Insert Title

Insert Speaker InformationFebruary 23, 2011

Climate Change Adaptation: Public Health Preparedness

and the ASTHO Climate Change Collaborative

Insert Title

Insert Speaker InformationLinda Rudolph, Deputy DirectorCalifornia Department of Public Health, Center for Chronic Disease Prevention and Health Promotion

Climate Change Adaptation: Public Health Preparedness

and the ASTHO Climate Change Collaborative

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Why must public health be involved?

• Climate change happening now – Faster than expected– Scale of threat: global; touches all, everywhere

• Intensity of the threat: threatens our basic survival mechanisms --food, water, shelter and health.

• Scale of response: must engage every sector of society

• Timeframe for response: “…we have at most 10 years -- not 10 years to decide upon action, but 10 years to alter fundamentally the trajectory of global greenhouse emissions." “There is still time, but just barely.” (James Hansen)

• If we act urgently and aggressively we can– Prevent the most catastrophic climate scenarios – risk reduction– Promote mitigation and adaptation strategies with health co-benefits– Build resilient communities to better adapt

Climate Change is Happening Now

Warming is unequivocal; most of the warming of the past 50 years is very likely (90%) due to increases in greenhouse gases.

Warming plus: heat waves, wind patterns, drought, & more

• Physical and biological systems on all continents and in most oceans already affected by recent climate changes.

• Greenhouse gases at unprecedented levels, forcing the climate to change.

• Already committed to more warming (next few decades); choices about emissions affect the longer term more and more.

(IPCC2007)

Temperature

Sea Level

Snow Cover

Projected Impacts of Global Environmental Change

1 C 2 C 5 C4 C3 C

Sea level rise threatens major cities

Falling crop yields in many areas, particularly developing regions

Food

Water

Ecosystems

Risk of Abrupt and Major Irreversible Changes

0 C

Falling yields in many developed regions

Rising number of species face extinction

Increasing risk of dangerous feedbacks and abrupt, large-scale shifts in the climate system

Significant decreases in water availability in many areas, including Mediterranean and Southern Africa

Small mountain glaciers disappear – water supplies threatened in several areas

Extensive Damage to Coral Reefs

Extreme Weather Events

Rising intensity of storms, forest fires, droughts, flooding and heat waves

Possible rising yields in some high latitude regions450 ppm CO2 eq

650 ppm CO2 eq

The Copenhagen Diagnosis• Surging greenhouse gas emissions • Recent global temperatures demonstrate

human-based warming• Acceleration of melting of ice-sheets, glaciers

and ice-caps• Rapid Arctic sea-ice decline• Current sea-level rise underestimated• Sea-level prediction revised• Delay in action risks irreversible damage• The turning point must come soon

(http://www.copenhagendiagnosis.org)

Climate change means: Hotter Hots

Direct effects

Russian heat wave (2010): 58,000 deaths

European heat wave (2003) 70,000 – 80,000 deaths

Calif. heat wave (2006): 650 deaths

Indirect effects:

↑ ozone

Agricultural disruption

Power grid disruption

Climate change means: Drier Dries

Wildfire frequency/intensity and length of season increasing Displacement Air quality

• Drought – Water shortages – Impacts on agriculture– Security impacts

San Diego fire 2007- half a million evacuees

• Stephen Chu (Secretary, Dept of Energy)

“… you're looking at a scenario where there's no more agriculture in California. When you lose 70 percent of your water in the mountains, I don't see how agriculture can continue. California produces 20 percent of the agriculture in the United States. I don't actually see how they can keep their cities going.”

Climate change means: Drier Dries

Climate change means: Wetter Wets

Increased frequency & intensity Hurricanes Extreme precipitation events Floods

Climate change means: Higher Highs

Rising sea level Increased high tides &

flooding Threats to

Infrastructure Ecosystems

Source: USGS and U.S. Census 2000

The Climate Gap

Morello-Frosch, Pastor

Climate change means: More Frequent & Severe Extreme

Weather Events– Physical injury and death– Hyperthermia & dehydration– Hypothermia– Infectious diseases, water-borne diseases – Displacement – Mental health impacts

Climate change means: Threats to Survival

• Climate change threatens the systems on which humans depend for survival

– Air – Water – Food – Shelter– Peace/Security

We can’t afford to watch and wait

• “The Red Cross and Red Crescent has already been confronted with a sharp increase in weather-related disasters, and there is an urgent need to better manage the rising risk of extreme weather events, including through better early warning, enhanced disaster relief, increased efforts on disaster risk reduction…..”

