Disclaimer I have nothing to disclose OUTLINE Immediate and - - PDF document

Climate and Health in 2019

Paul English, PhD MPH Tracking California Public Health Institute 2019

Photos credit: Jon Tyson; Adrien Taylor on Unsplash

Disclaimer

I have nothing to disclose OUTLINE

‐ Immediate and Medium‐Term Threats ‐ Case studies: Transportation and Industrial Agriculture ‐ Moving Forward: Positive and Negative Social Pressures

Continuing Climate‐Related Health Threats

• Wildfires/Air Quality
• Heat Waves
• Heat‐Related Neuropathy
• Increased probability of rare catastrophic weather events
• Population Displacement
• Infectious Disease Spread

Medium‐Term Health Threats

• Limits of Human Tolerance to Heat
• Food supply
• Mental Health

11/9/18 Source: NASA Nov 14 2 PM image Location Air Quality Index San Francisco 177 Fremont 179 Beijing 34 Hong Kong 63 New Delhi 237 Ukiah 336

Air Quality from Woolsey/Camp Fires CA November 2018

‐ Childhood exposures ‐ Acute smoke exposures ‐ Long term consequences on lung function? ‐ Exposure to 24 hr avg PM2.5 during 2008 CA wildfires related to asthma ER and hosp (Reid, et al 2016) ‐ Wildfires could double the number of premature deaths from fine PM by 2100 (Ford et al 2018) ‐ Rescue meds to reduce airway inflammation among asthmatics during wildfire events ‐ Use of masks during wildfire events ‐ Prenatal exposures (UC Davis work) ‐ Firefighter exposures (biomonitoring)

Ongoing Issues on Wildfire Smoke Exposures

Solution

Source: Atlantic Magazine

Heat Stress Neuropathy

• Up to 20,000 deaths among sugarcane workers in El Salvador and

Costa Rica

• Moyce et al 2016 (UC Davis): 12% of approx. 300 workers had acute kidney

disease after a summer work shift (heat stress and dehydration)

• Not associated with traditional risk factors (diabetes, hypertension, etc.)
• “one of the first epidemics due to global warming?”

What is the limit of human survivability for heat?

“Human exposure to approx 35°C (95°F) wet bulb temperature for even a few hours will result in death even for the fittest of humans under shaded, well‐ventilated conditions” (Im, et al 2017) (ambient air wet bulb temperature (combined measure of temp and humidity) Threshold likely to be reached in South Asia by end of this century (Im, et al 2017)

• Fig. 1 Spatial distribution of highest daily maximum wet-bulb temperature, TWmax (°C), in

modern record (1979–2015).

Eun-Soon Im et al. Sci Adv 2017;3:e1603322 Published by AAAS

• Fig. 3 Vulnerability due to population density, poverty, and outdoor working conditions.

Eun-Soon Im et al. Sci Adv 2017;3:e1603322 Published by AAAS

Solution

Dubai Mall of the World “The world’s first temperature‐controlled city” Dubai summer average high around 106 °F and overnight lows around 88 °F Totally enclosed 13 million square feet 250‐room inn, 22 movie theatres, 120 restaurants, 14,000 parking spaces Street car system To be built using state of the art green technology?

2017: Houston Flooding CA: 5 of its 20 worst wildfires ever India: Epic monsoon flooding Insurance payout that year: $135 b Uninsured losses: $195 b (Source: The Economist 2.23.19)

Ongoing extreme events

Photo credits: CDC e.g. Hurricane Harvey August 2017 ‐ 1 year of rain in 1 week (Third “500 year” flood in less than 40 years) ‐ Massive evacuations, massive damage ‐ Largest flood event in Houston history

Increased probability of rare catastrophic weather events

Atmospheric river rare mega storm in CA scenario

• Could last for weeks and cause more than 1.5 million people

to evacuate

• Floodwaters would inundate cities and form lakes in the

Central Valley and Mojave Desert

• Damage estimated at more than $725 billion statewide.

Source: US Army Corps Engineers and USGS. Whittier Narrows Dam Source: Army Corp Engineers Source: CDC Source: Dominican Republic after Tropical Storm Isaac, 2012, CDC

Post‐storm infectious disease spread

Mosquito‐borne: Dengue Chikungunya Malaria Zika West Nile

• Migration of vectors due to changes in precipitation,

humidity, temperature

• Rise in drug and pesticide resistance

Climate Change Migration

• Role of climate change (drought, flooding, extreme weather) in causing famine, conflict,

and population displacement/migration ‐ Occurring in poorest areas with high vulnerability/few resources

• “Climate Gentrification” (residents moving to areas without climate change hazards

resulting in higher property values)

• Example: Phoenix to Flagstaff
• Mobility responses should be related to rate of onset of climate hazard (UNEP)

(photo courtesy of CDC)

Climate Change Migration Public Health Capacity to Address Climate‐Related Health Threats

• Lack of capacity at national, state and local levels: 75% of local health dept

respondents reported that their agencies “lacked the expertise to assess the potential impacts”

• f climate change (NACCHO 2008; 2012 and Roser‐Renouf, et al 2016)
• Over 19% of total state and local health dept workforce were lost

from 2008 to 2014 (51,000 jobs). (ASTHO)

• Only 14 percent of the workforce has formal training in public health,

despite a 300 percent increase in public health graduates since 1992. (ASTHO: PH WINS study 2017)

The Web of Climate‐Related Impacts on Human Health, Transportation Example Transportation (Anthropogenic climate forcing ) Wildfires Non‐ active Transport Diabetes /Obesity Public Health Action Loss of Public Health Capacity Lack of Trust in Science Increase in Vaccine Preventable Illness Human Limit on Heat Tolerance Drought Air pollution Respiratory and other disease

