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Extreme Weather Events: Infrastructure Damage and Impact on Vulnerable Populations Cindy L. Parker MD, MPH Physicians for Social Responsibility Johns Hopkins Bloomberg School of Public Health 1 Climate change: A risk amplifier Often affecting the social determinants of health 2 Heat Waves • More frequent, more severe, lasting longer • Worse in the Northern Hemisphere 3 Heat-related Deaths during 1995 Chicago Heat Wave MMWR, August 11, 1995, 44(31):577-579 4 U.S. EPA, Heat Island Effect 5 Baltimore’s Urban Heat Island Effect NASA images by Robert Simmon, based on data from the National Land Cover Database and Landsat 7. 6 Heat Stress: Risk Factors for Harm Being very young Being elderly Living in the inner-city Being poor Having chronic medical conditions Being socially isolated 7 70,000+ Died of Heat Stress in Western Europe during Summer 2003 Most Vulnerable •Elderly •Poor -Couldn’t leave cities (Italy) •Urban (except Spain) •NOT infants, children •↑mortality in cities that also had ↑ozone and PM10 levels •Social isolation Western Europe: Summer 2003 temperatures relative to 2000-2004 From NASA’s Moderate Resolution Imaging Spectrometer, courtesy of Reto Stöckli 8 9 One-Meter Sea Level Rise in Southern U.S. 10 Sea Level Rise in Northeast and Mid-Atlantic 11 Health Effects of Sea-Level Rise • Inundation of living areas; expansion of flood plains, inability to get insurance Erosion and loss of coastal land Worsening protection against future storm surge Contamination of fresh water Coastal wells tend to be shallow Population displacement Mental health effects Loss of critical infrastructure Hurricane Katrina as example 12 Health Care After Katrina • Of 7 hospitals “pre-K” – 2007, only 1 operating fully, 2 partially – 2010, 5 hospitals in full operation • Hundreds of doctors never returned, others are leaving • Many people newly uninsured • Doctors won’t come back until there are patients and facilities, patients won’t come back until there are doctors • Blocking economic revival 13 14 3-day average Sea Surface Temp 27.8°C=82° F 27.8° C needed for hurricanes to strengthen Min 26° C needed for hurricanes to form. Adapted from NEJM, October 6, 2005, 353;14 15 More Hurricanes with Climate Change? • Likely more in some areas; fewer in others • Hurricanes that do form are likely to be stronger • Hurricanes that do form are likely to hold— and drop—more water 16 How Does Climate Change Affect Water Supplies? • More precipitation expected to fall as rain instead of snow • Reduced snowpacks, which release water slowly throughout the summer • Earlier melting of snowpacks—flooding, low flows in late spring and summer when irrigation demands greatest • Snowpacks in Cascade mountains in OR, WA drop by 60% reducing summer stream flows by 20-50% • Glaciers melting (Alps, Andes, Himalayas) – 1/6 of the global population relies on water from melting Himalayan glaciers for their water supply 17 Health Effects of Droughts Concentrate micro-organisms and contaminants in water supplies Crop failures (current) >1 billion people hungry >5 million children die starvation every year Water shortages for hygiene Increase risk of forest fires Increase risk of infectious disease 18 Droughts and Famine 30-40% of disaster-related deaths Causes of famine—usually multifactorial – – – – – Global climate change Natural variation Water overuse/mismanagement Regional deforestation or forest fires Loss of healthy soil from erosion, salting from overirrigation, overuse leading to nutrients exhausted – Conflict – Ecosystem failure Worldwatch Institute, 2001 19 Hurricane Katrina & The Bayou 20 21 Louisiana Wetlands Lost 1500 sq mi lost since 1940 – Loss of Mississippi sediment – Canals dug for oil and gas Nutria introduced in 1930s 25+ sq. miles disappearing every year – 217 sq. miles lost from Katrina – Katrina pushed salt water far up into marsh 22 Potential Actions to Reduce Disastrous Consequences of Disasters Reversing environmental degradation – Protecting, replacing natural environmental buffers Early warning systems Improved evacuation and disaster response Sensible zoning—stop building in high-risk areas Voluntary relocation of people & infrastructure in high-risk areas Health professionals can get involved in local policymaking, such as zoning 23 Ecosystem Restoration Watch this brief video for a great example of a restoration here in Maryland http://ecosystemrestoration.com/bishopvillevideo/ 24