Red Cross Climate Centre

• “This is not a “black swan” – an event beyond normal expectation….This is not a small probability of a rather unattractive outcome. This is a big probability of a very bad outcome.

“If humanity wishes to preserve a planet similar to that on which civilization developed and to which lifeon Earth is adapted, paleoclimate evidence and ongoing climate changesuggest that CO2 will need to be reduced from its current (385) ppm to at most 350 ppm. If the present overshoot of this target CO2 is not brief, there is a possibility of seeding irreversible catastrophic effects.”James HansenDirector, NASA Goddard Space Science Institute

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Adaptation and Mitigation:BOTH ARE NECESSARY

• Mitigation involves attempts to slow, stabilize, or reverse the process of global climate change by lowering the level of greenhouse gases in the atmosphere– Public health primary and secondary prevention

• Adaptation involves developing ways to protect people and places by reducing their vulnerability to and lessen the impact of climate change– Public health preparedness & response, tertiary

prevention

We can do something about it

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Transportation Sector Health Co-Benefits

Reductions• GHG emissions • Air pollution• Noise• Infrastructure costs• Community SeveranceIncreases• Physical Activity• Social Capital

Reductions• Respiratory disease • Traffic injuries• Heart disease• Cerebrovascular disease• Depression • Osteoporosis • Diabetes• Breast Cancer • Stress

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Climate & Health Benefits of Local Sustainable Food Systems

Reductions• Greenhouse gas emissions • Pesticide use• Synthetic fertilizer use • Food miles• Antibiotic use• Water pollution (nitrates)• Air pollution• Biodiversity loss• Soil erosion• Unsustainable H2O consumption

Increases• Local food systems• Rural community strength

Reductions• Ischemic heart disease • Obesity• Colorectal cancer• Breast & prostate cancers • Type II Diabetes • Antibiotic resistance• Respiratory disease• Pesticide health effects

Public Health Adaptation Strategy

Guiding Principles & Core Strategies• Community resilience• Equity• Co-benefits• Communication, education• Resources • Community empowerment

and engagement• Surveillance• Emergency preparedness• Research

http:/wwww.climatechange.ca.gov/adaptation/publichealth/index.html

Promote Community Resilience

• Promote built environments that mitigate climate change and/or reduce the impact of climate change on health

– Location efficient housing– Active transportation infrastructure– Parks and open space– Energy efficiency– Fire resistant landscape/materials– Urban heat island mitigation– Permeable surfaces– Sustainable local food systems

• Reduce baseline exposure to toxins (e.g. air pollution)

• Promote strong social support networks

• Promote local sustainable food systems

• Strengthen health and PH infrastructure

• Disaster resilience:– Reduced failure probabilities

• Critical infrastructure, systems

– Reduced consequences of failures• Injuries, deaths, socio-economic impacts

– Reduced time to recovery• Restore to normal functionality

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HeatCalifornia Historical and Projected July Temperatures

Urban Heat Island: can add 7 – 12 F

Heat Emergency Preparedness & Response

• Improve public health preparedness and emergency response– Identify vulnerable populations– Public and provider education

• Prevention & recognition of heat illness• Recognition and management of heat illness

• Promote public health infrastructure– Heat warning system– Cooling Centers– Heat buddy systems

• Strengthen PH Surveillance Capacity– Real-time ER/hospital surveillance

Rate Ratios for ER visits for heat related illness

California 2006: estimated 650 excess deaths

Alameda County, CA, Heat Vulnerability Index

Heat Adaptive Capacity and Resilience

• Promote community resilience to reduce vulnerability to climate change – Reduce health inequities

• Identify populations vulnerable to urban heat islands – Map heat vulnerability locally

» e.g. temperature, tree cover, surfaces, ozone, fuel poverty• Implement policies to protect vulnerable populations

– Cal OSHA Heat Standard– Household energy assistance

– Urban heat island mitigation• Urban greening

– SGC grants• Built environment

– Cool pavement, cool roofs, energy efficiency– Building codes, incentives

– Reduce baseline exposures • Air pollution

– Expand clean technologies/fuels in ports, rail yards, transportation corridors– Address cumulative burdens in polices to address GHG emissions

– Build stronger social support networks• Community-based strategies, resilience groups, transition towns• Participatory and inclusive climate action planning, integrate into health equity

– Need more research on acclimatization (heat)

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Heat Adaptation Co-Benefits

• Urban greening– Places to be active– Healthy food access– Reduce storm water run-off– Decrease flooding risk– Improve aesthetics

• Reduce crime

• Reduce heat island effect– Decrease energy consumption– Lower energy costs– Reduce air pollution

What were they thinking?

