stress of dealing with insurance claims, renovation work and displacement Heat waves Heat waves and Climate Change Likely to increase in duration and intensity after 2030 Become increasingly more severe after 2060 Increased mortality and morbidity •Elderly •Food poisoning •People may acclimatise... • August 2003 Heat Wave • Max CET: 31.5oC on 08/08/03 • All Cause Mortality in WM: 1469 between 04 – 10/08/03 • All Cause Mortality in WM in the previous week was 1086 Urban Heat Island Effect Cause urban areas to be warmer than surrounding rural areas Birmingham UHI showed a magnitude >4.5oC on a heat wave day in 2006 • Generalized cross-section of typical urban heat island, (after Oke, 1976) Likely to increase with climate change • Exacerbate health issues related to temperature Birmingham UHI Magnitude under extremely stable conditions. C. Tomlinson, 2009 Global vs. West Midlands Exercise – New Delhi, London, San Paulo? Percentage of Deaths by age 0-14 48.1 10.3 1.4 15-64 38.6 41.7 18.5 65+ 13.3 47.7 80.0 15.5 37.8 42.4 8.9 14.3 14.5 75.7 47.9 43.1 Percentage of deaths by cause Cardiovascular Respiratory Other Fair Society, Healthy Lives Policy Objective E: Create and develop healthy sustainable places and communities http://www.marmot-review.org.uk/ Main objectives for international public health 1) Raising awareness: of the health implications of climate change 2) Strengthening partnerships: to place health at the centre of climate change policy 3) Generating evidence: on the health effects of adaptation and mitigation policies 4) Strengthening public health systems to cope with additional threats posed by climate change Possible surveillance and monitoring systems Health impact Data requirements & programmes Heat-related Solar radiation monitoring, Ozone depletion, Daily mortality & morbidity data Cold-related data Primary care data, Hospital admissions, Public Health Observatories, PCTs HPA infections Communicable disease surveillance, Emerging infections, Notifications of Infectious Diseases Air pollution Committee on the Medical Effects of Air Pollutants (COMEAP) & Medical Research Council (MRC) data Cancer Registry Cancer incidence Environment agency/ Met Office Met data -Temperature/Precipitation/Sea-level rise/Storms Effective flood forecasting and warning. Data on impacts of disasters Sea-level rise Ground water quality Diarrhoeal disease surveillance Mental health Data on mental health morbidity 0.63 Information and Communication 0.13 0.1 0.22 Other procurement 0.32 Waste products and recycling 0.36 Water & Sanitation 0.39 Construction 0.53 Food and Catering Manufactured fuels/ chemicals/ gases 0.72 Other manufactured products 0.97 NHS Freight transport 0.98 Paper products Business services Medical Instruments/equipment 4.50 4.00 3.50 3.00 2.50 2.00 1.50 1.00 0.50 0.00 Pharmaceuticals CO2 Emissions (MtCO2) NHS Carbon Footprint Figure 4: 2004 NHS England CO2 emissions - 11.07MtCO2 Procurement Breakdown procurement sub-sector breakdown 4.06 1.66 NHS Carbon Reduction Public Health role • Champions within NHS organisations – emphasising health co-benefits • Commissioning – Building sustainability into health service contracts – Public health programmes to improve health while reducing carbon • Integrating resilience and carbon management – Managing risk: risk register, action plans on flooding, heat waves, energy & food security • Partnerships – Working with partners outside the NHS “The cost and environmental benefits of doing so are significant and given the climate of spending cuts and a painful squeeze on NHS funds it is perhaps surprising that they are not taking these issues more seriously.” The Copenhagen Accord • The goal to limit climate change to 2C; • A new and additional funding commitment for developing nations of up $30bn to 2012 and $100bn annually by 2020 to be overseen by a Global Climate Fund; • Binding actions on both developed and developing nations; agreement on international monitoring, reporting and verification of some actions; • And the establishment of new international technology collaboration and forestry mechanisms. • Perhaps most importantly, this represents the first agreement involving all major nations including the US and China since 1997. Competing forces…? wants material wealth now instincts resource-rich local interests visible causation country certainty consumerism identified people material growth/prosperity needs wellbeing future logical considerations resource-poor society’s interests abstract science global community probabilities fairness statistical people sustainability • model developed by Aubrey Meyer • widely accepted global framework for reducing greenhouse gas emissions to safe levels in a socially just way • equity is a governing principle of the C&C model. • http://www.tangentfilms.com/C&CPRES.swf What would that mean? • Global ‘carbon budget’ with annual reduction targets based on levels considered safe to avert dangerous climate change (ie. limit rise to 2°C) • Continue to reduce or ‘contract’ global emissions year-on-year • Eventual situation: everyone has the same personal carbon ‘budget’ & chooses how to use it • Developing countries allowed to increase initially, using cost- and carbon-efficiency lessons already learnt by developed In the UK a ‘30% internal’ rather than a 20% reduction in GHG emissions would result in public health benefits of: • between €326 million and €941 million per year from 2020. • An increase in life expectancy of 4,000 years spread across the population. • Better health and lower health costs: 404,000 fewer days of restricted activity; 38,000 fewer days when people need to use respiratory medication; 4,000 fewer consultations for upper respiratory symptoms and asthma. • A more productive workforce - 93,000 fewer working days lost annually due to cardiac and respiratory problems. Mitigation and health benefits Heatwaves: long term planning Managing high temperatures – strategies available at: catchment scale neighbourhood scale building scale Shaw, R., Colley, M., and Connell, R. (2007) Climate change adaptation by design: a guide for sustainable communities. TCPA, London Albedo enhancement of lowlevel maritime clouds Qualitative assessment World Health Organisation www.who.int/globalchange/climate/en Climate and Health Council www.climateandhealth.org Sign the declaration and contribute to the five actions The Climate Connection www.theclimateconnection.org Build partnerships, share evidence, experience and ideas