Download BCC_2.5_Human_Health_2015_05

Section 2. The effects of climate change
on people and the environment
2.5. Climate Change and Human Health
USAID LEAF
Regional Climate Change Curriculum Development
Module: Basic Climate Change (BCC)
Basic Climate Change (BCC) Module Team
Basic Climate Change Module Team
Name
Affiliation
Name
Affiliation
Developers
Michael Furniss; Co-Lead
US Forest Service
David Ganz, Chief of Party
Bunleng Se; Co-Lead
Royal University of Phnom Penh, Cambodia
Chi Pham, Project Coordinator USAID LEAF Bangkok
Chan Hoy Yen
Universiti Kebangsaan Malaysia
Naroon Waramit
Kasetsart University, Thailand
Kalyan Ly
Royal University of Agriculture, Cambodia
Phi Thi Hai Ninh
Vietnam Forestry University, Vietnam
Somvang Phimmavong
National University of Laos
Lam Ngoc Tuan
Dalat University, Vietnam
Latsamy Boupha
National University of Laos
Le Hai Yen
Dalat University, Vietnam
Sokha Kheam
Royal University of Phnom Penh, Cambodia
Nguyen Le Ai Vinh
Vinh University, Vietnam
Ahmad Makmom Bin Abdullah
Universiti Putra Malaysia
Nguyen Thi Viet Ha
Vinh University, Vietnam
Jirawan Kitchaicharoen
Chiang Mai University, Thailand
Nicole Kravec
USAID LEAF Bangkok
Thaworn Onpraphai
Chiang Mai University, Thailand
Hour Limchhun
USAID LEAF Cambodia
Patthra Pengthamkeerati
Kasetsart University, Thailand
Le Nhu Bich
Dalat University, Vietnam
Kieu Thi Duong
Vietnam Forestry University, Vietnam
Somsy Gnophanxay
National University of Laos
Truong Quoc Can
Vietnam Forests and Deltas Program
Karen Castilow
University of Virginia
Nguyen Thi Kim Oanh
Asian Institute of Technology, Thailand
Geoffrey Blate
US Forest Service
Mokbul Morshed Ahmad
Asian Institute of Technology, Thailand
Elizabeth Lebow
US Forest Service
Ly Thi Minh Hai
USAID LEAF Vietnam
Kent Elliott
US Forest Service
Danielle Morvan
Tulane University, New Orleans
Ann Rosecrance
California State University., Northridge
USAID LEAF Bangkok
Reviewers
Andrea Tuttle
Freelance consultant
Somsy Gnophanxay
National University of Laos
Sermkiat Jomjunyoug
Chiang Mai University, Thailand
Jamil Tajam
Universiti Kebangsaan Malaysia
Sampan Singharajwarapan
Chiang Mai University, Thailand
Ajimi Bin Jawan
Universiti Kebangsaan Malaysia
Chea Eliyan
Royal University of Phnom Penh, Cambodia
Ratcha Chaichana
Kasetsart University, Thailand
I.
HOW AND WHY THE CLIMATE IS CHANGING
1.1.
1.2.
1.3.
1.4.
Introduction to Climate Science and Climate Change
The Causes of Climate Change
Climate Intensification: Floods and Droughts
Climate Modeling
II. THE EFFECTS OF CLIMATE CHANGE ON PEOPLE AND THE ENVIRONMENT
2.1.
2.2.
2.3.
2.4.
Introduction to Climate Change Impacts
Sea Level Rise
Climate Change and Water Resources: Effects
Climate Change and Food Security
2.5. Climate Change and Human Health
2.6. Climate Change and Terrestrial Ecosystems
III. REPONSES AND ADAPTATION TO CLIMATE CHANGE
3.1.
3.2.
3.3.
3.4.
3.5.
3.6.
3.7.
Climate Change and Forest Management
Climate Change and Water Resources: Response and Adaptation
Principles and Practice of Climate Vulnerability Assessment
Dealing with Uncertainties in Climate Change
Introduction to Ecosystem Services
Introduction to REDD+
Bioenergy and the Forest
3.8. Communications and Engagement
IV. CURRICULUM MODUL RESOURCES AND TOOLS
4.1.
4.2.
4.3.
4.4.
Curated Video Collection
Literature – Annotated Bibliography
Climate Change Glossary
Reading and Video Assignments and Problem Sets
At the end of this session, learners will be able to:

Describe the diseases likely to be exacerbated by climate
change - from local, regional, and global perspectives

Identify the most vulnerable people and populations whose
health could be affected by climate change

