danger and opportunity: climate solutions and public health boston version

DANGER & OPPORTUNITY

Climate Solutions and Public Health

Impacts on N. America

WILDFIRES

INCREASED HEAT

HEAVY RAIN,STORMS, FLOODS

IPCC: Only one safe course of action

Sam Moody Atlanta, GA

Steve Groff Holtwood, PA

CARMAGEDDON Los Angeles, CA

Ultrafine Particulates down 83 % PM2.5 down 36 percent

ER Visits UCLA decreased 23%ER Visits Mt Sinai decreased 13%911 calls decreased 12%

Jeffery Thompson MDGundersen Lutheran Health System

LaCrosse, WI

$2 MILLION ANNUAL SAVINGS FROM ENERGY EFFICIENCY

100% CLEAN ENERGY BY 2015

TOP 10 CAUSES OF DEATH IN US

RENAL

LRI

SUICIDE

HEART DISEASE

CANCER

ASTHMA/COPD

STROKE

UNINTENTIONAL INJURY

ALZHEIMERS

DIABETES

RENAL DISEASE

LOWER RESP. INFECTION

SUICIDE

TOP 10 CAUSESOF THE CAUSES OF DEATH

1) tobacco

2) high blood pressure

3) overweight and

obesity

4) physical inactivity

5) high blood glucose

6) high cholesterol

7) low fruit and vegetable intake

8) urban outdoor air pollution

9) alcohol

10) occupational

WHO 2009

TOP 3 “CAUSES OF THE CAUSES OF THE CAUSES” OF DEATH

Air pollution

Car centric built environment

Industrial agriculture and food system

AIR POLLUTIONAIR POLLUTION

Air pollutant plume extends 2000 meters from LA freeways during peak commute

S. Paulson, 2012

AIR POLLUTION AND CVD

Rate of carotid intimal thickening is doubled in people who live within 100 m of busy roadway

(Kinsli, 2010)

Each 10ug/m3 PM2.5

4.5% increase in acute cardiac events

13% increase in CHF

8-18% increase in CVD mortality

(Pope, 2004, 2006, 2008)

AIR POLLUTION AND DIABETES

10ug/m3 PM2.5 = 1% increase in prevalence DM2(Pearson, 2010)

Exposure to traffic and PM increased risk of new onset DM2 15-42% (Kramer, 2010)

2SD increase in childhood exposure NO2/ PM2.5 = 18% increase in insulin resistance. (Thiering, 2013)

AIR POLLUTION AND OBESITY

Prenatal exposure to higher levels of PAH doubled risk of obesity at age 7 (Rundle, 2012)

Residential proximity to traffic in childhood associated with higher BMI at age 18

(Kramer, 2010)

Kids in the 90th percentile for traffic related air pollution exposure had 16.3% increase in annual BMI growth. (Jerrett, 2014)

AIR POLLUTION AND ASTHMA

Children playing 3 or more sports in areas with high ozone had three times the RR of developing asthma compared with children who played no sports. (McConnell, 2002)

Childhood asthma incidence increased 16% per 10ug/m3 of fine particulate exposure, and 7% per 10ug/m3 of Nox. (Anderson, 2013)

A 5-ppb increase in average NO2 during the first year of life was associated with an odds ratio of 1.17 for physician-diagnosed asthma. (Nishimura, 2013)

US AIR POLLUTION DEATHS from fossil fuel combustion

200,000 each year due to PM 2.5

10,600 each year due to ozone

(More deaths than breast cancer + colon cancer

+ prostate cancer + motor vehicle accidents + firearms

+ suicide + influenza + HIV)

F. Caiazzo et al. / Atmospheric Environment 79 (2013) 198e208

FOSSIL FUEL BURNING POWER PLANTS

#2 source of US air pollution

AND

#1 cause of global warming

GLOBAL WARMING AND OZONEVOC + NOx + heat= Ground Level Ozone

------------------------------------------------------------------------------------------EPA STANDARD 75 ppb

