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Conducting a human health vulnerability assessment to frame climate change priorities Tribal Water Workshop 2014 October 7, 2014 Kristin Raab, MPH, MLA Minnesota Department of Health MN Climate & Health Program Environmental Impacts Analysis Unit 625 Robert Street North Saint Paul, Minnesota 55164 Outline Climate Change in Minnesota Health impacts, recent past occurrence, vulnerable populations Extreme Heat Events Air Pollution Changing environment/ecosystems: Allergens & Vector-borne diseases Flooding and Drought Planning for the health impacts of climate change using GIS 2 Climate Change in Minnesota There have been three recent significant observed climate trends in Minnesota: The average temperature is increasing The average number of days with a high dew point may be increasing The character of precipitation is changing 3 Temperature Changes in Minnesota Minnesota Average Temperature 12 month period ending December Source: Western Regional Climate Center 49 Temperature (°F) 47 45 43 41 39 37 35 Ending Year of Period Annual Average Temperature 4 10-Year Running Average Temperature Changes in Minnesota Significant observations in warming pattern: Winter temperatures have been rising about twice as fast as annual average temperatures Minimum or ‘overnight low’ temperatures have been rising faster than maximum or ‘daytime high’ temperatures Regional differences – Northern part of the state is warming faster than the Southern 5 Temperature Changes in Minnesota Seasonal Temperature Trends (°F per century) Based on 1895-2010 Data SPRING: + 1.6° AUTUMN: + 0.5° 6 SUMMER: + 0.8° WINTER: + 2.2° Dew Point Changes Dew point – a measure of water vapor in the air A high dew point makes it more difficult for sweat to evaporate off the skin, which is one of the main mechanisms the body uses to cool itself The number of days with high dew point temperatures (≥ 70°F) may be increasing in Minnesota 7 Changes in Precipitation Minnesota Total Annual Precipitation 12 month period ending in December Source: Western Regional Climate Center 40 Precipitation (inches) 35 30 25 20 15 10 Ending Year of Period Total Annual Precipitation 8 10-year Running Average Changes in Precipitation Precipitation in Minnesota is changing: More localized, heavy precipitations events Potential to cause both increased flooding and drought 9 Extreme Precipitation Midwest had a 37% increase in the heaviest storm events from 19582012 Total precipitation in the Midwest and Northeast is expected to increase with the largest increases in heavy precipitation events Heaviest 1% of all daily events : 1958-2012 10 2012 Extreme Precipitation 2012 USDA primary or contiguous flood disaster counties 2012 FEMA primary or contiguous drought disaster counties 2012 counties declared for both disasters Source data: USDA, 2012 and FEMA, 2012 In 2012, counties in blue declared disaster areas due to flooding by FEMA, while counties in brown were declared primary or contiguous disaster areas due to drought by USDA. Counties with crosshatching received both designations in 2012. Observed Climate Changes Increased Temperature Increased Humidity Extreme Precipitation/ Changes in Precipitation Events Health Outcomes Extreme Heat Heat-related illnesses and deaths Air Pollutants/ Ozone Changes in Environment & Habitat Flooding & Severe Storms Drought Wildfire Cardiovascular diseases and stroke Respiratory Illness, Allergies Injuries, Drowning Infectious diseases Stress and Mental Illnesses Threat to Livelihood/ Displacement Food insecurity Heat Waves • The 1995 Chicago heat wave caused more than 700 heat-related deaths over 5 days. • France, summer of 2003: 14,802 excess deaths • Moscow, July/Aug 2010: over 11,000 excess Twin Cities, July 19, 2011: deaths Heat index record ≈ 130° – Hurricane Katrina: 1,836 confirmed deaths – World Trade Center: 2,752 deaths Air temp was 95F paired with the 82F dew point temp Extreme Heat & Human Health – Heat tetany (hyperventilation) – Heat rash – Heat cramps – Heat exhaustion – Heat edema (swelling) – Heat syncope (fainting) – Heat/sun stroke – Death – Exacerbates pre-existing conditions 14 https://apps.health.state.mn.us/mndata/heat_ed Extreme Heat Events Climate change may increase the frequency and intensity of extreme heat events 16 Populations At Risk to Extreme Heat • Everyone • Elderly persons 65 years and older – Especially who live alone • Children (5 and under) • Persons with chronic disease conditions • Persons taking certain medications that hinder thermoregulation or cause dehydration 17 17 Heat-Illness ED Visits by Age & Sex Source: MDH Environmental Public Health Tracking 18 18 Heat-Illness Hospitalizations by Age & Sex Source: MDH Environmental Public Health Tracking 19 Risk Factors Lack of air conditioners in homes Low socioeconomic status (income) Homelessness Living in