global climate change: what does it mean for health?gaia.jhuapl.edu/sites/default/files/parker gaia...

Global Climate Change:What Does it Mean for Health?

Cindy L. Parker MD, MPHJohns Hopkins Program on Global Sustainability and Health

Dept. of Environmental Health SciencesDept. of Earth and Planetary Sciences

Presenter

Presentation Notes

What is Health?

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

-World Health Organization, 1946

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Health Effects of Climate Change• Stressed ecosystems, potential for collapse, and

loss of ecosystem services• Threatened quantity and quality of water supplies• Environmental refugees, global security concerns• Threatened food supplies, toxins• More accidents and injuries from increased flooding,

storm surge, and extreme weather events• Rising sea levels • Worsening air quality• Greater risk of infectious diseases• More heat-related illness

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Heat Stress: Some Populations Are Particularly Vulnerable

Presenter

Presentation Notes

45,000 excess deaths occurred in Western Europe during August 2003 heatwave, Eurosurveillance, Vol 10(7-9):148-9 Several populations are particularly vulnerable to the effects of climate change. Children may not have fully developed immune or heat-regulatory systems. Also children are more vulnerable to air pollution because of their physiology (breathe more air per pound than adults) and their behavior (more likely to play outside). The elderly are at risk from extreme weather events (falls, injury, difficulty evacuating) and are more vulnerable to heat-related illness. Previously ill people, such as a persons with pre-existing heart or lung conditions are at risk of illness or death from heat and air pollution. Immuno-compromised individuals at higher risk of infectious diseases spread by contaminated food or water. The urban poor are also vulnerable because urban environments trap heat and many individuals in this category may not have air conditioning or access to cooled public spaces. In addition many may not be able to seek early or preventative health care from physicians. Source: J Longstreth, Public health consequences of global climate change in the United States—some regions may suffer disproportionately, Environmental Health Perspectives 2000; 107(Suppl 1):169-79.

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45,000+ Died of Heat Stress in Western Europe during Summer 2003

From NASA’s Moderate Resolution Imaging Spectrometer, courtesy of Reto StöckliWestern Europe: Summer 2003 temperatures relative to 2000-2004

Most Vulnerable•↑mortality in cities that also had ↑ozone and PM10 levels•Socially isolated

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Infectious Disease: Dengue Risk

• In 1990, almost 30% of the world population, 1.5 billion people, lived in regions where the estimated risk of dengue transmission was >50%

• In 2085, an estimated 50-60% of the projected global population, 5-6 billion people, would be at risk of dengue transmission, compared with 35% (3.5 billion) if climate change didn’t happen.

Hales, de Wet, Maindonald, Woodward, The Lancet, 2002, 360:830

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Heat Worsens Ozone Air Pollution

Ozone

Nitrogen Oxides

Volatile Organic CompoundsPhoto: Pedro Henriques

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Increased risk of hospital admissions and ER visits for people with asthma

3X greater risk of DEVELOPING asthma 1 in 9 Maryland children has asthma

Air pollution Climate change

Health Effects of Ozone

But what about the ozone hole? Isn’t ozone good?

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Storm Surge Risk• 13 of the world’s 20

megacities are at sea level

• 75 Million people are currently at risk from storm surge

• By 2050, 200 million people will be at risk

World Health Organization

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Health Effects of Sea-Level Rise• Inundation of living areas; expansion of flood plains,

inability to get insurance Erosion and loss of coastal land

Worsening protection against future storm surge Contamination of fresh water

Coastal wells tend to be shallow Population displacement Mental health effects Loss of critical infrastructure

Hurricane Katrina as example

Presenter

Presentation Notes

Sea-level rise may put more coastal land (and populations) at risk from flooding and erosion. The Federal Emergency Management Agency estimates that a 35 inch sea level rise could increase the area of flood plains from 19,500 square miles to 27,000 square miles in the United States Fresh water supplies could be invaded by salt water as water levels change along coastal areas. Moreover, the rising water table could lead to a release of contaminants, such as pathogens in septic systems, into waterways. These changes could lead to massive displacements of populations. REFERENCE: Climate Change and Human Health, Chapter 7; IPCC, Regional Assessment, 1998, 301.

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Health Care After Katrina

• Of 7 hospitals pre-K, Now 1 operating fully, 2 partially• Hundreds of doctors never returned, others are leaving• Many people newly uninsured• Doctors won’t come back until there are patients and

facilities, patients won’t come back until there are doctors• Blocking economic revival• Meanwhile, illness and death rates are ↑

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One-Meter Sea Level Rise in Southern U.S.