Ozone Climate Penalty

ACUTE EXPOSUREOzone level and beta agonist use

Thurston GD Am J Respir Crit Care Med February 1, 1997 vol. 155 no. 2654-660

CHRONIC OZONE EXPOSURE Causes and Exacerbates Asthma

Pediatric Asthma Admissions by Exposure Level

Shao, L. Environ Health Perspect.  2008 December;  116(12): 1725–1730

INCREASED ER VISITS FOR ASTHMAPredicted Impact of Climate-Related Ozone on

Pediatric ED Visits for Asthma 1990- 2020

Sheffield PE,   SeAm J Prev Med.p;41(3):251-7

INCREASED PREMATURE DEATHS FROM OZONE

GLOBAL WARMING AND INSECT BORNE

INFECTIONS

Length of breeding season

Maturation time

Viral replication

Biting and host seeking frequency

Vector & Host Ranges

Vector and Host Populations

Human Contact

Lone Star Ticks Erlichiosis and Meat Allergy

2000 2011

Ogden 2014 http-/dx.doi.org/10.1289/ehp.1307799

Effect of Warming on Ixodes Ticks and Reproductive Number of Lyme Disease

2010-2040

2041-2070

Aedes aegypti Aedes albopictus

Aedes albopictus Future Range Expansionin Northeastern US

I Rochlin et al, PLoS One. 2013; 8(4):

High Emissions Scenario Moderate Emissions Scenario

Ziska, Australian Journal of Plant Physiology, 2000. 27: 893− 898.

GLOBAL WARMING AND POLLENMore Longer Increased Days Ragweed Season 1995-2005

US National Climate Assessment

MOLD and Asthma

For each 10 U increase in home Environmental Relative Moldiness Index (ERMI) in infancy, risk of incident asthma by age 7 increased 80% (Reponen, 2011)

GLOBAL WARMING &WILDFIRE SMOKE

A Kenward et al 2013

LOS ANGELESPM 2.5 2003

Wildfire Contribution to Fine Particulates San Diego Fire Season 2007

California Air Resources Board

URBAN BASELINE FIRE SEASON

DIOXINS, PAH and WildfiresSmoke from Idaho Fires

2013

Wildfire Contribution to Ground Level Ozone

Northwest Fire Season 2012

Jaffe et al | Environ. Sci. Technol. 2013, 47, 11065−11072

Clean energy

eliminates a big chunk of air pollution and global warming

XLifecycle Analysis CO2

US WIND POWER POTENTIAL

US SOLAR POWER POTENTIAL

Science Summary 80-100% Renewable Energy Possible by 2050

Physicians, Scientists, and Engineers for Healthy Energy June 2014

100% CLEAN BY 2050thesolutionsproject.org

Percent renewable generation achieved with conventional technology

www.thesolutionsproject.org

LEVEL THE PLAYING FIELD

STOP EXTERNALIZING HEALTH AND CLIMATE COST OF CARBON

POLICIES for CLEAN AIR

Shift subsidies from fossil fuel to clean energy Strong National Renewable Electricity Standard

50% of electricity by 2030, 100% by 2050

National net metering (utilities pay for surplus generation)

MORE EFFICIENT BUILDINGS

PROGRESSIVE EFFICIENCY STANDARDS for New and Remodeled Buildings

www.architecture2030.org

MORE EFFICIENT VEHICLES

POLICIES FOR ENERGY EFFICIENCY

Stronger fuel economy standards National Energy Building Code National Retrofit Financing

Carbon Abatement Cost Curve

Decrease in O3 and PM 2.5 with 3 Climate Policy Options

Clean Electricity Std Transportation Carbon Tax

T Thompson, Nature Climate Change (July 2014)

Value of decreased mortality from air quality improvement exceeds cost of emissions reduction

