Climate Change, Respiratory Health, and Equity Asthma Regional - - PowerPoint PPT Presentation

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Climate Change, Respiratory Health, and Equity Asthma Regional - - PowerPoint PPT Presentation

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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

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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

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Disclosures

None

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My Journey

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Global Moral Imperative

Costello et al, Lancet 2009

Public Domain Image

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Making Climate Change Personal

Public Domain Image

Health

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Audience Poll

Prior Exposure to Climate Change & Health

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Agenda

  • Climate Change in

the Northeast

  • Implications for

Respiratory Health and Equity

  • Opportunities
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The Essentials of Climate Change in the Northeast

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Greenhouse Gas Emissions

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Greenhouse Gases

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Rising Atmospheric CO2

https://climate.nasa.gov/climate_resources/24/

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Northeast: Canary in the Coal Mine

Public Domain Image

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Increasing Global Temperature

https://data.giss.nasa.gov/gistemp/graphs/#

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U.S. 2018 Experience

https://www.ncdc.noaa.gov/billions/

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NE Will Reach 2°C by 2035

NCA4 2018

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Sea Level Rise

https://www.epa.gov/climate-indicators/climate-change-indicators-sea-level

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NE Sea Level Rise 3-4 x Higher

EPA

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Northeast Continental Shelf Sea Surface Temperatures

NCA4 2018

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Annual Massachusetts Precipitation

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Seasonal Precipitation Changes

USGCRP, 2017

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Our 2018 Precipitation Experience

https://www.ncei.noaa.gov/

3rd wettest year in 124 years

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Billion-Dollar Weather & Climate Disasters

Figure Source: NOAA NCEI

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U.S. 2018 Experience

https://www.ncdc.noaa.gov/billions/

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Climate Change, Respiratory Health, and Equity

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Center for Disease Control (CDC). (2015, July 26). Climate effects on health. Retrieved from https://www.cdc.gov/climateandhealth/effects/

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Top 20 Most Challenging Places for Asthma

https://www.aafa.org/media/2420/aafa-2019-asthma-capitals-report.pdf

#1 – Springfield, MA #8 – Boston, MA #11 – New Haven, CT #13 – Hartford, CT Includes: Air quality Pollen counts Poverty Rate of uninsured

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Climate Change and Air Pollution

Orru H et al (2017)

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World Health Organization Estimates

WHO COP24 Special Report – Health & Climate Change (2018)

7 million deaths annually from fossil fuel combustion indoor and outdoor pollutants worldwide

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Air Pollution in U.S.

EPA 2018

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Massachusetts Air Pollution Facts: PM

ALA 2019 State of the Air

All counties with data = A

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Massachusetts Air Pollution Facts: Ozone

ALA 2019 State of the Air

Counties ranked from B (Middlesex) to F (Barnstable)

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Annual Massachusetts Temperatures

Ozone Levels in Massachusetts: Past Year

Mass Air Online

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Change in Ozone by 2030

USGCRP 2016

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Death from Ozone by 2030

USGCRP 2016

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Air Pollution Facts

ALA 2019 State of the Air

141.1 million live in counties with unhealthy levels

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Massachusetts Air Pollution Facts

ALA 2019 State of the Air

Nearly 847,000 with Asthma & 700,000 in poverty

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Mortality in the Elderly: PM 2.5 and Ozone

Di et al, JAMA 2017

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Oak Pollen Levels

EPA Report – Multi-Model Framework, 2017

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Asthma ED Visits: Adults & Pediatric

EPA Report – Multi-Model Framework, 2017

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Pollen Levels

GeoHealth, Volume: 3, Issue: 1, Pages: 11-27, First published: 15 December 2018, DOI: (10.1029/2018GH000153)

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Asthma Visits with Pollen Exposure

GeoHealth, Volume: 3, Issue: 1, Pages: 11-27, First published: 15 December 2018, DOI: (10.1029/2018GH000153)

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Temperature & Pediatric Asthma

O’Lenick et al (2018) – Environ Res.

Change in maximum temperature from 27C to 32C Atlanta, GA Stronger RRs: Non-white

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Wildfires: Wettstein et al (2018)

J Am Heart Assoc. 2018;7

2015 California Wildfires; OSHPD Emergency Department Dataset

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Wildfires: Liu et al (2017)

Epidemiology, 2017: 28(1): 77-85

2004-2009 California Wildfires; Medicare Beneficiaries

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Wildfires: Liu et al (2017)

Epidemiology, 2017: 28(1): 77-85 // Liu et al Am J Epidemiol.

2004-2009 California Wildfires; Medicare Beneficiaries 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%)

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Risk for Negative Health Impacts from Climate Change

Public Domain Images

Globally…

100 million

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Social Determinants of Health

USGCRP, 2016

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Vulnerable Populations

USGCRP, 2016

  • Low Income
  • Communities of Color
  • Immigrant Groups (limited English)
  • Indigenous Peoples
  • Vulnerable Occupational Groups
  • Persons with Disabilities
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Opportunities

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Opportunities

Mitigation Adaptation

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Mitigation Health Professionals are Trusted Sources

Salas et al Lancet Countdown U.S. Brief, 2018

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Mitigation

IPCC, AR5, 2014

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Mitigation in the Northeast

Salas RIMJ 2019

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Mitigation in the Northeast

Salas RIMJ 2019

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Example: Weymouth Compressor Station

https://www.patriotledger.com/opinion/20190412/baker-and-larocque-compressor-station- threatens-weymouths-health-and-safety

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Healthcare Sustainability

HCWH / Practice Greenhealth – from A. Collins

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Adaptation How can we use data?

Vaidyanathan et al, PNAS 2019

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Local Assessments: SVI

USGCRP, 2016

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The Path Forward

USGCRP, 2016

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Discussion & Questions Thank you!