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More Extreme Weather Events

Hurricane Floyd, photo by Liz Roll/FEMA News Photo

Photo courtesy FEMA

Presenter

Presentation Notes

Climate change means not only warmer temperatures, but also more unpredictability in weather patterns and more extreme weather conditions. The concentration of greenhouse gases in the atmosphere increases heat and moisture. Heat and water vapor create climatic instability, possibly leading to more frequent and more severe weather activity. Extreme weather events appear to be on the rise. The effects of global warming on our earth, could increase the severity of these event’s effect on our health. Of the 20 worst storms in the United States this past century, ten occurred in the past twenty years. Extreme weather events can cause profound human suffering and huge economic losses. As sea levels rise the storm surges associated with these storms will also increase. In 1998, extreme weather events caused 455 deaths and over $24.6 billion in economic losses nationwide (Source: U.S. Public Interest Research Group, Flirting with Disaster: Global Warming and the Rising Costs of Extreme Weather Events, Oct. 27, 1999). In North America most of these extreme weather events will be manifested in changes in precipitation patterns, more droughts in some areas, floods in others.

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Health Effects of Floods

• Cause injuries and deaths

• Long term psychological and physical effects

• Increased risk of infectious disease

• Mold• Contaminate water

supplies: surface & wells

Photo courtesy of FEMA

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Food Supply: Effects of Climate Change on Crop Production

Direct Effects: • temperature• precipitation• CO2 levels

Indirect Effects:• plant pests• plant diseases• Salt contamination

of soil• ozone

There is no “health” without food.

Presenter

Presentation Notes

Higher temperatures would increase some crop yields, but lower others. Similarly increased precipitation worldwide could increase crop production in some arid regions, but flooding and erosion would have the opposite effect. Some areas, such as the American Midwest, would experience decreased precipitation, decreasing crop production. Severe weather events such as heat waves, droughts, and cyclones have catastrophic effects of crop production. In 1999, when drought swept the eastern United States, all or part of forty-five states were declared agricultural disaster areas (USDA, Secretarial Disaster Designations, http://drought.fsa.usda.gov/designations.htm. The range of several crop pests in the United States, including the soybean cyst nematode and the corn gray leaf blight, two of the most destructive pests, have expanded since the early 1970s, possibly in part due to climate trends. Pest and disease occurrences often coincide with extreme weather events and with anomalous weather conditions. Recent climate trends, such as increased nighttime and winter temperatures, may be contributing to the greater prevalence of crop pests. REFERENCE: Climate Change and Human Health, Chapter 5; �Source: C Rozenzweig et al., Climate Change and U.S. Agriculture: The Impacts of Warming and Extreme Weather Events on Productivity, Plant Diseases, and Pests (Boston: Center for Global Health and Environment, 2000), http://www.med.harvard.edu/chge/. (Optional)

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How Does Climate Change Affect Water Supplies?

• Rain will come in fewer, “heavy precipitation” events• Extended droughts between these events• More precipitation expected to fall as rain instead of snow• Reduced snowpacks, which release water slowly

throughout the summer• Earlier melting of snowpacks—flooding, low flows in late

spring and summer when irrigation demands greatest• Snowpacks in Cascade mountains in OR, WA drop by 60%

reducing summer stream flows by 20-50%• Glaciers melting (Alps, Andes, Himalayas)

– 1/6 of global population depend on melting Himalayan glaciers

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Climate and Water

• 1/3 of the world’s population, about 2 billion people, currently lives in water-stressed countries (UNEP, IPCC)

• By 2025, that number is expected to increase to 3.5+ billion (UNEP, IPCC)

• Nearly 1/3 of the world’s land surface may be at risk of extreme drought by 2100. (Burke et.al. Journal of Hydrometeorology, Sept. 2006)

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Health Effects of Droughts

Concentrate micro-organisms and contaminants in water supplies

Increase risk of forest fires Increase risk of infectious

disease Water shortages for hygiene Crop failures ~1 billion people hungry 5 million children die

starvation

Presenter

Presentation Notes

Reference: IPCC, Regional Assessment, 1998, 278 (forest fires) and 284 (contaminated water supplies); Ohio Department of Agriculture, ODA offers free aflatoxin testing in drought-stressed corn, Sep. 16, 1999.

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Climate Change and Security: An Equation for Disaster

+ Forced migration of millions of people+ Scarce resources becoming scarcer+ Already stressed infrastructures

= Conflict

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Deaths Attributed to Climate Change NOW300,000 per year

Patz, Jonathan, et. al (November, 2005). Impact of regional climate change on human health. Nature, Vol. 438.

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If we do not change direction, we are likely to end up exactly where we are headed

- Chinese proverb

global climate change: what does it mean for health?gaia.jhuapl.edu/sites/default/files/parker gaia...

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