We can do something about it

Insert Title

Insert Speaker InformationMax Learner, Director of Public Health PreparednessSouth Carolina Department of Health and Environmental Control

Climate Change Adaptation: Public Health Preparedness

and the ASTHO Climate Change Collaborative

Climate Change and Public Health Preparedness

• Climate change is real and we must adapt to it.

• Public Health Job 1: Protect human health• Prepare for extreme weather events• Adaptation requires close cooperation

among all public health programs

What’s Happening Now?

10 of 10 Indicators Show Warming Trends

National Snow and Ice Data Center: Average ice extent declining by 6.4% per decade. 2010 on track to be 2nd lowest extent on record.

Heat Wave, Wildfires, Smog –Moscow, August

Rain, Flooding –Pakistan, August

Rain, Mudslides –Gansu Province, China, August

Climate Related Disasters2010

Nationally, 2010 was the fourth warmest summer on record in the last 116 years.

Columbia, SC Famously hot

Chills

Snow – Northeast US, February

Record Hail – Vivian, SD, July

The Winter of 2009-10 was 14th Coldest on record for the US

Extreme Weather Tornadoes - Harrah, OK MayFloods - Nashville, TN May

(and IA and TX…)

Wildfires - Tehachapi, CA August (and CO)

Heat wave – Everywhere, All Summer

What are the climate-related threats to human health?

• Event types:– Heat waves/air pollution– Extreme rainfall events– Winter storms– Floods – Drought– Wildfires– Tornados – Hurricanes– Sea level rise and

coastal flooding

• Potential impacts:– Direct health effects –

heat stroke, asthma, cancer, injuries, deaths

– Climate-sensitive diseases

– Vector borne diseases– Fresh water supply– Food production and

food safety issues– Migration

96 weather disasters, over $700 billion in 2009 dollars

Preparedness• State and local vulnerability assessment and

strategic planning for public health programs• Emergency operations plans for the full range

of potential extreme weather events• Surveillance of climate-related health and

environmental indicators• Communicating with the public about health

impacts and adaptation measures• Extreme weather health alerts and warnings

Environmental Health• Disaster response and recovery

– Safe drinking water– Waste disposal– Shelter sanitation– Food safety and restoration of food services– Vector control

• Disease outbreak response– Food and water borne illness– Vector borne illness

Other Public Health Issues• Disaster response and recovery

– Vulnerable populations• People with chronic illness• Mothers and children• Frail elderly

– Restoration of public health and medical services

• Adaptation and mitigation– Building community resilience– Facilitating adaptation and change

Climate Change Collaborative

• The ASTHO Climate Change Collaborative (CCC) is comprised of representatives from varied disciplines and plays a role in improving the ability of State and Territorial Health Agencies to prepare for, mitigate against and react to the effects of climate change.

Mission• The Climate Change Collaborative’s

mission is to support and build the capacity of health agencies to tackle the public health challenges presented by climate change.

Climate Change: A Serious Threat to Public Health Key Findings from ASTHO’s 2009 Climate Change Needs Assessment

Is climate change a public health priority?

• A strong majority (77%, n=33) say climate change does not make the top ten list of agency priorities

• Only 23% (n=10) identify climate change as a top 10 issue, but…

• …these health officers think it is a major issue, with 90% (n=9) ranking climate change in the top five agency priorities.