urban areas: urban heat island effect Living in topmost floor Living in nursing homes/ being bedridden – Living alone/ Lack of social or family ties (social isolation) – Prolonged exposure to sun – Drinking alcohol – – – – – – 20 20 Air Pollution: Particulate Matter Climate change may affect exposures to PM by: Increasing emissions from fossil fuel-fired power plants due to demand for electricity for cooling Increasing natural sources of air pollutant emissions 21 Wildfire smoke induced by drought and heat Ground-Level Ozone Climate change could significantly increase summertime ground-level ozone by: Increasing temperatures Creating stagnant air conditions Affecting natural sources of air pollutant emissions (biogenic VOCs) Overall, increase poor air quality index (AQI) days Effect is most likely during the summer months, downwind of urban areas 22 Populations at Risk to Air Pollution • • • • • 24 young children older adults outdoor workers outdoor exercisers persons with existing cardiovascular or respiratory diseases, such as asthma or COPD Climate Change Environment: Plant Changing Hardiness Zone Maps 25 Allergenic Pollen •Longer pollen season •Increased pollen production •Increased potency of airborne allergens •Proliferation of weedy plant species known producers of allergenic pollen •Introduction of new allergenproducing plant species •Mpls has experienced a 16 day increase in length of ragweed pollen season from 1995 to 2009 26 Changing Environment Vectorborne Diseases Climate changes such as warmer temperatures, increased rainfall, longer warm season and less severe winters can impact the range and incidence of vectorborne disease. Risk is also impacted by land use, population density, and human behavior. 27 Tick-borne Disease Risk Increased temperature Increased precipitation/humidity 28 - Longer tick growing/feeding season - Lower mortality in winter - New tick species - New disease agents - Increased blacklegged tick survival in warm season - Increased time available for tick feeding each day David Neitzel, MPH, MDH Vulnerable Populations • Although people of any age may contract these vector-borne diseases, vulnerability to the most severe symptoms is higher for older adults or persons with impaired immune systems 32 Flooding Health Impacts physical injuries (including drowning) allergies (mold) contaminated drinking water and water-borne illnesses displacement mental health issues interruption of emergency services food insecurity 33 34 Populations at Risk of Floods • Age: older adults, especially if living alone • Physical or mental infirmity that impairs ability to provide adequately for their care • Limited economic resources • Living in substandard housing or mobile homes • No vehicle • Not proficient in English • Living in low lying areas 35 Drought Impacts • Reduced lake and wetland levels and stream flows • Potential concentration of pollutants • Decreased water supply for drinking and agriculture • Negative effects on soil moisture and crop progress way impact food security & livelihoods • Increased risk of wildfires 36 Preparing for climate change Events • Extreme heat • Air pollution • Changes to growing season/habitats • Extreme rainfall events/flooding • Drought • Wildfire Vulnerabilities • People/places Develop a plan for preparing for the health impacts of climate change • Tool: GIS Identification of high-risk and vulnerable persons 40 40 GIS Mapping Technical Assistance Characteristics mapped: • • • • • • • • • • • • • • 41 child/day care facilities schools community centers libraries pools assisted living facilities & nursing homes churches restaurants movie theaters museums parks and recreation shopping malls impervious surface/land cover percentage of residential buildings with central A/C Learn More 1. Extreme Heat Events, Climate Change and Public Health 2. Air Quality, Climate Change and Public Health 3. Water Quality and Quantity, Climate Change and Public Health 4. Climate Change & Public Health 101 5. Agriculture and Food Security Climate Change 6. Mental Health, Climate Change and Public Health Download from the MN Climate & Health Program’s website: http://www.health.state.mn.us/divs/climatechange/communication.html Health & Climate film http://www.health.state.mn.us/divs/climatechange/climatevideo.html 42 Acknowledgements This work was supported by cooperative agreement 5UE1EH000738 from the Centers for Disease Control and Prevention (CDC) Climate Ready States Initiative 43 Contact Us Minnesota Climate and Health Program [email protected] www.health.state.mn.us/topics/places/ www.health.state.mn.us/divs/climatechange/ MN Climate & Health Program Team Kristin Raab, Director, [email protected], 651-201-4893 Kelly Muellman, Planner, [email protected], 651-201-5637 Brenda Hoppe, Senior Epidemiologist, [email protected], 651201-4908 Dan Symonik, Supervisor November 21, 2013 44