Propose possible adaptations to climate change-related
human health issues, risks, and problems
4
1.
South East Asia is disaster prone
2.
The most vulnerable people
3.
Climate-sensitive health outcomes
4.
Exacerbating current burden of disease
5.
General adaptation for health sector
6.
Discussion questions
5
Portier CJ, Thigpen Tart K, Carter SR, Dilworth CH, Grambsch AE, Gohlke J,
Hess J, Howard SN, Luber G, Lutz JT, Maslak T, Prudent N, Radtke M, Rosenthal
JP, Rowles T, Sandifer PA, Scheraga J, Schramm PJ, Strickman D, Trtanj JM,
Whung P-Y. 2010. A Human Health Perspective On Climate Change: A Report
Outlining the Research Needs on the Human Health Effects of Climate
Change. Research Triangle Park, NC:Environmental Health
Perspectives/National Institute of Environmental Health Sciences.
doi:10.1289/ehp.1002272 Available: www.niehs.nih.gov/climatereport
6
2013. Turn down the heat :
climate extremes, regional
impacts, and the case for
resilience
Chapter 4 – South East Asia
pages 82-86
Washington DC ; World Bank.
http://documents.worldbank.org/curated/e
n/2013/06/17862361/turn-down-heatclimate-extremes-regional-impacts-caseresilience-full-report
Read this report:
http://www.niehs.nih.gov/climatereport
Questions:

What are the most important human health impacts to
your area or region?

Why?

What can be done to reduce or mitigate the risks to human
health of these impacts?

Who is responsible for making the adaptations?
8

More extreme weather events: storms, cyclones, flooding

Heat waves: more frequent, hotter, and longer

Rapid glacier melting: landslides, flash floods, and reduced
water availability

Disturbed rainfall patterns: more droughts, more extreme
precipitation events, more intense rainfall, floods, and
disrupted water supply

Sea-level rise: inundation, saltwater intrusion, loss of land and
assets, increased coastal flood frequency/severity

Air pollution: increase in levels of ground ozone, more
allergens
9
Southeast Asia
region
Nature (2005; 488:310-317)
McMichael et al. (2003) and WHO (2008)
12


Direct effect:

Injuries, disability, drowning

Heat stress
Indirect effect:

Water and food–borne diseases

Malnutrition

Vector–borne diseases

Air pollution (e.g., particulate
matter, ozone) and allergy
(e.g., pollen season)

Psychological stress
Photo:
http://southasia.oneworld.net/ImageCatalog/ climatepicture.jpg
1996-2005: 57% of people killed globally in natural
disasters were from SEAR (South East Asia Region)
countries.

Indonesia: 2007, 3 flood events;
4 landslides; 2 tornadoes.

Maldives: May 2007, high tide floods

Bangladesh: November 2007: Super cyclone
SIDR: 4,000 dead, millions affected.

Myanmar: May 2008, Cyclone Nargis, 135,000
perish.

Philippines: November 2013, Typhoon Haiyan,
>6,000 dead.
Photo:
http://cache.daylife.com/imageserve/02fA
d1d1tWeAW/340x.jpg
14
15
Source: http://climatechange.thinkaboutit.eu/think4/post/why_always_the_poorests
16
17

2005: 3.9 million people in SEA Region exposed to flooding
caused by storm surges and sea-level rise

2070s: Estimated 28 million people to be affected in SEA
Region by projected 50 cm sea-level rise

Asset exposure projection: 2,100 – 4,600% increase between
2005-2070, with no adaptation measures

Flooding projections:

Ho Chi Minh City: 60-77% built up area exposed to 100 cm rise

Bangkok: 43-69% flooding in 2025-2100

Manila: 24% damage in 100-year return period flood
18

Additional reason for SEA Region is population factors.

Population factors affecting the risks/impacts of extreme
weather events include population size, age, health status,
wealth, and type of settlement.

The most vulnerable are those who have less capacity to cope
with climate change effects.
WHO (2008)
19
The most vulnerable are:

children, women, the elderly,
pregnant women

disabled and sick people

the poor (including slum
dwellers, those in informal
settlements, the landless and
marginalized, and informal
open air workers, but also
displaced communities and
individuals).
Image:
http://www.caritas.org.au/images/cambodia/cam_ss
pr_july04_2.JPG?sfvrsn=7
20
The most vulnerable people in the SEA Region will be:

The poor (fewer resources to adapt to the rapid environmental
changes)

In rural areas, women are increasingly becoming household
heads and have the double burden of social reproduction and
agricultural work

Pregnant women are especially vulnerable

People living in substandard housing or water systems will
experience greater risks to life and health with severe weather
events

