Climate Change, Respiratory Health, and Equity Asthma Regional Council of New England May 14, 2019 Renee N. Salas, MD, MPH, MS Burke Fellow and Affiliated Faculty, Harvard Global Health Institute Lead, Lancet Countdown United States Brief Founder & Chair, Society of Academic Emergency Medicine Climate & Health Interest Group Department of Emergency Medicine, Massachusetts General Hospital / Harvard Medical School
Disclosures None
My Journey
Global Moral Imperative Public Domain Image Costello et al, Lancet 2009
Making Climate Change Personal Health Public Domain Image
Audience Poll Prior Exposure to Climate Change & Health
Agenda • Climate Change in the Northeast • Implications for Respiratory Health and Equity • Opportunities
The Essentials of Climate Change in the Northeast
Greenhouse Gas Emissions
Greenhouse Gases
Rising Atmospheric CO2 https://climate.nasa.gov/climate_resources/24/
Northeast: Canary in the Coal Mine Public Domain Image
Increasing Global Temperature https://data.giss.nasa.gov/gistemp/graphs/#
U.S. 2018 Experience https://www.ncdc.noaa.gov/billions/
NE Will Reach 2°C by 2035 NCA4 2018
Sea Level Rise https://www.epa.gov/climate-indicators/climate-change-indicators-sea-level
NE Sea Level Rise 3-4 x Higher EPA
Northeast Continental Shelf Sea Surface Temperatures NCA4 2018
Annual Massachusetts Precipitation
Seasonal Precipitation Changes USGCRP, 2017
Our 2018 Precipitation Experience 3rd wettest year in 124 years https://www.ncei.noaa.gov/
Billion-Dollar Weather & Climate Disasters Figure Source: NOAA NCEI
U.S. 2018 Experience https://www.ncdc.noaa.gov/billions/
Climate Change, Respiratory Health, and Equity
Center for Disease Control (CDC). (2015, July 26). Climate effects on health. Retrieved from https://www.cdc.gov/climateandhealth/effects/
Top 20 Most Challenging Places for Asthma #1 – Springfield, MA #8 – Boston, MA #11 – New Haven, CT #13 – Hartford, CT Includes: Air quality Pollen counts Poverty Rate of uninsured https://www.aafa.org/media/2420/aafa-2019-asthma-capitals-report.pdf
Climate Change and Air Pollution Orru H et al (2017)
World Health Organization Estimates 7 million deaths annually from fossil fuel combustion indoor and outdoor pollutants worldwide WHO COP24 Special Report – Health & Climate Change (2018)
Air Pollution in U.S. EPA 2018
Massachusetts Air Pollution Facts: PM All counties with data = A ALA 2019 State of the Air
Massachusetts Air Pollution Facts: Ozone Counties ranked from B (Middlesex) to F (Barnstable) ALA 2019 State of the Air
Annual Massachusetts Temperatures Ozone Levels in Massachusetts: Past Year Mass Air Online
Change in Ozone by 2030 USGCRP 2016
Death from Ozone by 2030 USGCRP 2016
Air Pollution Facts 141.1 million live in counties with unhealthy levels ALA 2019 State of the Air
Massachusetts Air Pollution Facts Nearly 847,000 with Asthma & 700,000 in poverty ALA 2019 State of the Air
Mortality in the Elderly: PM 2.5 and Ozone Di et al, JAMA 2017
Oak Pollen Levels EPA Report – Multi-Model Framework, 2017
Asthma ED Visits: Adults & Pediatric EPA Report – Multi-Model Framework, 2017
Pollen Levels GeoHealth, Volume: 3, Issue: 1, Pages: 11-27, First published: 15 December 2018, DOI: (10.1029/2018GH000153)
Asthma Visits with Pollen Exposure GeoHealth, Volume: 3, Issue: 1, Pages: 11-27, First published: 15 December 2018, DOI: (10.1029/2018GH000153)
Temperature & Pediatric Asthma Change in maximum temperature from 27C to 32C Atlanta, GA Stronger RRs: Non-white O’Lenick et al (2018) – Environ Res.
Wildfires: Wettstein et al (2018) 2015 California Wildfires; OSHPD Emergency Department Dataset J Am Heart Assoc. 2018;7
Wildfires: Liu et al (2017) 2004-2009 California Wildfires; Medicare Beneficiaries Epidemiology, 2017: 28(1): 77-85
Wildfires: Liu et al (2017) Increased Risk of Admission… Women (10.4%) vs Men (3.7%) Black (21.7%) vs White (6.9%) -- Not statistically significant Lower-education county (12.7%) vs Higher-education country (6.1%) 2004-2009 California Wildfires; Medicare Beneficiaries Epidemiology, 2017: 28(1): 77-85 // Liu et al Am J Epidemiol.
Risk for Negative Health Impacts from Climate Change Globally… 100 million Public Domain Images
Social Determinants of Health USGCRP, 2016
Vulnerable Populations • Low Income • Communities of Color • Immigrant Groups (limited English) • Indigenous Peoples • Vulnerable Occupational Groups • Persons with Disabilities USGCRP, 2016
Opportunities
Opportunities Mitigation Adaptation
Mitigation Health Professionals are Trusted Sources Salas et al Lancet Countdown U.S. Brief, 2018
Mitigation IPCC, AR5, 2014
Mitigation in the Northeast Salas RIMJ 2019
Mitigation in the Northeast Salas RIMJ 2019
Example: Weymouth Compressor Station https://www.patriotledger.com/opinion/20190412/baker-and-larocque-compressor-station- threatens-weymouths-health-and-safety
Healthcare Sustainability HCWH / Practice Greenhealth – from A. Collins
Adaptation How can we use data? Vaidyanathan et al, PNAS 2019
Local Assessments: SVI USGCRP, 2016
The Path Forward USGCRP, 2016
Discussion & Questions Thank you!
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