West et al, Nature Climate Change 3: 885-889 2013

HIGH VALUE LOW VALUE ABATEMENT COST / TON CO2

20,000 Heart Attacks PREVENTED23,000 Deaths each year

SAVED: OVER 100 BILLION DOLLARS PER YEAREPA 2013

CAR CENTRIC BUILT ENVIRONMENT

Interurban Lines

1930-2000 Interurbans to Automobiles

Grids to Subdivisions

HEART DISEASE,OBESITY, DIABETES; COLON CANCER ONE THIRD PROSTATE CANCER, AND

RECURRENT BREAST CANCER ATTRIBUTABLE TO PHYSICAL INACTIVITY

WALKABILITY, OBESITY, AND DIABETES

TEN YEAR PROSPECTIVE STUDY Ontario

Least walkable neighborhoods

DM +6%

Obesity/Overweight +13%

Most walkable neighborhoods

DM -7%

Obesity/Overweight - 9%

(Booth, 2014, presented at ADA)

WALKABILITY AND CARDIOMETABOLIC DISEASE

Sprawl and disconnected street networks are associated with increased rates of obesity, diabetes, and CVD. (Marshall, 2014)

Residents of “walkable” metro areas walk more & use more public transit, have lower BMI & BP, less DM, and 3 years longer life expectancy than people living with sprawl. (Ewing, 2014)

TRANSIT ORIENTED DEVELOPMENT

TRANSIT AND OBESITYUsers of public transit are 45% less likely to be

obese or overweight (Zheng, Y. 2008)

Transit commuters walk twice as many minutes/day as car commuters, weigh an average of 6-7 lb less and have lower % body fat. (Flint, 2014)

Increased use of public transit would cut the annual increase in obesity prevalence by 45%.

(Edwards, 2008)

TRANSIT AND MVA DEATHSUrban Traffic Fatalities/100,000

by Transit Use by Smart Growth/ TOD

Per Capita Health Savings from Rapid Transit and TOD

AverageUrban Transit

High Quality Urban Rail or Rapid Bus

Transit Oriented Development

CARS AND GLOBAL WARMING

#1 cause of air pollution

AND

#2 cause of global warming

US Emissions from Transportation

We could get rid of a big chunk of air pollution and global warming

X

POLICIES FOR ACTIVE/PUBLIC TRANSITSmarth growth, Infrastructure Investment,

Coordination (Health in All Policies)

10,000 colon cancers215,000 heart attacks

32,000 MVA fatalities PREVENTED570,000 new diabetes cases each year

ANNUAL SAVINGS SF BAY AREA Maizlish, N. Am J Public Health. 1.4-22 BILLION DOLLARS PER YEAR 2013 Apr;103(4):703-9.

Good news: We're already on our way. Vehicle miles per capita decreasing

INDUSTRIAL FOOD SYSTEM

From family farm to agribusiness

Increased consumption of high fructose corn syrup

Adult Obesity Trend

High Fructose Corn Syrup and Metabolic Syndrome

Meta-analysis: Fructose consumption increases FBG, triglycerides, and systolic BP. (Kelishadi, 2014)

Fructose sweetened beverages increase FBG and insulin levels, decrease insulin sensitivity (Stanhope, 2009)

Fructose induced insulin resistance in rats is attenuated by lycopene (Yin, 2014)

Red Meat, DM, Cancer, and CVDNIH-AARP Study:

Highest quintile: 20-50% increased mortality from cancer, CVD, and all causes. (Sinha, 2009)

Womens' Health Study:

Highest quintile: 28% more incident DM over 8 years (Song, 2004)

Nurses' Health Study/ Health Professionals Followup Study:

13% increase in mortality per serving (all cause, cancer, and CVD). (Pan, 2012)

Increasing daily meat intake by ½ serving raised risk of DM 48% for next 4 years (Pan, 2013)

OBESITY AND ASTHMANumerous prospective studies in adults found

obesity associated with increased risk of incident asthma with BMI “dose response”

Weight loss, both surgical and non surgical, associated with resolution of asthma, decrease in asthma symptoms or increased FEV1

(Ford, E The Epidemiology of Obesity and Asthma

J Allergy Clin Immunol 2005;115:897-909.)

International Study of Asthma and Allergies in Childhood

BURGERS AND ASTHMA

Nagel, Thorax. 2010 Jun;65(6):516-22.