Informal settlements: 79% of population in Cambodia, 44% of
population in Philippines and 41% of population in Vietnam
21
 Vulnerability will be greater in highly dense populations
 Vulnerability will be greatest in areas of low resources for health care
 Vulnerability will be greatest in areas of low resources for disaster and
emergency response
 Vulnerability will be greatest in areas of over allocated, polluted, and
inadequate water supplies
 Vulnerability will be greatest in areas of substandard housing and
sanitation
 Vulnerability will be greatest in areas of low diversity of agricultural
cropping systems
 Vulnerability will be greatest in areas of high proportion of women and
children in the population
 Greater vulnerability for populations with serious existing problems
Majority of Vector-borne Disease (VBD) burden borne by
developing countries (including SEA Region)
WHO (2008)
23
24
25
Negative Impact Positive Impact
Very High Confidence
• Malaria: Contraction and expansion,
changes in transmission season
High Confidence
• Increase in malnutrition
• Increase in the number of people suffering
from deaths, disease and injuries
from extreme weather events
• Increase in the frequency of cardio-respiratory
diseases from changes in air quality
• Change in the range of infectious disease vectors
• Reduction of cold-related deaths
Medium Confidence
• Increase in the burden of diarrheal diseases
Source: WHO (2008)
27
Photo: ©Abir Abdullah/Still Pictures
Photo: ©Abir Abdullah/Still Pictures
More extreme South East Asian weather
(e.g., Typhoon Haiyan (Philippines), Cyclone Nargis (Myanmar)
28
World Health Organization, 2008c

More than 175,000
children and teenagers
die from drowning each
year.

Children under the age
of 5 years are most at
risk.

Most child drowning
events happen in and
around the home.
29
Heat-related Illnesses
 Heat Rash
 Heat Cramps
 Heat Exhaustion
 Heat Stroke
 Dehydration and exacerbation
of chronic illness
Photo: ABC News


Risk factors for hyperthermia

Age

Underlying medical conditions / mental illness

Income and poverty status

Social isolation

Access to health care and cooling facilities

Neighborhood characteristics: land use/ land cover, crime rate,
housing type, urban heat islands

Substandard housing and water systems
Average of 688 reported heat-related death per year in US and overall
impact likely underestimated
Every death is preventable!

2003 Andhra Pradesh, India heat
wave, with temperatures of up to
54oC, resulted in death to 3,000
people.

The number of heat strokes was
not recorded.
Refugee Study Centre (RSC),
http://www.rsc.ox.ac.uk
Photo: © T. Balabaadkan UNEP / Still Pictures
32
Maximum Temperature and Daily Summer Mortality
Shanghai, China 1980-89
300
Scatter plot of daily
maximum
temperature and
total mortality to
help identify
possible
summertime
threshold
temperatures for
extreme heat in
Shanghai, China
based on the
mortality impact.
250
Daily Mortality
200
150
100
50
0
15
20
25
30
35
40
Maximum Temperature (C)
(L. Kalkstein, personal communication, 2002)
Source: WHO (2008)

Air pollution

Meeting increasing energy demands by greater use of fossil
fuels will increase in particulate matter and air pollutants (e.g.,
ground ozone) => respiratory and cardiovascular diseases