• utcomes

Adaptation and

• ther

preventative activities Industrial Agriculture, Ecological Impacts, and Climate Change ‐ Livestock (confined agricultural feeding) and Rice cultivation: Methane emissions ‐ Fossil Fuel use/fertilizers/pesticides ‐ Deforestation/Land Use ‐ Monoculture practice leading to loss of biodiversity/pesticide resistance: potential threats to food supply Nearly half of all insect species are In rapid decline Causes: deforestation Pollution Pesticides Climate change Source: International Union for the Conservation of Nature and Sanchez‐Bayo and Wyckhuys, 2019

The Web of Climate‐Related Impacts on Human Health, Industrial Agriculture Example Industrial Ag/CAFO (Anthropogenic Climate Forcing) Methane Catastrophic Insect Collapse Food Availability / Quality Ocean warming /Acidification Antibiotic Resistance Meat Consumption Increased Cancer Risk Deforestation CO2 73%

• f respondents think global warming is

happening, which is a 10% increase from 2015. 62% think climate change is mostly caused by Humans (source: Leiserowitz et al 2018.) Nearly half of Americans support a carbon tax. That share is higher when told that the tax would go toward environmental restoration or renewable energy R&D. (Source: Univ Chicago and AP, 2018) Green New Deal: focus on public spending

• n green energy

Social Trends: PROS

“Why, then, are we allowing an elite aristocracy of doctors and professors to bully people who disagree with them about laws that disempower parents and place an unequal vaccine risk burden on vulnerable children in the name of the public health?” (“Zero Tolerance Vaccine Laws in America: Will You Defend Vaccine Freedom?, National Vaccine Information Center, 2.19.19) Riots in France “Global warming is not about science, but about politics ‐‐ that is, about expanding the power of elites using the coercive instruments of government to control the lives of people everywhere. ” Charles Kadlec, “The Goal Is Power: The Global Warming Conspiracy,” Forbes Magazine, 7/25/11 “America was founded on liberty and independence, and not on government coercion, domination, and control. We are born free, and we will stay free.” ‐ 45th President of the United States

Social Trends: CONS

Rise of Scientific Populism

Conclusions

• Climate‐related health threats continue to multiply; with wildfires, air quality, and heat‐related

issues continued top threats nationally and globally

• If warming continues unabated, threshold of human heat tolerance will be reached (e.g. south Asia),

with large implications for health, worker productivity, and society

• Global inequities in resources and vulnerability status allows one to predict where greatest health

burden of climate change is occurring/will occur

• Climate change not only directly affects human health, but also affects health indirectly via

ecosystem impacts

• Winner of struggle between populism and mainstream science will have impacts on ability to address

climate change threats.

REFERENCES

Sánchez‐Bayo, Francisco, and Kris AG Wyckhuys. "Worldwide decline of the entomofauna: A review of its drivers." Biological Conservation 232 (2019): 8‐27. Reid, C. E., Jerrett, M., Tager, I. B., Petersen, M. L., Mann, J. K., & Balmes, J. R. (2016). Differential respiratory health effects from the 2008 northern California wildfires: A spatiotemporal approach. Environmental research, 150, 227‐235. Ford, B., et al. "Future fire impacts on smoke concentrations, visibility, and health in the contiguous United States." GeoHealth 2.8 (2018): 229‐247. Moyce, S., Joseph, J., Tancredi, D., Mitchell, D., & Schenker, M. (2016). Cumulative incidence of acute kidney injury in California's agricultural workers. Journal of occupational and environmental medicine, 58(4), 391‐397. Im, E. S., Pal, J. S., & Eltahir, E. A. (2017). Deadly heat waves projected in the densely populated agricultural regions of South Asia. Science advances, 3(8), e1603322. Roser‐Renouf, C., Maibach, E.W. and Li, J., 2016. Adapting to the changing climate: an assessment of local health department preparations for climate change‐related health threats, 2008‐2012. PloS one, 11(3), p.e0151558. ASTHO and de Beumont Foundation. 2017 Public Health Workforce Interests and Needs Survey (PH WINS) https://www.debeaumont.org/phwins/ accessed 2.28.19 Warren, R., et al. "The projected effect on insects, vertebrates, and plants

• f limiting global warming to 1.5 C rather than 2 C." Science 360.6390 (2018): 791‐795.

Leiserowitz, A., Maibach, E., Rosenthal, S., Kotcher, J., Ballew, M., Goldberg, M., & Gustafson, A. (2018). Climate change in the American mind: December 2018. Yale University and George Mason University. New Haven, CT: Yale Program on Climate Change Communication. Energy Policy Institute at the University of Chicago (EPIC) and The Associated Press‐NORC Center for Public Affairs Research, Nov 2018 Poll https://epic.uchicago.edu/news‐events/news/ new‐poll‐nearly‐half‐americans‐are‐more‐convinced‐they‐were‐five‐years‐ago‐climate accessed 2.28.19

Thank You

Paul English Paul.English@trackingcalifornia.org

• 1. How is the anti‐vaccination movement related to difficulties

in communicating the health harms of climate change?

• A. Vaccines contain global warming gases
• B. Because communities with an increasing lack of

trust in science will likely greet climate change warnings with skepticism

• C. Children who are not vaccinated are likely to

become climate change skeptics

• D. Anti‐vaxxers are more likely to be worried about

climate change than the average citizen

• 2. What percentage of Americans think global warming is

now occurring, according to a recent survey?

• A. 10%
• B. 46%
• C. 0.01%
• D. 73%
• 3. How much are the majority of Americans willing to

spend each month to fight climate change? A. $1

• B. $50
• C. $10
• D. $100