Inadequate Intake of Fruits/Vegetables

WATER POLLUTION

INDUSTRIAL AGRICULTURE AND GLOBAL WARMING

METHANE POLLUTION(70 x warming power of CO2 )

& MORE GLOBAL WARMINGNITROGEN OXIDE POLLUTION

(300 x warming power of CO2)

BLUE GREEN ALGAE BLOOMS

CyanotoxinsLake Erie

Dissolved Organic Carbon + Chlorine =Toxic “Disinfection Byproducts”

TRIHALOMETHANE

Low Birth Weight

Neural tube, cardiac defects

Spontaneous Abortions

Cancer

DIBROMOCHLOROMETHANE

MARINE BIOTOXINSSAXITOXIN: Paralytic Shellfish Poisoning

DOMOIC ACID: Amnesic Shellfish Poisoning

Combined Sewer Overflow

CSO Outflows

Vibrio infections increased 115%1996-2011

MMWR June 10, 2011 / 60(22);749-755

HUNGER

We could put a big dent in global warming and water pollution

XX

HEALTHY FOOD SYSTEM

LOCALDIVERSE

SUSTAINABLEHEALTHY FOOD

Mediterranean Diet

Mediterranean vs Western dietLess: GHG, H2O, energy, land

Sáez-Almendros et al. Environmental Health 2013 12:118 doi:10.1186/1476-069X-12-118

Organic farming vs Conventional 30% lower GHG, higher profit, equal yields

Mediterranean Diet & Asthma, Diabetes, and Cancer

PROSPECTIVE STUDIES

14% lower risk asthma (Nagel, 2010)

80% lower risk DM (Martinez-Gonzales, 2008)

24% lower risk cancer (Benetou, 2008)

31% lower CVD mortality (Sofi, 2008)

22% lower cancer mortality (Sofi, 2008)

Fruits prevent first chronic disease Vegetables prevent multi-morbidity

Ruel, Clinical Nutrition Volume 33, Issue 3, Pages 513–520, June 2014

INTERVENTION STUDIESMediterranean Diet

60% decrease cardiac events (Ornish, 1998)

70% decrease CVD mortality (DeLogeri, 1994)

35- 48% decrease in metabolic syndrome

(Esposito, 2004, Azadhbakt, 2005)

INTERVENTION STUDIESMediterranean Diet, Heart Disease and

Metabolic Syndrome

60% decrease cardiac events (Ornish, 1998)

70% decrease CVD mortality (DeLogeri, 1994)

35- 48% decrease in metabolic syndrome

(Esposito, 2004, Azadhbakt, 2005)

ADVISE SUBSIDIZE

Meat, Dairy 63%

Grains20%

Sugar,Oil, Alcohol 15%

Nuts, Legumes 2%

Fruits, Vegetables 1%

POLICIES FOR HEALTHY FOOD AND FARMS

Subsidize fruits and vegetables

Reward good stewardship

Crop diversity

Natural fertilizer

Crop rotation

Conservation set asides

Donate excess

Harvest energy from waste

300,000 Heart Attacks/Strokes PREVENTED260,000 New Diabetes Cases127,000 CVD Deaths each year144,000 Cancer Deaths

WE ARE HERETemperature increase 1.4 degrees F

Polluted AirToxic Food

Contaminated WaterSpread of Infectious Disease

AND HERE:

70% overweight or obese

34% CVD

12% diabetes

37% pre-diabetes

8% asthma

75 cents of every health dollar spent on preventable chronic disease

Sustainable agricultureActive and public transportationEfficient buildings and vehicles

Clean electricity

BUSINESS AS USUAL

2030

40% Obese

40% CVD

20% Diabetic

10% Asthmatic

2050

50% Obese

50% CVD

30% Diabetic

WHAT YOU CAN DO

Join the Climate March

www.peoplesclimate/health/

Contact your congresspeople and tell them that climate policy is essential to protect public health.

Speak out in your community for climate action. Speaker Training:

HEALTHY PEOPLE = HEALTHY PLANET

www.climate911.org