Increasing allergens (pollen and mold) due to the effect of
climate change => allergy
 Asian brown cloud (India): Air
particulates and pollutants and
prolonging period of dry season (late
raining)
Photo: © Deb Kushal -UNEP / Still Pictures
34
Ragweed allergen
production increases
with increasing CO2
concentration
Singer et al. (2005)
http://msnbcmedia3.msn.com
36
In 2005, diarrheal diseases
accounted for 20.1% of
deaths in children less than
five years
Photo credit: © Shehzad Noorani/Still Pictures
37
Source: FAO
Crop yields could
decrease up to 30%
in Central and South
Asia by the mid-21st
century.
Population growth
and urbanization will
magnify the
malnourished and
the risk of hunger.
Photo credit: © Shehzad Noorani / Still Pictures
39
Proportional mortality among children under five years of age −
World 2002
http://www.goldenrice.org/Content3Why/why.php
Susceptible
Populations
• Migration (forced)
•Vector environment
Vector
Pathogen
 Survival, lifespan
 Survival
 Reproduction/breeding patterns
 Transmission
 Biting behavior
 Replication in host
WHO (2008)
Combined with altered rainfall patterns, hotter conditions
may increase the spread of disease, such as malaria, dengue,
and chikungunya, to new areas
Warmer temperatures and
disturbed rain patterns could alter
the distribution of important
disease vectors
Aedes aegypti
“Tend to increase in range and incidence … actual occurrence
strongly influenced by local conditions.” (IPCC)
Health impact
Confidence
Move to higher altitudes
Medium - high
Move to higher latitudes
Medium - low
Extended transmission season
Medium - high
Increased population in areas of
potential transmission
Medium - high
Decreased transmission
where temperatures high
Low - medium
Relationship between temperature and
malaria parasite development time inside
mosquito (“extrinsic incubation period” or
EIP). EIP shortens at higher temps, so
mosquitoes are infectious sooner.
Incubation period
Survival probability
Biting frequency
1
50
(per day)
(days)
30
20
(per day)
0.3
40
0.2
0.1
0
15
20
25
30
35
40
Temp (°C)
0.6
0.4
0.2
10
0
0.8
0
10 15 20 25 30 35 40
10 15 20 25 30 35 40
Temp (°C)
Temp (°C)
TRANSMISSION POTENTIAL
1
P.vivax
P.falciparum
0.8
0.6
0.4
0.2
0
14 17 20 23 26 29 32 35 38 41
Temperature (°C)
Mode of
intervention
Stage
Stage of
of
intervention
intervention
Biological
Adaptive
immunity
Social
Social
Surveillance
Surveillance
Hlth
systems
Health systems
Behavioral
Use of
of
bednets
Individual
Individual
Other institutions
Community
or group
National
Level of
intervention
Global
Primary
Vaccination
Vaccination,
Dams
Tertiary
Early
treatment
Secondary
Early
warning
WHO (2008)
Based on McMichael and Kovats, 2000
Photo credit: © Shehzad Noorani /Majority World / Still Picture

In 2005, the estimated
population at risk from
dengue fever in the South
East Asia Region was 1.3
billion.

This is 52% of the global
estimated
2.5 billion at risk.
With the threat of a warmer,
wetter world and a larger
global population, scientists
are researching how climate
change may impact the
spread of infectious diseases,
such as cholera and dengue
fever, and how outbreaks
may be prevented.
http://youtube.com/v/AiuYuf1IqJQ
~ 5 minutes

Further develop emergency medical services.

Further develop disaster response capacity.

Improve climate-sensitive diseases surveillance and controls.

Improve safe water supply and sanitation.

Improve health services.

Expand and ensure safe water supplies and improved sanitation.

Educate citizens on the risks and responses to climate-related
health issues.

Address poverty, education, and gender inequalities.
49

The SEA Region has a large population that is currently
vulnerable to a number of climate sensitive health stressors.

These stressors are already having a significant adverse health
impacts in the Region.

Climate change is likely to increase the risks linked to these
stressors, and introduce new sources of risk.

Without adaptation and mitigation, climate change could result
in dramatically increased health burdens in the Region.

Much can be done now to adapt and prepare that will improve
the health of millions.
50

Where is the most vulnerable area in your country that
affected by climate change/natural disaters?

Who are the most vulnerable in your
communities/country?

In your communities, what illnesses/diseases that always
occurred/happened caused by climate change (flood,
drought, storms, and so on)?
51
Four fundamental questions should be carefully considered in
designing adaptation strategies:
1.
What are we adapting to?
2.
Who adapts? / Who is vulnerable?
3.
How do we adapt? and
4.
What do we want to achieve?
52
http://www.pbslearningmedia.org/resource/envh10.sci.life.eco.cchealth/clim
ate-change-and-human-health/
http://ecohealth.wisc.edu/index.php?option=com_content&view=article&id=
181%3Ateachers-lp-birds-article&catid=130&Itemid=272
McMichael, Anthony J., Rosalie E. Woodruff, and Simon Hales. "Climate change and
human health: present and future risks." The Lancet 367.9513 (2006): 859-869.
http://laes.hcwh3.seguetech.com/sites/default/files/documentsfiles/151/Climate_Chg_Human_Health.pdf
Climate change and human health - risks and responses. 2003. World Health
Organization
http://www.who.int/entity/globalchange/publications/climchange.pdf?ua=1
Summary of above document (Also available in Spanish, French, and Russian)
http://www.who.int/globalchange/publications/cchhsummary/en/
McCarthy, James J., ed. Climate change 2001: impacts, adaptation, and vulnerability:
contribution of Working Group II to the third assessment report of the
Intergovernmental Panel on Climate Change. Cambridge University Press, 2001.
https://ipcc.ch/ipccreports/tar/wg2/pdf/wg2TARfrontmatter.pdf
55

What was useful?

What is missing?

How did you, or would you, modify the materials to make
them better fit your instructional context?

Please share your experience and modifications here:
[email protected]