Capacity Building Grants• With CDC funding, ASTHO is supporting 3

states to conduct Climate Change activities within their agencies (July 09)

• Activities include:– Integration and coordination of climate change

activities across the health department– Raising awareness within health departments– Outreach to public, industry, other agencies– Assessing their agency’s capacity– Developing agency strategic plans

References• National Climatic Data Center, National Oceanic

and Atmospheric Administration, State of the Climate in 2009 Annual Report http://www1.ncdc.noaa.gov/pub/data/cmb/bams-sotc/climate-assessment-2009-lo-rez.pdf

• State of the Climate 2010 National overview http://lwf.ncdc.noaa.gov/sotc/national/2010/13

• Association of State and Territorial Health Officers, Climate Change: A Serious Threat to Public Healthhttp://www.astho.org/t/pb/mult.aspx?pageid=5168

Let’s not miss the boat…

Insert Title

Insert Speaker InformationRick Rumba, Environmental Health Program AdministratorNew Hampshire Department of Environmental Services

Climate Change Adaptation & Public Health Preparedness: New Hampshire's Experience

Background• Recipient of ASTHO Climate Change & Public

Health Capacity Building Grant - July 2009

• Conducted Needs Assessment & Developed 5-year Strategic Plan to assure that Public Health System is prepared to adapt to Climate Change

• Involved participation of several state agencies including: Public Health, Environment, Emergency Management, Transportation, Agriculture, Fish & Game, Planning - as well as local PH and others

Lessons Learned: • Many disease prevention, monitoring, surveillance,

planning & preparedness systems are already in place, but NOT specifically focused on climate change

• Greatest "Needs" identified: Mobilize Partners and Inform, Educate and Empower

• Engagement and education of partners crucial -especially public health and emergency preparedness - to understand roles & actively participate in CC adaptation efforts

How Do You Engage PH and Preparedness Partners?

• Be sure stakeholders understand their professional connection to climate change

• Keep discussion of climate science simple - avoid debates about causes

• Make it relevant: Local and Current• Link to existing, on-going activities

• Emphasize importance of their role

Be sure stakeholders understand their connection to climate change• Original outreach to ~100 stakeholders via email• 20% response rate• Follow up phone calls to non-responders• "I thought I was invited by mistake. My program

has nothing to do with climate change"• 90% affirmative response rate following

personal phone call explaining their involvement

Keep discussion of climate science simple

• Many partners are not scientists!• Not interested in highly technical discussions - ie:

"cap and trade", "North Atlantic oscillation", "carbon sequestration", etc.

• Causes of climate change irrelevant in context of adaptation - its already happening, doesn't matter why!

• Illustrate with familiar examples happening NOW

Climate Change Indicators in NH

Hodgkins et al., 2002; 2003; Wolfe et al., 2005; Wake and Markham, 2005; Wake et al., 2006

• More precipitation• More frequent extreme precipitation• Winter warming • Decreased snowfall• Fewer days with snow on ground• Lake ice-out dates earlier• Earlier spring runoff• Extended growing season• Sea-level rise

Conclusions

• Historical trends of increasing extreme precipitation are connected to greenhouse gas-enhanced climate change…

• Future increases in extremeprecipitation are very likely.

96 weather disasters, over $700 billion in 2009 dollars

Presidentially Declared Storm-Related Disasters in NH

Make it relevant

• Provide relevant, local evidence to illustrate that we are already experiencing effects of climate change!

• Many PH and Preparedness partners believed that climate effects would not occur for another 50-100 years!

Southwestern NH – October 2005

Central NH - May 2006

Eastern NH - April 2007

Upper Valley July 2007

Ice storm paralyzes parts of New EnglandClose to a million without powerBoston Globe December 13, 2008

Connect to on-going activities• Link climate change adaptation to familiar,

on-going activities - ie: communicable disease and hazard mitigation planning

• Hazard Mitigation Plans are required for ALL NH Communities

• Hazard Mitigation Plans must be updated every 5 years.

Emphasize their importance• Adaptation planning is a comprehensive

process - need input and participation from many partners

• PH and Emergency Preparedness folks have been doing similar work for years, and their expertise and assistance are invaluable

• Increase efficiency and effectiveness: too much overlap and too few resources to be re-inventing the wheel.

Where are we now?• Continuing to adopt actions in Strategic Plan

emphasizing local planning, partnership engagementand outreach & education across state

• Conducted CC workshop at annual New Hampshire Emergency Preparedness Conference in June 2010

• Additional interest in topic emerged from that presentation – additional presentations to public health community

• Co-presented technical workshop on CC Adaptation with Emergency Preparedness staff at American Planning Association of NE conference in Oct. 2010

Take Home Messages• Climate Change Adaptation planning is a

comprehensive process that benefits from multiple partnerships

• Preparedness programs have been addressing the same issues, but from a different perspective

• Easier to accomplish when you can link with ongoing work and make it routine

• Provides opportunity to focus on "prevention" rather than just "response"

THANKYOU!